A real-time examination and comparison of differentiation among suicidal thinking and affect items in an adolescent...

Suicide risk assessments require individuals to differentiate among types of suicidal thoughts (e.g., passive vs. active); yet most research relies on aggregate metrics that obscure this differentiation. Indeed, more severe forms of suicidal thinking are thought to involve the simultaneous experience of multiple forms of thoughts at high intensities. The present study draws on concepts from the affect differentiation literature to (a) examine different ways to operationalize differentiation in suicidal thinking and (b) compare differentiation in suicidal thinking with differentiation in affect. Adolescents (N = 200) recently hospitalized for suicidal thoughts and behaviors completed a 28-day ecological momentary assessment protocol assessing positive affect, negative affect, and suicidal thinking. The sample was 53% White, 21% Black, 13.5% multiracial, and 23% Hispanic/Latino; 52.5% identified as cisgender female, 17.5% cisgender male, 11.0% transgender, and 10% as genderqueer, nonbinary, or genderfluid. Differentiation in suicidal thinking was examined through three metrics: standard deviation (measuring item dispersion), Gini coefficient (measuring item inequality), and emodiversity (measuring item diversity and prevalence). Results revealed consistent positive associations between suicidal thinking differentiation and negative affect differentiation. When examining only occasions in which suicidal thinking was present, suicidal thinking differentiation was associated with increased differentiation in both positive and negative affect, beyond mean levels. Effect sizes ranged from small to large with narrow confidence intervals. Differences across metrics suggest that future research should carefully consider how to operationalize differentiation in the context of the specific data structure. Suicidal thinking differentiation represents a meaningful framework capturing clinically relevant heterogeneity in high-risk adolescents. (PsycInfo Database Record (c) 2026 APA, all rights reserved).