Investigating Predictors of Differential Trajectories of Suicidal Desire Across an Intensive Longitudinal Design.

objectiveTo understand the evolution of suicide risk, repeated assessments of suicide-related symptoms are necessary. Though previous studies have examined sample-level effects, there is a dearth of research examining possible differential risk trajectories, including vulnerable subgroups, and how subgroup differences may produce distinct pathways of suicide risk.

methodsCommunity-based adults (n = 237) with severe suicidal ideation completed six daily prompts across a 14-day period. Growth mixture models identified subgroups (i.e., classes) of trajectories of SI. One-way ANOVAs examined differential predictors of these classes' average intensity, variability, stability, and baseline levels of suicide risk factors.

resultsA three-class linear trajectory was best-fitting. The largest class (Class 3, n = 146) exhibited decreases in suicidal desire; the second class (Class 2, n = 54) displayed increasing suicidal desire; and the smallest group (Class 1, n = 37) maintained moderate, stable levels of suicidal desire. Class 2 generally exhibited higher mean intensity/baseline levels, lower mean variability, and mixed stability of suicide risk factors.

conclusionsAlthough our study design does not imply causality, a subset of participants may be emotionally reactive to repeated assessments. Future research should ethically investigate and address why some individuals may experience heightened suicide risk during repeated assessments and analytically accommodate class-specific trajectories of suicidality.