The Differences Between Suicide Ideators and Suicide Attempters: Simple, Complicated, or Complex?

Objective: Suicide ideators and suicide attempters might differ in 3 possible ways. First, they might differ in a simple way such that one or a small set of factors are both necessary and sufficient to distinguish between the 2 groups. Second, ideators and attempters might differ in a complicated way such that a specific combination of a large set of factors is necessary and sufficient for the distinction. Third. complex differences might exist: many passible combinations of a large set of factors may be sufficient to distinguish the 2 groups, but no combination may be necessary. This study empirically examined these possibilities. Method: Across 5 samples (total N = 3,869), univariate logistic regressions were conducted to test for simple differences. To test for complicated and complex differences. machine learning (ML) methods were used to identify the optimized algorithm with all variables. Subsequently, the same methods were repeated after removing the top 5 most important or discriminative variables, and a randomly selected 10% subset of variables. Multiple logistic regressions were conducted with all variables. Results: Results were consistent across samples. Univariate logistic regressions on average yielded chance-level accuracy. ML algorithms with all variables showed good accuracy; substantial deviation from the optimized algorithms through the removal of variables did not result in significantly poorer performance. Multiple logistic regressions produced poor to fair accuracy. Conclusions: Differences between suicide ideators and attempters are complex. Findings suggest that their differences may be better understood on a psychological primitive level than a biopsychosocial factor level.