Liming Dong1, Viktoryia A Kalesnikava1, Richard Gonzalez2, Briana Mezuk3. 1. Department of Epidemiology (LD, VK, BM), University of Michigan School of Public Health, Ann Arbor, MI. 2. Research Center for Group Dynamics (RG, BM), Institute for Social Research, University of Michigan, Ann Arbor, MI; Department of Psychology (RG), University of Michigan, Ann Arbor, MI. 3. Department of Epidemiology (LD, VK, BM), University of Michigan School of Public Health, Ann Arbor, MI; Research Center for Group Dynamics (RG, BM), Institute for Social Research, University of Michigan, Ann Arbor, MI. Electronic address: bmezuk@umich.edu.
Abstract
OBJECTIVES: To provide valid estimates of the 12-month prevalence of passive suicidal ideation among older adults, without conditioning on depression status, using the Health and Retirement Study (HRS). METHODS: Data come from the 2012 HRS (n = 17,434) and 2004/5 Baltimore Epidemiologic Catchment Area (ECA) Study (n = 755). In the HRS, passive suicidal ideation (i.e., thought a lot about death-your own, someone else's, or death in general) is only assessed on respondents who reported dysphoria/anhedonia; in the ECA, ideation is assessed on all respondents, regardless of depression. We compare two approaches to estimating the 12-month prevalence of passive suicidal ideation in the HRS without conditioning on depression symptoms: 1) a probit selection model within the HRS, and 2) a prediction model developed using appended ECA data applied to the HRS. RESULTS: Using observed data alone on those who screened positive for depression, 6% of older adults reported passive suicidal ideation in the past year. Depending on the approach used, between 5.4% and 9.2% of HRS respondents who screened negative for depression would have reported passive suicidal ideation had they been assessed. Correcting for this selection bias, between 10.9% and 13.4% of U.S. adults over age 50 experienced passive suicidal ideation in 2012. CONCLUSIONS: Population surveillance of suicidal ideation among older adults is biased by survey approaches that only assess ideation in the context of depression.
OBJECTIVES: To provide valid estimates of the 12-month prevalence of passive suicidal ideation among older adults, without conditioning on depression status, using the Health and Retirement Study (HRS). METHODS: Data come from the 2012 HRS (n = 17,434) and 2004/5 Baltimore Epidemiologic Catchment Area (ECA) Study (n = 755). In the HRS, passive suicidal ideation (i.e., thought a lot about death-your own, someone else's, or death in general) is only assessed on respondents who reported dysphoria/anhedonia; in the ECA, ideation is assessed on all respondents, regardless of depression. We compare two approaches to estimating the 12-month prevalence of passive suicidal ideation in the HRS without conditioning on depression symptoms: 1) a probit selection model within the HRS, and 2) a prediction model developed using appended ECA data applied to the HRS. RESULTS: Using observed data alone on those who screened positive for depression, 6% of older adults reported passive suicidal ideation in the past year. Depending on the approach used, between 5.4% and 9.2% of HRS respondents who screened negative for depression would have reported passive suicidal ideation had they been assessed. Correcting for this selection bias, between 10.9% and 13.4% of U.S. adults over age 50 experienced passive suicidal ideation in 2012. CONCLUSIONS: Population surveillance of suicidal ideation among older adults is biased by survey approaches that only assess ideation in the context of depression.
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