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Category: Project

Description: Acute risk of death by suicide manifests is sudden, short-lived increases in suicidal ideation. These surges are best understood as complex and mutually reinforcing relationships between dispositional vulnerability factors and individually suicidogenic short-term stressors. Together, these processes represent the core of clinical safety planning and our therapeutic tools accommodate a reasonable degree of idiosyncrasy when choosing adequate interventions. Unraveling these multifaceted semantic and temporal characteristics on a quantitative level, however, requires estimation frameworks that match theoretical and practical considerations relevant to psychotherapy. Using, data from a 21-day ambulatory assessment protocol, we developed personalized (i.e., idiographic) models of interacting risk factors closest to the time of an emerging suicidal crisis via Group Iterative Multiple Model Estimation (GIMME) in a sample of people diagnosed with borderline personality disorder stratified for a history of high lethality suicide attempts. They revealed high levels of heterogeneity in state-like risk factors related to suicidal ideation, with no features shared among the majority of all participants or even considerably homogenous clusters of participants (i.e., subgroups).We discuss relevant milestones toward successful clinical implementation of personalized models to potentially improve safety planning by capturing changes in proximal risk factors closest to a climaxing suicide risk.