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

Background : Identifying typologies of patients who are suicidal have important clinical implications. The Suicide Status Form (SSF) of the Collaborative Assessment and Management of Suicidality (CAMS) is a well-validated 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 SSF variables in aggregate. Method : This study uses 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. Results : 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) female gender and features of borderline personality disorder, and (3) male gender and externalizing traits. The fourth profile reported the lowest ratings of suicide risk at termination, overall, while there was preliminary evidence showing that those in profile one and two were at elevated risk of attempting suicide. Limitations : A limitation is that the sample size is relatively small for LPA, despite the stability of the profiles. Conclusion : This study identified four distinct suicide typologies based on both qualitative and quantitative factors related to suicide risk, as derived from a widely used clinical assessment tool. These typologies were found to vary according to sex, history of suicide attempt, acute stressors, borderline personality traits, and externalizing behaviors. Clinical implications and future directions for research are also discussed.