Introduction: Adolescent depression necessitates rapid screening and robust diagnostic tools that reflect unique developmental presentations. Traditional models often overlook the central role of existential distress and hopelessness, which are critical precursors to suicidal ideation in this age group.
Purpose: This study aimed to develop both an optimized screening instrument and a comprehensive diagnostic version by identifying the most predictive symptom clusters through an integrated methodological approach.
Method: The sample consisted of 688 adolescents aged 13-18. The community group included 627 participants (252 males; M_age=15.5, SD=1.57), and the depression group included 61 participants (13 males; M_age=16.0, SD=1.32). Data analysis was performed using the JASP Network module. Optimal cut-off points were determined using the Uncertain Intervals (UI) module within the jYS package in Jamovi, specifically applying the Dichotomization (no uncertainty) method with a Youden index threshold to maximize classification accuracy.
Results: Network analysis identified "Sense of Meaninglessness" (D8) and "Depressed Mood" (D1) as critical system mediators (Betweenness = 1.73). Comparative analysis revealed that weighted scoring (Sc_w) consistently yielded superior prognostic accuracy over simple total scores. The 12-item screening version (Sc_12_w) achieved a high sensitivity of 0.869, a specificity of 0.754, and a positive likelihood ratio (LR+ = 3.54). The full 23-item diagnostic version further enhanced the clinical profile, achieving a sensitivity of 0.852, a specificity of 0.801, and a higher likelihood ratio (LR+ = 4.28).
Conclusions: The 12-item tool provides an efficient screening option with prioritized sensitivity, while the 23-item version serves as a robust diagnostic aid with higher specificity. The application of the Uncertain Intervals methodology ensures that optimal thresholds are identified, confirming that weighted scoring based on symptom centrality significantly improves the identification of adolescent suicidal risk compared to traditional summation methods.