2025 Theses Doctoral

Detecting Suicidal Thoughts and Behaviors: The Verbal and Nonverbal in Suicide Assessments with Adolescents and Young Adults

Gratch, Ilana

Suicide is a leading cause of death among adolescents and young adults in the United States. Detecting suicidal thoughts and behaviors is an important component of suicide prevention. The current three-paper dissertation aimed to address limitations in the extant youth suicide assessment research through three empirical studies.

In Paper 1, we address the lack of research examining whether brief screeners adequately capture suicidal thinking by comparing single- and multi-item assessments of ideation in adolescents. In Paper 2, we seek to expand beyond verbal self-report by using the Facial Action Coding System (FACS) to conduct an in-depth examination of facial expressions exhibited by young adults and their clinical interviewers during a widely used suicide assessment. In Paper 3, we build upon this foundation by maximizing on advancements in affective computing to automatically extract a wider range of nonverbal behaviors associated with affective engagement, and test whether these behaviors predict suicidal thoughts and behaviors crosssectionally and prospectively.

Results across all three studies suggest that researchers and clinicians concerned with assessment would stand to benefit from expanding beyond just that which is said by the suicidal person, and into that which is registered and expressed verbally and nonverbally by both members of the interviewer-respondent dyad.