Subtypes of suicidal ideation among university students: An ecological momentary assessment study

Ana Portillo-van Diest, Gemma Vilagut*, Laura Ballester, Paula Carrasco, Raquel Falcó, Margalida Gili, Glenn Kiekens, Francisco H. Machancoses, Jose A. Piqueras, Miquel Roca, Tíscar Rodríquez-Jiménez, Jordi Alonso, Philippe Mortier

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
Suicide is a leading cause of death among youth ages 15 to 29. This study identifies suicidal ideation (SI) subtypes among university students based on daily reports of SI, assesses how stress sensitivity may affect SI variability within these subtypes, and how they differ in terms of past and future self-injurious thoughts and behaviors (SITB).

Methods
756 students participated in a 14-day ecological momentary assessment and web-based survey at baseline and 12-month follow-up. Latent Profile Analysis identified SI subtypes using indicators of intensity,
variability and frequency. Multinomial regressions evaluated the associations between SITB and SI subtypes, as
well between SI subtypes and future SITB. Linear models assessed how stress sensitivity was associated to SI variability within the subtypes.

Results
Three SI subtypes were identified: sporadic and low intensity/variability (S1), frequent and medium intensity/variability (S2), and frequent and high intensity/variability (S3). Stress sensitivity was highest in S2 and S3, in S3 higher stress sensitivity was associated with lower day-to-day variability. Nearly all aORs for SITB significantly increased from S1 to S3 compared to controls, with each subtype showing higher aORs compared to the previous subtype (S3 vs, S2 vs S1). S3 students showed higher persistence of suicidal thoughts and behaviors
at follow-up (aOR = 20.6; 95 % CI = 8.3–51.2), with 4 of the 7 attempts occurring among students in this subtype.

Conclusions
Daily SI severity predicts future active SI and attempts, with stress sensitivity contributing to more extreme, rigid suicidal thinking. Targeting stress sensitivity could be effective for suicide prevention among university students.
Original languageEnglish
Article number119865
Number of pages9
JournalJournal of Affective Disorders
Volume391
Early online date11 Jul 2025
DOIs
Publication statusPublished - Dec 2025

Keywords

  • Suicidal ideation
  • College students
  • Experience sampling methods
  • Mental health
  • Stress sensitivity
  • Affect reactivity

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