Improving Forecasts of Suicide Attempts for Patients with Little Data

Forecasting suicide risk is difficult due to the high heterogeneity of patients and the low base rate of suicide-related events (SREs). We present Latent Similarity Gaussian Processes (LSGPs), which embed patients in a continuous latent space to jointly model similarity and forecast risk. By selectively drawing information from latent peers, LSGPs better capture individualized risk trajectories, generalizing nomothetic (pooled), idiographic (per-patient), and hierarchical frameworks. Our contributions are: (1) an identifiable two-channel Similarity Kernel; (2) proof that the standard model-fitting algorithm, mean-field variational inference, collapses LSGPs to nomothetic models, along with a fix; and (3) empirical results on intensive longitudinal suicide data showing LSGPs outperform nomothetic, idiographic, and hierarchical models for next-week risk forecasting, with the largest gains in forecasting first-occurrence SREs.

Ecological Momentary Assessment (EMA) studies enable the collection of high-frequency self-reports of suicidal thoughts and behaviors (STBs) via smartphones. Latent stochastic differential equations (SDEs) are a promising model class for EMA data, as it is irregularly sampled, noisy, and partially observed. But SDE-based models suffer from two key limitations. (a) These models often violate domain constraints, undermining scientific validity and clinical trust of the model. (b) Training is numerically unstable without ad hoc fixes (e.g. oversimplified dynamics) that are ill-suited for high-stakes applications. Here, we develop a novel class of expressive SDEs whose solutions are provably confined to a prescribed compact polyhedral state space, matching the domains of EMA data. In this work, (1) we show why chain-rule based constructions of SDEs on compact domains fail, theoretically and empirically; (2) we derive constraints on drift and diffusion for general and stationary SDEs so their solutions remain in the desired state space; and (3), we introduce a parameterization that maps arbitrary (neural or expert-given) dynamics into constraint-satisfying SDEs. On several real EMA datasets, including a large suicide-risk study, our parameterization improves forecasts and optimization dynamics over standard latent neural SDE baselines. These contributions pave the way for principled, trustworthy continuous-time models of suicide risk and other clinical time series and extend applications of SDE-based methods (e.g. diffusion models) to domains with hard state constraints.

Accurate forecasting of pathological outcomes is a central problem in psychology. To do so, psychologists often collect intensive longitudinal data. However, in such studies, the desire to acquire a large number of variables for the sake of accurate prediction is often counteracted by the need to minimize participant burden. Acquiring more variables per occasion can yield better predictions, but having too many acquisitions increase the risk of non-response and attrition. Longitudinal Active Feature Acquisition (LAFA) is a principled approach to resolve this conundrum. Instead of requiring responses to every item at every acquisition occasion, LAFA produces a policy that seeks to optimally select dynamic subsets of items to be acquired at each timepoint while preserving our ability to forecast a specific outcome. However, existing LAFA methods are mostly based on Neural Networks (NN) that are difficult to interpret in practice. In this work, we introduce a tree distillation method for learning an interpretable policy from NN-based LAFA networks. We validated our method through both a simulation and an empirical EMA dataset on forecasting daily alcohol consumption. In both cases, we find that we can meaningfully reduce the number of items acquired at each occasion with minimal loss in accuracy. Networks (NN) that are difficult to interpret in practice. In this work, we introduce a tree distillation method for learning an interpretable policy from NN-based LAFA networks. We validated our method through both a simulation and an empirical EMA dataset on forecasting daily alcohol consumption. In both cases, we find that we can meaningfully reduce the number of items acquired at each occasion with minimal loss in accuracy.