Simulation Networks Elucidate the Preliminary Structure of Suicide Risk Factors Among Adolescents

ABSTRACT Introduction Suicide represents a public health concern with international reach that challenges healthcare systems and policies. Despite high rates of death by suicide among adolescents, few studies have examined suicide risk factors among this group (generally) and within a vulnerable adolescents placed in residential care (specifically). This preliminary study utilizes simulation network models to identify structural differences in suicide risk factor networks when comparing adolescents who either reported or did not report suicidal ideation. Methods Adolescents from residential care units in the Basque Country (northern Spain) were recruited for this study (age 12–18, n = 415). Adolescents completed baseline measures on suicidal cognitions, entrapment, mental pain, depression, suicide attempts before baseline, hopelessness, perceived burdensomeness, thwarted belongingness, and exposure to suicidal behavior. Data from these measures were used to create separate networks demarcated by respondent reporting of suicidal ideation (i.e., a network for participants reporting ‘Yes’ and a separate network for participants reporting ‘No’). Results ‘Yes’ and ‘No’ networks had differences in risk factor connectivity, but also in influential risk factors. ‘Yes’ was driven primarily by perceived burdensomeness, suicidal cognitions, and entrapment while ‘No’ was driven by perceived burdensomeness, entrapment, and psychache. Discussion Separate ‘Yes’ and ‘No’ networks indicate differential structure and influential risk factors among adolescents. Those identified influential risk factors could serve as intervention targets to disrupt suicide risk networks (and, by extension, prevent suicidal behavior).