Subgroups of suicidal ideation and simulated intervention responses among left-behind children with depression risk: an Ising computational network model

Abstract

Background: Left-behind children (LBC) with depression risk exhibit a higher suicide risk than their peers. To better understand the psychological mechanisms contributing to elevated suicide risk, this study employed a person-centered approach to systematically identify latent subgroups of suicidal ideation, with a particular focus on the roles of positive and negative suicidal ideation, and to investigated their differential responses to simulated interventions. Methods: From the Psychological Healthcare Guard Children and Adolescents Project of China cohort, 10,852 left-behind children with depression risk were selected. Using self-reported demographic data, depressive symptoms, and positive and negative suicidal ideation, we conducted latent profile analysis, network analysis, and computational simulation to evaluate the effects of key intervention targets. Results: Latent profile analysis identified three suicidal ideation subgroups—low, moderate, and high (40%, 39%, and 21%, respectively)—with significant differences in depression levels across groups. The Ising network model revealed that the most influential node in the overall sample was the negative suicidal ideation (SN08: Frustrated in life), whereas positive suicidal ideation nodes (SP03: Satisfied with life and SP06: Confident about the future) dominated in all subgroups. Simulated interventions showed that positive ideation nodes had the greatest impact on suicidal ideation risk, particularly in the high-risk group, where risk scores increased by 1.9 points under the aggravation intervention, highlighting the pivotal role of positive emotion-focused interventions. Conclusions: This study offers novel insights into suicidal ideation among left-behind children with depression risk, from an individual-centered level, demonstrating that positive suicidal ideation plays a more important role than negative ideation in both aggravation and alleviation intervention effects, with key targets varying across subgroups. Targeted interventions prioritizing positive ideation in high-risk groups are recommended to optimize prevention and treatment strategies.