Are false positives in suicide classification models a risk group? Evidence for “true alarms” in a population-representative longitudinal study of Norwegian adolescents

IntroductionFalse positives in retrospective binary suicide attempt classification models are commonly attributed to sheer classification error. However, when machine learning suicide attempt classification models are trained with a multitude of psycho-socio-environmental factors and achieve high accuracy in suicide risk assessment, false positives may turn out to be at high risk of developing suicidal behavior or attempting suicide in the future. Thus, they may be better viewed as “true alarms,” relevant for a suicide prevention program. In this study, using large population-based longitudinal dataset, we examine three hypotheses: (1) false positives, compared to the true negatives, are at higher risk of suicide attempt in future, (2) the suicide attempts risk for the false positives increase as a function of increase in specificity threshold; and (3) as specificity increases, the severity of risk factors between false positives and true positives becomes more similar.MethodsUtilizing the Gradient Boosting algorithm, we used a sample of 11,369 Norwegian adolescents, assessed at two timepoints (1992 and 1994), to classify suicide attempters at the first time point. We then assessed the relative risk of suicide attempt at the second time point for false positives in comparison to true negatives, and in relation to the level of specificity.ResultsWe found that false positives were at significantly higher risk of attempting suicide compared to true negatives. When selecting a higher classification risk threshold by gradually increasing the specificity cutoff from 60% to 97.5%, the relative suicide attempt risk of the false positive group increased, ranging from minimum of 2.96 to 7.22 times. As the risk threshold increased, the severity of various mental health indicators became significantly more comparable between false positives and true positives.ConclusionWe argue that the performance evaluation of machine learning suicide classification models should take the clinical relevance into account, rather than focusing solely on classification error metrics. As shown here, the so-called false positives represent a truly at-risk group that should be included in suicide prevention programs. Hence, these findings should be taken into consideration when interpreting machine learning suicide classification models as well as planning future suicide prevention interventions for adolescents

Predicting suicide attempts among Norwegian adolescents without using suicide-related items: a machine learning approach

IntroductionResearch on the classification models of suicide attempts has predominantly depended on the collection of sensitive data related to suicide. Gathering this type of information at the population level can be challenging, especially when it pertains to adolescents. We addressed two main objectives: (1) the feasibility of classifying adolescents at high risk of attempting suicide without relying on specific suicide-related survey items such as history of suicide attempts, suicide plan, or suicide ideation, and (2) identifying the most important predictors of suicide attempts among adolescents.MethodsNationwide survey data from 173,664 Norwegian adolescents (ages 13–18) were utilized to train a binary classification model, using 169 questionnaire items. The Extreme Gradient Boosting (XGBoost) algorithm was fine-tuned to classify adolescent suicide attempts, and the most important predictors were identified.ResultsXGBoost achieved a sensitivity of 77% with a specificity of 90%, and an AUC of 92.1% and an AUPRC of 47.1%. A coherent set of predictors in the domains of internalizing problems, substance use, interpersonal relationships, and victimization were pinpointed as the most important items related to recent suicide attempts.ConclusionThis study underscores the potential of machine learning for screening adolescent suicide attempts on a population scale without requiring sensitive suicide-related survey items. Future research investigating the etiology of suicidal behavior may direct particular attention to internalizing problems, interpersonal relationships, victimization, and substance use

The impact of diagnosed fetal anomaly, diagnostic severity and prognostic ambiguity on parental depression and traumatic stress: a prospective longitudinal cohort study

Introduction - The detection of a fetal anomaly during routine obstetric ultrasound is a potentially traumatic experience. The aim of this study is to examine longitudinally the impact of diagnosis of fetal anomaly on symptoms of depression and traumatic stress among mothers and fathers, and to examine how variations in psychological adjustment relate to diagnostic severity and prognostic ambiguity. Material and methods - In this prospective observational study conducted at a tertiary perinatal referral center, 81 mothers and 69 fathers with ultrasound findings of fetal anomaly completed the Edinburgh Postnatal Depression Scale (EPDS) and Impact of Events Scale (IES) at four time points in pregnancy (T1–T4) and 6 weeks after birth (T5). We compared this with depression and traumatic stress in a sample of non-affected parents (n = 110 mothers, 98 fathers). Results - Linear mixed effects models indicated that parents who received a diagnosis of fetal anomaly experienced higher levels of depression and traumatic stress over time, compared with non-affected parents. Depression: mean difference mothers = 4.46 ± 0.47, fathers = 2.80 ± 0.42. Traumatic stress: mean difference mothers = 20.04 ± 2.13, fathers = 12.66 ± 1.74. Parents with a more severe diagnosis experienced elevated symptoms compared with parents with a less severe diagnosis. Among mothers, prognostic ambiguity and changes in the anticipated diagnosis after birth were also associated with increased distress, regardless of whether the change was for the better or worse. Conclusions - Diagnosis of fetal anomaly increases risk of depression and traumatic stress in expectant mothers and fathers, both acutely and over time

Justice sensitivity is undergirded by separate heritable motivations to be morally principled and opportunistic

Injustice typically involves some people benefitting at the expense of others. An opportunist might then be selectively motivated to amend only the injustice that is harmful to them, while someone more principled would respond consistently regardless of whether they stand to gain or lose. Here, we disentangle such principled and opportunistic motives towards injustice. With a sample of 312 monozygotic- and 298 dizygotic twin pairs (N = 1220), we measured people’s propensity to perceive injustice as victims, observers, beneficiaries, and perpetrators of injustice, using the Justice Sensitivity scale. With a biometric approach to factor analysis, that provides increased stringency in inferring latent psychological traits, we find evidence for two substantially heritable factors explaining correlations between Justice Sensitivity facets. We interpret these factors as principled justice sensitivity (h2 = 0.45) leading to increased sensitivity to injustices of all categories, and opportunistic justice sensitivity (h2 = 0.69) associated with increased sensitivity to being a victim and a decreased propensity to see oneself as a perpetrator. These novel latent constructs share genetic substrate with psychological characteristics that sustain broad coordination strategies that capture the dynamic tension between honest cooperation versus dominance and defection, namely altruism, interpersonal trust, agreeableness, Social Dominance Orientation and opposition to immigration and foreign aid

The Genetic and Environmental Sources of Resemblance Between Normative Personality and Personality Disorder Traits

Recent work has suggested a high level of congruence between normative personality, most typically represented by the big five factors, and abnormal personality traits. In 2,293 Norwegian adult twins ascertained from a population-based registry, the authors evaluated the degree of sharing of genetic and environmental influences on normative personality, assessed by the Big Five Inventory (BFI), and personality disorder traits (PDTs), assessed by the Personality Inventory for DSM-S-Norwegian Brief Form (PID-5NBF). For four of the five BFI dimensions, the strongest genetic correlation was observed with the expected PID-5-NBF dimension (e.g., neuroticism with negative affectivity [+], conscientiousness with disinhibition [-]). However, neuroticism, conscientiousness, and agreeableness had substantial genetic correlations with other PID-S-NBF dimensions (e.g., neuroticism with compulsivity [+], agreeableness with detachment [-]). Openness had no substantial genetic correlations with any PID-5-NBF dimension. The proportion of genetic risk factors shared in aggregate between the BFI traits and the PID-5-NBF dimensions was quite high for conscientiousness and neuroticism, relatively robust for extraversion and agreeableness, but quite low for openness. Of the six PID-S-NBF dimensions, three (negative affectivity, detachment, and disinhibition) shared, in aggregate, most of their genetic risk factors with normative personality traits. Genetic factors underlying psychoticism, antagonism, and compulsivity were shared to a lesser extent, suggesting that they are influenced by etiological factors not well indexed by the BFI

Førstelinjemedarbeidere og tjenesteinnovasjon: Hvordan bidrar førstelinjemedarbeidere til tjenesteinnovasjon i Telia?

Tema for denne bacheloravhandlingen er å utforske førstelinjemedarbeideres bidrag til tjenesteinnovasjon i telekommunikasjonsselskapet Telia. Selskapet jobber aktivt med å være en ledende innovatør og digital tilrettelegger i samfunnet. I denne oppgaven har vi undersøkt hvordan førstelinjemedarbeidernes ideer generes, hvilken rolle mellomleder har knyttet til å håndtere ideer og hvordan ledelsen involverer førstelinjemedarbeidere i innovasjonsprosesser. Oppgavens problemstilling er: Hvordan bidrar førstelinjemedarbeidere til tjenesteinnovasjon i Telia? På bakgrunn av problemstillingens omfang valgte vi å faktorisere den ned til tre forskningsspørsmål: F1: Hva kan førstelinjemedarbeidere bidra med? F2: Hvilken rolle har mellomleder i forbindelse med førstelinjemedarbeideres bidrag til tjenesteinnovasjon? F3: Hvordan involverer ledelsen førstelinjemedarbeidere i Telias tjenesteinnovasjon? For å besvare disse spørsmålene har vi benyttet oss av et enkeltcase-studie med intervjuer av førstelinjemedarbeidere, mellomledere og personer tilknyttet innovasjonsavdelingen i Telia. Våre funn indikerer at førstelinjemedarbeidere i Telia besitter et stort potensiale til å kunne bidra i tjenesteinnovasjon på bakgrunn av deres høye domenekunnskap. Deres posisjon som bindeledd mellom kunde og organisasjon anses å være kritisk for å kunne bidra effektivt i innovasjonsprosesser. For å forløse førstelinjemedarbeideres potensiale har mellomlederne en viktig rolle knyttet til idéhåndtering. På bakgrunn av at det ikke er tilrettelagt noen formaliserte strukturer for å effektivt kunne videreformidle ideer og gi feedback, tyder det på at det er mange ideer som aldri realiseres, og at dette har en negativ effekt på motivasjonen til kreativ tenking for de ansatte. Ideer utover hva som defineres som bricolage-innovasjon får dermed sjelden gjennomslag. På den andre siden har førstelinjemedarbeidere mulighet til å bidra med verdifull innsikt og ideer gjennom å delta i flere organiserte prosesser som arrangeres av ledelsen

Genetic and Environmental Structure of DSM-IV Criteria for Antisocial Personality Disorder: A Twin Study

Results from previous studies on DSM-IV and DSM-5 Antisocial Personality Disorder (ASPD) have suggested that the construct is etiologically multidimensional. To our knowledge, however, the structure of genetic and environmental influences in ASPD has not been examined using an appropriate range of biometric models and diagnostic interviews. The 7 ASPD criteria (section A) were assessed in a population-based sample of 2794 Norwegian twins by a structured interview for DSM-IV personality disorders. Exploratory analyses were conducted at the phenotypic level. Multivariate biometric models, including both independent and common pathways, were compared. A single phenotypic factor was found, and the best-fitting biometric model was a single-factor common pathway model, with common-factor heritability of 51% (95% CI 40–67%). In other words, both genetic and environmental correlations between the ASPD criteria could be accounted for by a single common latent variable. The findings support the validity of ASPD as a unidimensional diagnostic construct

The genetic underpinnings of right-wing authoritarianism and social dominance orientation explain political attitudes beyond Big Five personality

Objective: Political attitudes are predicted by the key ideological variables of right-wing authoritarianism (RWA) and social dominance orientation (SDO), as well as some of the Big Five personality traits. Past research indicates that personality and ideological traits are correlated for genetic reasons. A question that has yet to be tested concerns whether the genetic variation underlying the ideological traits of RWA and SDO has distinct contributions to political attitudes, or if genetic variation in political attitudes is subsumed under the genetic variation underlying standard Big Five personality traits. Method: We use data from a sample of 1987 Norwegian twins to assess the genetic and environmental relationships between the Big Five personality traits, RWA, SDO, and their separate contributions to political policy attitudes. Results: RWA and SDO exhibit very high genetic correlation (r = 0.78) with each other and some genetic overlap with the personality traits of openness and agreeableness. Importantly, they share a larger genetic substrate with political attitudes (e.g., deporting an ethnic minority) than do Big Five personality traits, a relationship that persists even when controlling for the genetic foundations underlying personality traits. Conclusion: Our results suggest that the genetic foundations of ideological traits and political attitudes are largely non-overlapping with the genetic foundations of Big Five personality traits

Caffeine Consumption, Toxicity, Tolerance and Withdrawal; Shared Genetic Influences With Normative Personality and Personality Disorder Traits

Public Health Significance Both the amount of caffeine people consume and their response to caffeine is heritable. A modest proportion of the genetic influences underlying caffeine use and response is shared with personality and personality disorder traits. Our main aim was to estimate the extent of overlapping etiology between caffeine consumption and response and normative and pathological personality. Linear mixed-effects models were used to identify normative personality domains and personality disorder (PD) traits for inclusion in multivariate twin analyses together with individual caffeine related measures. Data were obtained from Norwegian adult twins in a face-to-face interview conducted in 1999-2004 as part of a population-based study of mental health and through self-report in 2010-2011 and 2015-2017. Personality disorder data was available for 2,793 twins, normative personality for 3,889 twins, and caffeine for 3,862 twins (mean age 43.0 years). Normative personality was assessed using the self-reported Big Five Inventory, PD traits were assessed by the Structured Interview for DSM-IV Personality, and caffeine consumption, toxicity, tolerance, and withdrawal were assessed through a self-report questionnaire developed at the Norwegian Institute of Public Health. Caffeine measures were found to be moderately heritable, h(2) = 30.1%-45.0%. All normative personality domains and four PD traits, antisocial, borderline, dependent and paranoid, were significantly associated with at least one caffeine variable. A small proportion of variance in caffeine consumption was attributable to genetic factors shared with normative personality (1.3%) and personality disorders (11.4%). A modest proportion of variance in caffeine tolerance and toxicity was attributable to genetic factors shared with both normative personality (26.9%, 24.8%) and personality disorders (21.0%, 36.0%). The present study found caffeine consumption and response to be heritable and provides evidence that a small to-modest proportion of this genetic etiology is shared with both normative and pathological personality.Peer reviewe