Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Comparison of the Prediction Model of Adolescents' Suicide Attempt Using Logistic Regression and Decision Tree: Secondary Data Analysis of the 2019 Youth Health Risk Behavior Web-Based Survey

로지스틱 회귀모형과 의사결정 나무모형을 활용한 청소년 자살 시도 예측모형 비교: 2019 청소년 건강행태 온라인조사를 이용한 2차 자료분석

  • Lee, Yoonju (College of Nursing, Pusan National University) ;
  • Kim, Heejin (College of Nursing, Pusan National University) ;
  • Lee, Yesul (College of Nursing, Pusan National University) ;
  • Jeong, Hyesun (College of Nursing, Pusan National University)
  • Received : 2020.08.27
  • Accepted : 2021.01.26
  • Published : 2021.02.28
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Abstract

Purpose: The purpose of this study was to develop and compare the prediction model for suicide attempts by Korean adolescents using logistic regression and decision tree analysis. Methods: This study utilized secondary data drawn from the 2019 Youth Health Risk Behavior web-based survey. A total of 20 items were selected as the explanatory variables (5 of sociodemographic characteristics, 10 of health-related behaviors, and 5 of psychosocial characteristics). For data analysis, descriptive statistics and logistic regression with complex samples and decision tree analysis were performed using IBM SPSS ver. 25.0 and Stata ver. 16.0. Results: A total of 1,731 participants (3.0%) out of 57,303 responded that they had attempted suicide. The most significant predictors of suicide attempts as determined using the logistic regression model were experience of sadness and hopelessness, substance abuse, and violent victimization. Girls who have experience of sadness and hopelessness, and experience of substance abuse have been identified as the most vulnerable group in suicide attempts in the decision tree model. Conclusion: Experiences of sadness and hopelessness, experiences of substance abuse, and experiences of violent victimization are the common major predictors of suicide attempts in both logistic regression and decision tree models, and the predict rates of both models were similar. We suggest to provide programs considering combination of high-risk predictors for adolescents to prevent suicide attempt.

Keywords

References

  1. World Health Organization (WHO). Suicide [Internet]. Geneva: WHO; c2019 [cited 2020 Jul 3]. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide.
  2. Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Queen B, et al. Youth risk behavior surveillance-United States, 2017. Morbidity and Mortality Weekly Report Surveillance Summaries. 2018;67(8):1-114. https://doi.org/10.15585/mmwr.ss6708a1
  3. Statistics Korea (KOSTAT), Ministry of Gender Equality and Family (MOGEF). The report of the Korean adolescent in 2020 [Internet]. Daejeon: Statistics Korea; c2020 [cited 2020 Jul 27]. Available from: http://kostat.go.kr/assist/synap/preview/skin/doc.html?fn=synapview381815_1&rs=/assist/synap/preview.
  4. Korea Centers for Disease Control and Prevention (KCDC). The statistics on the 15th Korea youth risk behavior webbased survey in 2019. Cheongju: KCDC; 2019 Dec. Report No.: 11-1460736-000038-10.
  5. Klonsky ED, May AM. The Three-Step Theory (3ST): A new theory of suicide rooted in the "ideation-to-action" framework. International Journal of Cognitive Therapy. 2015;8(2):114-129. https://doi.org/10.1521/ijct.2015.8.2.114
  6. Klonsky ED, May AM, Saffer BY. Suicide, suicide attempts, and suicidal ideation. Annual Review of Clinical Psychology. 2016;12:307-330. https://doi.org/10.1146/annurev-clinpsy-021815-093204
  7. World Health Organization (WHO). Mental health status of adolescents in South-East Asia: Evidence for action [Internet]. New Delh: WHO Regional Office for South-East Asia; c2017 [cited 2020 Oct 20]. Available from: https://apps.who.int/iris/bitstream/handle/10665/254982/9789290225737-eng.pdf?sequence=1&isAllowed=y.
  8. Sohn SY. Factors affecting suicidal ideation, suicidal plan and suicidal attempt in Korean adolescents. Journal of the Korea Academia-Industrial Cooperation Society. 2014;15(3):1606-1614. https://doi.org/10.5762/KAIS.2014.15.3.1606
  9. Hong SH, No UK, Jung S. Meta-analysis about relationship between adolescents' suicidal ideation and protective factors. Survey Research. 2016;17(1):137-166. https://doi.org/10.20997/SR.17.1.7
  10. Miranda-Mendizabal A, Castellvi P, Parés-Badell O, Alayo I, Almenara J, Alonso I, et al. Gender differences in suicidal behavior in adolescents and young adults: Systematic review and meta-analysis of longitudinal studies. International Journal of Public Health. 2019;64(2):265-283. https://doi.org/10.1007/s00038-018-1196-1
  11. Lee J, Jang H, Kim J, Min S. Development of a suicide index model in general adolescents using the South Korea 2012-2016 national representative survey data. Scientific Reports. 2019;9(1):1846. https://doi.org/10.1038/s41598-019-38886-z
  12. Liu HC, Liu SI, Tjung JJ, Sun FJ, Huang HC, Fang CK. Self-harm and its association with internet addiction and internet exposure to suicidal thought in adolescents. Journal of the Formosan Medical Association. 2017;116(3):153-160. https://doi.org/10.1016/j.jfma.2016.03.010
  13. Park S, Song H. Factors that affect adolescent drug users' suicide attempts. Psychiatry Investigation. 2016;13(3):360-363. https://doi.org/10.4306/pi.2016.13.3.360
  14. Park S, Lee Y, Lee JH. Association between energy drink intake, sleep, stress, and suicidality in Korean adolescents: Energy drink use in isolation or in combination with junk food consumption. Nutrition Journal. 2016;15(1):87. https://doi.org/10.1186/s12937-016-0204-7
  15. Tang JJ, Yu Y, Wilcox HC, Kang C, Wang K, Wang C, et al. Global risks of suicidal behaviours and being bullied and their association in adolescents: School-based health survey in 83 countries. EClinicalMedicine. 2020;19:100253. https://doi.org/10.1016/j.eclinm.2019.100253
  16. Joung M, Seo S. Predictors of attempts at suicide - a focus on the attune adolescent facing a suicidal crisis -. Studies on Korean Youth. 2014;25(2):145-171. https://doi.org/10.14816/sky.2014.25.2.145
  17. Kim G, Park G. Risk and protective factors for suicide that affect middle school students' suicidal ideation and attempts: Focusing on gender difference. Journal of Rehabilitation Psychology. 2015;22(1):115-130.
  18. Ryu H, Kim Y, Kim J. Association between subjective body image and suicide ideation: Based on 14th Korean Youth Health Behavior Survey. Health Policy and Management. 2020;30(2):211-220. https://doi.org/10.4332/KJHPA.2020.30.1.211
  19. Oh SY, Sim HI, Cho YO. Impact of victimization experience of domestic violence, school violence and cyber bullying on suicidal ideation of juveniles -focused on mediated effect of depression symptoms-. Korean Criminal Psychology Review. 2020;16(1):87-110. https://doi.org/10.25277/KCPR.2020.16.1.87
  20. Park HS, Hong SA. Gender comparison of factors affecting the suicide ideation of adolescents - based on the Korea Youth Risk Behavior Web-based Survey, 2019 -. Korean Public Health Research. 2020;46(3):47-57. https://doi.org/10.22900/kphr.2020.46.3.004
  21. Kim MK, Cho KW. Factors affecting health risk behaviors, suicidal ideation, suicidal plans and suicidal attempts in adolescents. Korean Journal of Health Education and Promotion. 2020;36(3):61-71. https://doi.org/10.14367/kjhep.2019.36.3.61
  22. Cox DR. The regression analysis of binary sequences. Journal of the Royal Statistical Society: Series B (Methodological). 1958;20(2):215-232. Correction in: Journal of the Royal Statistical Society: Series B (Methodological). 2018;21(1):238. https://doi.org/10.1111/j.2517-6161.1958.tb00292.x
  23. Breiman L, Friedman JH, Olshen RA, Stone CJ. Classification and regression trees. Belmont (CA): Wadsworth International Group; 1984. p. 237-251.
  24. Long WJ, Griffith JL, Selker HP, D'Agostino RB. A comparison of logistic regression to decision-tree induction in a medical domain. Computers and Biomedical Research. 1993;26(1):74-97. https://doi.org/10.1006/cbmr.1993.1005
  25. Rudolfer SM, Paliouras G, Peers IS. A comparison of logistic regression to decision tree induction in the diagnosis of carpal tunnel syndrome. Computers and Biomedical Research. 1999;32(5):391-414. https://doi.org/10.1006/cbmr.1999.1521
  26. Morgan J, Daugherty R, Hilchie A, Carey B. Sample size and modeling accuracy of decision tree based data mining tools. Academy of Information and Management Sciences Journal. 2003;6(2):77-91.
  27. Steyerberg EW. Clinical prediction models: A practical approach to development, validation, and updating. New York (NY): Springer; 2009. p. 301-302.
  28. Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982;143(1):29-36. https://doi.org/10.1148/radiology.143.1.7063747
  29. Nagamitsu S, Mimaki M, Koyanagi K, Tokita N, Kobayashi Y, Hattori R, et al. Prevalence and associated factors of suicidality in Japanese adolescents: Results from a population-based questionnaire survey. BMC Pediatrics. 2020;20(1):467. https://doi.org/10.1186/s12887-020-02362-9
  30. Lindsey MA, Sheftall AH, Xiao Y, Joe S. Trends of suicidal behaviors among high school students in the United States: 1991-2017. Pediatrics. 2019;144(5):e20191187. https://doi.org/10.1542/peds.2019-1187
  31. Ministry of Health and Welfare (MOHW), Korea Suicide Prevention Center (SPC Korea). Summary of 2020 suicide prevention white book. Seoul: Korea Suicide Prevention Center; 2020 May. Report No.: 11-1352000-001635-10.
  32. Kwon H, Lee JS, Kim AR, Hong HJ, Kweon YS. Risk factors for suicidal ideation and attempts in adolescents. Journal of the Korean Academy of Child and Adolescent Psychiatry. 2018;29(3):114-121. https://doi.org/10.5765/jkacap.170010
  33. Liu XC, Chen H, Liu ZZ, Wang JY, Jia CX. Prevalence of suicidal behaviour and associated factors in a large sample of Chinese adolescents. Epidemiology and Psychiatric Sciences. 2019;28(3):280-289. https://doi.org/10.1017/S2045796017000488
  34. Mendle J. Why puberty matters for psychopathology. Child Development Perspectives. 2014;8(4):218-222. https://doi.org/10.1111/cdep.12092
  35. Compas BE, Jaser SS, Bettis AH, Watson KH, Gruhn MA, Dunbar JP, et al. Coping, emotion regulation, and psychopathology in childhood and adolescence: A meta-analysis and narrative review. Psychological Bulletin. 2017;143(9):939-991. https://doi.org/10.1037/bul0000110
  36. Guo L, Xu Y, Deng J, Huang J, Huang G, Gao X, et al. Association between nonmedical use of prescription drugs and suicidal behavior among adolescents. JAMA Pediatrics. 2016;170(10):971-978. https://doi.org/10.1001/jamapediatrics.2016.1802
  37. Divin AL, Zullig KJ. The association between non-medical prescription drug use and suicidal behavior among United States adolescents. AIMS Public Health. 2014;1(4):226-240. https://doi.org/10.3934/publichealth.2014.4.226
  38. Hong SA. A study on the status of durg addiction and psychological support of teenagers. Korean Association of Addiction Crime Review. 2018;8(2):93-115. https://doi.org/10.26606/kaac.2018.8.2.5
  39. World Health Organization (WHO). Preventing youth violence: An overview of the evidence [Internet]. Geneva: WHO; c2015 [cited 2020 Jul 27]. Available from: https://apps.who.int/iris/bitstream/handle/10665/181008/9789241509251_eng.pdf?sequence=1.
  40. Carballo JJ, Llorente C, Kehrmann L, Flamarique I, Zuddas A, Purper-Ouakil D, et al. Psychosocial risk factors for suicidality in children and adolescents. European Child and Adolescent Psychiatry. 2020;29(6):759-776. https://doi.org/10.1007/s00787-018-01270-9
  41. Liu RT, Miller I. Life events and suicidal ideation and behavior: A systematic review. Clinical Psychology Review. 2014;34(3):181-192. https://doi.org/10.1016/j.cpr.2014.01.006
  42. Travagin G, Margola D, Revenson TA. How effective are expressive writing interventions for adolescents? A meta-analytic review. Clinical Psychology Review. 2015;36:42-55. https://doi.org/10.1016/j.cpr.2015.01.003
  43. Banzer R, Haring C, Buchheim A, Oehler S, Carli V, Wasserman C, et al. Factors associated with different smoking status in European adolescents: Results of the SEYLE study. European Child and Adolescent Psychiatry. 2017;26(11):1319-1329. https://doi.org/10.1007/s00787-017-0980-4
  44. Gwon SH, Jeong S. Factors influencing adolescent lifetime smoking and current smoking in South Korea: Using data from the 10th (2014) Korea Youth Risk Behavior Web-Based Survey. Journal of Korean Academy of Nursing. 2016;46(4):552-561. https://doi.org/10.4040/jkan.2016.46.4.552
  45. Ha YS, Choi YH. Effectiveness of the self-determination theory based a motivational interviewing YOU-TURN program for smoking cessation among adolescents. Journal of Korean Academy of Nursing. 2015;45(3):347-356. https://doi.org/10.4040/jkan.2015.45.3.347
  46. Jung S, Lee D, Park S, Lee K, Kweon YS, Lee EJ, et al. Gender differences in Korean adolescents who died by suicide based on teacher reports. Child and Adolescent Psychiatry and Mental Health. 2019;13:12. https://doi.org/10.1186/s13034-019-0274-3
  47. Whiting D, Fazel S. How accurate are suicide risk prediction models? Asking the right questions for clinical practice. Evidence-based Mental Health. 2019;22(3):125-128. https://doi.org/10.1136/ebmental-2019-300102

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