Identifying Chinese adolescents with a high suicide attempt risk

•This is a study based on a large sample of Chinese adolescents.•A decision tree model was developed to demonstrate interactions between suicide related factors of high suicide attempt risk.•This is the first study that provides evidence to identify Chinese adolescents with high suicide attempt risk using CRUISE. Adolescent suicide has become a serious public health problem in China. Since suicide attempts are considered the strongest predictor of suicide completion, it is valuable to identify adolescents with a high suicide attempt risk. This study aimed to develop a decision tree model for the interactive prediction of high suicide attempt risk in Chinese adolescents. A classification tree analysis was conducted in a sample of senior high school students (N = 6,686) based on the CRUISE program. The results indicated that depression, anxiety, social support, gender, self-esteem, family cohesion and adaptability were significant predictors of high suicide attempt risk, and interactions among these predictors constructed a hierarchical decision tree model. The tree model offered a series of reliable rules to identify Chinese adolescents with high suicide attempt risk, for example, adolescents with high depression scores had the highest probability (69.22%) of having a suicide attempt, female adolescents with low social support and low depression scores had the second highest probability (57.58%), and adolescents with low anxiety, low family adaptability, and medium depression scores had the third highest probability (55.77%). These exploratory findings suggested that different screening criteria are needed to detect at-risk Chinese adolescents with different severities of depression.