Citation

Huang X, Ribeiro JD, Franklin JC. Front. Psychiatry 2020; 11: e239.

Affiliation

Department of Psychology, Florida State University, Tallahassee, FL, United States.

Copyright

(Copyright © 2020, Frontiers Media)

DOI

10.3389/fpsyt.2020.00239

PMID

32317991

PMCID

PMC7154073

Abstract

BACKGROUND: Why do some people engage in nonsuicidal self-injury (NSSI) while others attempt suicide? One way to advance knowledge about this question is to shed light on the differences between people who engage in NSSI and people who attempt suicide. These groups could differ in three broad ways. First, these two groups may differ in a simple way, such that one or a small set of factors is both necessary and sufficient to accurately distinguish the two groups. Second, they might differ in a complicated way, meaning that a specific set of a large number of factors is both necessary and sufficient to accurately classify them. Third, they might differ in a complex way, with no necessary factor combinations and potentially no sufficient factor combinations. In this scenario, at the group level, complicated algorithms would either be insufficient (i.e., no complicated algorithm produces good accuracy) or unnecessary (i.e., many complicated algorithms produce good accuracy) to distinguish between groups. This study directly tested these three possibilities in a sample of people with a history of NSSI and/or suicide attempt.

METHOD: A total of 954 participants who have either engaged in NSSI and/or suicide attempt in their lifetime were recruited from online forums. Participants completed a series of measures on factors commonly associated with NSSI and suicide attempt. To test for simple differences, univariate logistic regressions were conducted. One theoretically informed multiple logistic regression model with suicidal desire, capability for suicide, and their interaction term was considered as well. To examine complicated and complex differences, multiple logistic regression and machine learning analyses were conducted.

RESULTS: No simple algorithm (i.e., single factor or small set of factors) accurately distinguished between groups. Complicated algorithms constructed with cross-validation methods produced fair accuracy; complicated algorithms constructed with bootstrap optimism methods produced good accuracy, but multiple different algorithms with this method produced similar results.

CONCLUSIONS: Findings were consistent with complex differences between people who engage in NSSI and suicide attempts. Specific complicated algorithms were either insufficient (cross-validation results) or unnecessary (bootstrap optimism results) to distinguish between these groups with high accuracy.

Copyright © 2020 Huang, Ribeiro and Franklin.

Language: en

Keywords

complexity; differences; machine learning; nonsuicidal self-injury; suicide attempt