Updates in Research on Suicide Assessment

TW: the following blog discusses suicidal ideation and risk

September is National Suicide Prevention Research. According to the CDC Data & Statistics Fatal Injury report for 2019 (Retrieved 2020; CDC ), suicide in the 10th leading cause of death in the country and 47,511 Americans died by suicide in 2019. In total, there were 1.38 million suicide attempts. Thus, there is a pressing need to understand suicide and potential risks for suicidal ideation.

Currently, suicide ideation assessments primarily rely on self-report measures; which are not perfect measures. Patients may minimize their symptoms or fail to disclose the severity of their suicidal urges. So, psychologists are quickly devising novel assessment strategies for suicide risk including cognitive and implicit bias metrics, ecological momentary assessment, digital phenotyping, and neuoimaging paradigms and analyses to determine neural circuits associated with suicirde risk. Excitingly, these methods also have the potential to reveal whether treatments can impact variability in suicidal ideation. However, it should be noted that many of these treatments have not yet been validated.

(Read more about these methods)

It is important to note that suicidal ideation is not always constant, and can ebb and flow across the week, month, or year. Researchers at University of North Carolina at Chapel Hill and Merill Health, though, believe the answer to continuous monitoring lies right within technology. Cellphones collect behavioral information on movement, communication and affect while wearable devices such as Apple Watches or Fitbits track physiological data like heart rate and sleep patterns. Benjamin Nelson, PhD, (postdoc scholar at UNC Chapel Hill) is currently studying a sample of adolescents using a wearable device which measures heart rate, step count, calories, distance traveled, and self-harm behaviors

Read more about wearable devices to understand patient mood

Finally, researchers are also working to better craft screeners and scales to assess risk for suicide. The Computerized Adaptive Screen for Suicidal Youth (CASSY), for example, has been designed to detect suicide risk in teenagers who visit an emergency department. In a recent study, CASSY was able to correctly identify 83% of teens who would then make a suicide attempt in the next 3 months. Researchers at The Ohio State University Wexner Medical Center have created the Suicide Cognitions Scale which asks patients how much they agree with statements such as "I don't deserve to be forgiven" or "I can't imagine anyone tolerating this pain." They've found the scale predicts attempted suicides better than directly asking if they are considering killing themselves.

Read more about CASSY
Read more about the Suicide Cognitions Scale

In conclusion, strides are being made by scientists to better assess suicide risk in a timely and effective manner. However, many times the first suicide accessor is someone close to the individual. If you are worried about a loved one the American Foundation for Suicide Prevention recommends these steps:

  1. Talk to them privately

  2. Listen

  3. Tell them you care

  4. Ask directly if they are considering suicide

  5. Encourage them to seek treatment

If someone expresses that they are thinking about suicide take them seriously. Work to keep them safely away from Lethal means and contact the National Suicide Prevention Lifeline: 1-800-273-TALK (8255).

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