{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:58:40Z","timestamp":1785419920048,"version":"3.56.0"},"reference-count":61,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/00789fa95","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Suicidal ideation and behavior in adolescence remain difficult to assess due to their multifactorial and fluctuating nature. Performance-based measures may provide additional information on psychological correlates associated with suicidality beyond self-report and interview data. Methods: This study examined multivariate associations between RorschachPerformance Assessment System (R-PAS) variables and suicidality in a clinical sample of 153 help-seeking adolescents. Elastic net penalized regression models were estimated to evaluate joint patterns of R-PAS variables derived from the Suicide Concern Composite (SC-Comp) and selected developmentally relevant indices, controlling for age, sex at birth, sociodemographic and clinical factors. Suicidal ideation severity and lifetime suicidal behavior were assessed using the Columbia\u2013Suicide Severity Rating Scale (C-SSRS). Results: For both outcomes, morbid content (MOR) and Location, Space, and Object Qualities-Complexity (LSO-Cmplx) emerged as consistent multivariate correlates, with vigilance\u2013avoidance (VFD) contributing only in the model for suicidal ideation severity. Model performance was modest (R2 = 0.09), indicating limited explanatory power. The findings do not support clinical or predictive use of R-PAS variables for suicidal ideation and behaviors, but indicate a small set of reproducible multivariate associations within this sample. Conclusions: The results suggest that certain R-PAS variables show weak but consistent associations with suicidality in a help-seeking adolescent sample. Given the cross-sectional design and modest explanatory power, the findings should be interpreted as exploratory and hypothesis-generating, and further studies are needed to clarify the robustness and meaning of these associations.<\/jats:p>","DOI":"10.3390\/brainsci16050519","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:17:23Z","timestamp":1779203843000},"page":"519","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multivariate Associations Between R-PAS Variables and Suicidal Ideation and Behaviors in Help-Seeking Adolescents"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9066-6505","authenticated-orcid":false,"given":"Marzia","family":"Di Girolamo","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Invernizzi","sequence":"additional","affiliation":[{"name":"Child Neurology and Psychiatry Unit, ASST Lecco, 23900 Lecco, Italy"},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Galli","sequence":"additional","affiliation":[{"name":"Child Neurology and Psychiatry Unit, ASST Lecco, 23900 Lecco, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9667-1759","authenticated-orcid":false,"given":"Irene","family":"Orlandi","sequence":"additional","affiliation":[{"name":"Child Neurology and Psychiatry Unit, ASST Lecco, 23900 Lecco, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9540-4803","authenticated-orcid":false,"given":"Luciano","family":"Giromini","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Viglione","sequence":"additional","affiliation":[{"name":"Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92193, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Borgatti","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy"},{"name":"Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9583-0554","authenticated-orcid":false,"given":"Martina","family":"Mensi","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy"},{"name":"Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2783-5262","authenticated-orcid":false,"given":"Marika","family":"Orlandi","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy"},{"name":"Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025, January 25). 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