Assessment of Suicidal Thoughts and Behaviors in Adults: A Systematic Review of Measure Psychometric Properties and Implications for Clinical and Research Utility

Overview

Journal Clin Psychol Rev

Specialty Psychology

Date 2024 Aug 6

PMID 39106741

Authors

Olivia H Pollak

Ana E Sheehan

Rachel F L Walsh

Auburn R Stephenson

Holly Zell

Jenna Mayes

Hannah R Lawrence

Alexandra H Bettis

Richard T Liu

Affiliations

Soon will be listed here.

Abstract

High-quality clinical care and research on suicidal thoughts and behaviors (STBs) depends on availability and implementation of reliable and valid measures of STBs. In contrast to studies examining STB risk factors, screening instruments, or treatment, little research has rigorously examined the content, characteristics, and psychometric properties of STB measures themselves. This systematic review (1) identified STB measures that conform to empirically supported definitions of STBs, and (2) identified peer-reviewed papers reporting on the psychometric properties of these measures in adults. Data on psychometric properties and other measure characteristics were extracted. A total of 21 eligible measures were identified in the first stage. In the second stage, 70 articles (with 79 independent samples) were included with psychometric data in adult samples for 19 measures. Although there was support for strong internal consistency and content validity across many measures, face validity and clinical utility concerns were prevalent. Few measures comprehensively assessed suicidal behaviors, and interview-based assessments tended to show the strongest psychometric properties and clinical utility. Findings are discussed in the context of recommendations for improving existing measures, including future research to increase utility and translatability across clinical settings, delivery methods, and diverse populations.

References

Wang S, Coppersmith D, Kleiman E, Bentley K, Millner A, Fortgang R . A Pilot Study Using Frequent Inpatient Assessments of Suicidal Thinking to Predict Short-Term Postdischarge Suicidal Behavior. JAMA Netw Open. 2021; 4(3):e210591. PMC: 7944382. DOI: 10.1001/jamanetworkopen.2021.0591. View

Kessler R, Berglund P, Borges G, Nock M, Wang P . Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990-1992 to 2001-2003. JAMA. 2005; 293(20):2487-95. DOI: 10.1001/jama.293.20.2487. View

McGillivray L, Rheinberger D, Wang J, Burnett A, Torok M . Non-disclosing youth: a cross sectional study to understand why young people do not disclose suicidal thoughts to their mental health professional. BMC Psychiatry. 2022; 22(1):3. PMC: 8728900. DOI: 10.1186/s12888-021-03636-x. View

Ammerman B, Burke T, Jacobucci R, McClure K . How we ask matters: The impact of question wording in single-item measurement of suicidal thoughts and behaviors. Prev Med. 2021; 152(Pt 1):106472. DOI: 10.1016/j.ypmed.2021.106472. View

Fox K, Harris J, Wang S, Millner A, Deming C, Nock M . Self-Injurious Thoughts and Behaviors Interview-Revised: Development, reliability, and validity. Psychol Assess. 2020; 32(7):677-689. DOI: 10.1037/pas0000819. View

Gratch I, Choo T, Galfalvy H, Keilp J, Itzhaky L, Mann J . Detecting suicidal thoughts: The power of ecological momentary assessment. Depress Anxiety. 2020; 38(1):8-16. DOI: 10.1002/da.23043. View

Flesch R . A new readability yardstick. J Appl Psychol. 1948; 32(3):221-33. DOI: 10.1037/h0057532. View

Flores-Kanter P, Alvarado J . The State of Open Science Practices in Psychometric Studies of Suicide: A Systematic Review. Assessment. 2024; 31(8):1567-1579. DOI: 10.1177/10731911241236315. View

Silverman M . The language of suicidology. Suicide Life Threat Behav. 2006; 36(5):519-32. DOI: 10.1521/suli.2006.36.5.519. View

10.

Carter T, Walker G, Aubeeluck A, Manning J . Assessment tools of immediate risk of self-harm and suicide in children and young people: A scoping review. J Child Health Care. 2018; 23(2):178-199. DOI: 10.1177/1367493518787925. View

11.

Hom M, Stanley I, Duffy M, Rogers M, Hanson J, Gutierrez P . Investigating the reliability of suicide attempt history reporting across five measures: A study of US military service members at risk of suicide. J Clin Psychol. 2019; 75(7):1332-1349. DOI: 10.1002/jclp.22776. View

12.

Youngstrom E, Salcedo S, Frazier T, Perez Algorta G . Is the Finding Too Good to Be True? Moving from "More Is Better" to Thinking in Terms of Simple Predictions and Credibility. J Clin Child Adolesc Psychol. 2019; 48(6):811-824. DOI: 10.1080/15374416.2019.1669158. View

13.

Jobes D . The challenge and the promise of clinical suicidology. Suicide Life Threat Behav. 1995; 25(4):437-49. View

14.

Glenn C, Lanzillo E, Esposito E, Santee A, Nock M, Auerbach R . Examining the Course of Suicidal and Nonsuicidal Self-Injurious Thoughts and Behaviors in Outpatient and Inpatient Adolescents. J Abnorm Child Psychol. 2016; 45(5):971-983. PMC: 5397367. DOI: 10.1007/s10802-016-0214-0. View

15.

Liu R, Bettis A, Lawrence H, Walsh R, Sheehan A, Pollak O . Measures of Suicidal Thoughts and Behaviors in Children and Adolescents: A Systematic Review and Recommendations for Use in Clinical and Research Settings. Assessment. 2024; :10731911241249438. DOI: 10.1177/10731911241249438. View

16.

Deming C, Harris J, Castro-Ramirez F, Glenn J, Cha C, Millner A . Inconsistencies in self-reports of suicidal ideation and attempts across assessment methods. Psychol Assess. 2021; 33(3):218-229. DOI: 10.1037/pas0000976. View

17.

Thom R, Hogan C, Hazen E . Suicide Risk Screening in the Hospital Setting: A Review of Brief Validated Tools. Psychosomatics. 2019; 61(1):1-7. DOI: 10.1016/j.psym.2019.08.009. View

18.

Nock M, Borges G, Bromet E, Alonso J, Angermeyer M, Beautrais A . Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry. 2008; 192(2):98-105. PMC: 2259024. DOI: 10.1192/bjp.bp.107.040113. View

19.

De Leo D, Burgis S, Bertolote J, Kerkhof A, Bille-Brahe U . Definitions of suicidal behavior: lessons learned from the WHo/EURO multicentre Study. Crisis. 2006; 27(1):4-15. DOI: 10.1027/0227-5910.27.1.4. View

20.

Mazefsky C, Conner C, Breitenfeldt K, Leezenbaum N, Chen Q, Bylsma L . Evidence Base Update for Questionnaires of Emotion Regulation and Reactivity for Children and Adolescents. J Clin Child Adolesc Psychol. 2021; 50(6):683-707. PMC: 10205090. DOI: 10.1080/15374416.2021.1955372. View