Identifying Chinese adolescents with a high suicide attempt risk

Adolescent suicide has become a serious public health problem in China. Since suicide attempts are considered the strongest predictor of suicide completion, it is valuable to identify adolescents with a high suicide attempt risk. This study aimed to develop a decision tree model for the interactive prediction of high suicide attempt risk in Chinese adolescents. A classification tree analysis was conducted in a sample of senior high school students (N = 6,686) based on the CRUISE program. The results indicated that depression, anxiety, social support, gender, self-esteem, family cohesion and adaptability were significant predictors of high suicide attempt risk, and interactions among these predictors constructed a hierarchical decision tree model. The tree model offered a series of reliable rules to identify Chinese adolescents with high suicide attempt risk, for example, adolescents with high depression scores had the highest probability (69.22%) of having a suicide attempt, female adolescents with low social support and low depression scores had the second highest probability (57.58%), and adolescents with low anxiety, low family adaptability, and medium depression scores had the third highest probability (55.77%). These exploratory findings suggested that different screening criteria are needed to detect at-risk Chinese adolescents with different severities of depression.