Abstract
To examine whether there are subtypes of suicidal thinking using real-time digital monitoring, which allows for the measurement of such thoughts with greater temporal granularity than ever before possible. We used smartphone-based real-time monitoring to assess suicidal thoughts four times per day in two samples: Adults who attempted suicide in the past year recruited from online forums (n=51 participants with a total of 2,889 responses, surveyed over 28 days; ages ranged from 18 to 38 years) and psychiatric inpatients with recent suicidal ideation or attempts (n=32 participants with a total of 640 responses, surveyed over the duration of inpatient treatment [mean stay=8.79 days], ages ranged 23-68 years). Latent profile analyses were used to identify distinct phenotypes of suicidal thinking based on the frequency, intensity, and variability of such thoughts. Across both samples, five distinct phenotypes of suicidal thinking emerged that differed primarily on the intensity and variability of suicidal thoughts. Participants whose profile was characterized by more severe, persistent suicidal thoughts (i.e., higher mean and lower variability around the mean) were most likely to have made a recent suicide attempt. Suicidal thinking has historically been studied as a homogeneous construct, but using newly available monitoring technology we discovered five profiles of suicidal thinking. Key questions for future research include how these phenotypes prospectively relate to future suicidal behaviors, and whether they represent remain stable or trait-like over longer periods.
Highlights
To examine whether there are subtypes of suicidal thinking using real-time digital monitoring, which allows for the measurement of such thoughts with greater temporal granularity than ever before possible
The existence of suicidal thoughts and behaviors has presented a fundamental challenge to the belief that human and animal behavior is motivated by an innate and ever-present drive for self-preservation and gene survival (Dawkins, 1976; Lorenz, 1963; Wilson, 1978)
Approximately 9% of adults around the world report that they have seriously considered suicide at some point in their lives (Nock et al, 2008), and suicide accounts for over 800,000 deaths each year (World Health Organization, 2016a), more than all wars and other forms of interpersonal violence combined—meaning that we each are more likely to die by our own hand than by someone else’s (World Health Organization, 2016b)
Summary
The goal of this study was to see if we could classify phenotypes of suicidal thinking based upon the experience of suicidal thinking itself
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