Who Responds To CAMS? Latent Profiles of Patients who Received the Collaborative Assessment and Management of Suicidality

Identifying typologies of patients who are suicidal has important clinical implications. The Suicide Status Form (SSF) of the Collaborative Assessment and Management of Suicidality (CAMS) is a well-validated and rich suicide assessment tool that may help derive clinical subtypes. Despite the strong psychometric properties of different sections of the SSF, no prior studies have examined all initial session SSF variables in aggregate. This study used latent profile analysis (LPA) to statistically generate subtypes of patients who are suicidal based on a diverse and aggregate sample from three clinical trials conducted in an inpatient setting, an active-duty Army outpatient clinic, and a university counseling center. Based on fit indices, the four-profile model yielded the best fit with the data. The four profiles were characterized by (1) acute stress, (2) history of multiple attempts, (3) features of borderline personality disorder, and (4) externalized distress. The first two profiles were overall the most responsive to CAMS by termination, despite preliminary descriptive data indicating that these individuals were more likely to attempt suicide during the study period. A limitation is that the sample size is relatively small for LPA, despite the stability and face validity of the profiles. This study identified four distinct suicide typologies as derived from a widely used clinical assessment tool. These typologies also varied according to gender distributions, history of suicide attempts, acute stressors, borderline personality traits, and externalizing behaviors. Clinical implications and future directions for research also are discussed.