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Liu RT, Bettis AH, Lawrence HR, Walsh RFL, Sheehan AE, Pollak OH, Stephenson AR, Kautz MM, Marlowe RM. 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. [PMID: 38742801 DOI: 10.1177/10731911241249438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Empirically supported measures of suicidal thoughts and behaviors (STBs) are needed to serve as reference outcomes for suicide risk screening tools and to monitor severity and treatment progress in children and adolescents with STBs. The present paper systematically reviewed existing measures of STBs in youth and studies evaluating their psychometric properties and clinical utility. Measures were then evaluated on reliability, validity, and clinical utility. Sixteen articles (20 independent samples) were found with psychometric data with youth samples for eight measures. Interview-based measures were found to have the strongest psychometric support and clinical utility. Significant limitations exist for all self-report measures due to inherent characteristics of these measures that cannot be remedied through additional psychometric study. There is an urgent need for the development and validation of new self-report measures of STBs, particularly for preadolescent children, sexual and gender minority youth, and racial/ethnic minority youth.
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Affiliation(s)
- Richard T Liu
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
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Levkovich I, Elyoseph Z. Suicide Risk Assessments Through the Eyes of ChatGPT-3.5 Versus ChatGPT-4: Vignette Study. JMIR Ment Health 2023; 10:e51232. [PMID: 37728984 PMCID: PMC10551796 DOI: 10.2196/51232] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND ChatGPT, a linguistic artificial intelligence (AI) model engineered by OpenAI, offers prospective contributions to mental health professionals. Although having significant theoretical implications, ChatGPT's practical capabilities, particularly regarding suicide prevention, have not yet been substantiated. OBJECTIVE The study's aim was to evaluate ChatGPT's ability to assess suicide risk, taking into consideration 2 discernable factors-perceived burdensomeness and thwarted belongingness-over a 2-month period. In addition, we evaluated whether ChatGPT-4 more accurately evaluated suicide risk than did ChatGPT-3.5. METHODS ChatGPT was tasked with assessing a vignette that depicted a hypothetical patient exhibiting differing degrees of perceived burdensomeness and thwarted belongingness. The assessments generated by ChatGPT were subsequently contrasted with standard evaluations rendered by mental health professionals. Using both ChatGPT-3.5 and ChatGPT-4 (May 24, 2023), we executed 3 evaluative procedures in June and July 2023. Our intent was to scrutinize ChatGPT-4's proficiency in assessing various facets of suicide risk in relation to the evaluative abilities of both mental health professionals and an earlier version of ChatGPT-3.5 (March 14 version). RESULTS During the period of June and July 2023, we found that the likelihood of suicide attempts as evaluated by ChatGPT-4 was similar to the norms of mental health professionals (n=379) under all conditions (average Z score of 0.01). Nonetheless, a pronounced discrepancy was observed regarding the assessments performed by ChatGPT-3.5 (May version), which markedly underestimated the potential for suicide attempts, in comparison to the assessments carried out by the mental health professionals (average Z score of -0.83). The empirical evidence suggests that ChatGPT-4's evaluation of the incidence of suicidal ideation and psychache was higher than that of the mental health professionals (average Z score of 0.47 and 1.00, respectively). Conversely, the level of resilience as assessed by both ChatGPT-4 and ChatGPT-3.5 (both versions) was observed to be lower in comparison to the assessments offered by mental health professionals (average Z score of -0.89 and -0.90, respectively). CONCLUSIONS The findings suggest that ChatGPT-4 estimates the likelihood of suicide attempts in a manner akin to evaluations provided by professionals. In terms of recognizing suicidal ideation, ChatGPT-4 appears to be more precise. However, regarding psychache, there was an observed overestimation by ChatGPT-4, indicating a need for further research. These results have implications regarding ChatGPT-4's potential to support gatekeepers, patients, and even mental health professionals' decision-making. Despite the clinical potential, intensive follow-up studies are necessary to establish the use of ChatGPT-4's capabilities in clinical practice. The finding that ChatGPT-3.5 frequently underestimates suicide risk, especially in severe cases, is particularly troubling. It indicates that ChatGPT may downplay one's actual suicide risk level.
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Affiliation(s)
- Inbar Levkovich
- Oranim Academic College, Faculty of Graduate Studies, Kiryat Tivon, Israel
| | - Zohar Elyoseph
- Department of Psychology and Educational Counseling, The Center for Psychobiological Research, Max Stern Yezreel Valley College, Emek Yezreel, Israel
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
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Liu B, Di X, Apuke OD. Comparative analysis of the effect of interactive audio-visual based art therapy and music therapy in reducing suicidal ideation among school children who survived abduction. Psychiatry Res 2023; 327:115408. [PMID: 37598628 DOI: 10.1016/j.psychres.2023.115408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 06/30/2023] [Accepted: 08/06/2023] [Indexed: 08/22/2023]
Abstract
This study looked at how exposure to interactive TV-based music and art therapy could assist in reducing suicidal thoughts of secondary school female children who survived abduction in Nigeria. A quasi-experiment was carried out in three randomly selected secondary schools in Northern Nigeria. The study sample comprised 470 students divided into three groups to form control group 235, art therapy group 118 and music therapy group 117. Results suggest that participants exposed to interactive TV-based art therapy and music therapy reported a lower score for suicidal ideation compared to the control group that was not exposed to any form of therapy aside from routine clinic checkups. Specifically, those exposed to interactive TV-based art therapy reported a lesser suicidal ideation score than the music and the control group. We recommend the introduction of interactive TV-based music therapy and art therapy in reducing suicidal ideation among children that survived kidnapping in Nigeria.
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Affiliation(s)
- Bin Liu
- College of Music, Shanxi Datong University, Datong 037009, China.
| | - Xin Di
- School of Foreign Language, Handan University, Handan 056001, China.
| | - Oberiri Destiny Apuke
- Faculty of Communication and Media Studies, Department of Mass Communication, Taraba State University, Jalingo PMB 1167, Nigeria.
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Moller CI, Badcock PB, Hetrick SE, Rice S, Berk M, Witt K, Chanen AM, Dean OM, Gao C, Cotton SM, Davey CG. Predictors of suicidal ideation severity among treatment-seeking young people with major depressive disorder: The role of state and trait anxiety. Aust N Z J Psychiatry 2023; 57:1150-1162. [PMID: 36629043 DOI: 10.1177/00048674221144262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Depression and suicidal ideation are closely intertwined. Yet, among young people with depression, the specific factors that contribute to changes in suicidal ideation over time are uncertain. Factors other than depressive symptom severity, such as comorbid psychopathology and personality traits, might be important contributors. Our aim was to identify contributors to fluctuations in suicidal ideation severity over a 12-week period in young people with major depressive disorder receiving cognitive behavioural therapy. METHODS Data were drawn from two 12-week randomised, placebo-controlled treatment trials. Participants (N = 283) were 15-25 years old, with moderate to severe major depressive disorder. The primary outcome measure was the Suicidal Ideation Questionnaire, administered at baseline and weeks 4, 8 and 12. A series of linear mixed models was conducted to examine the relationship between Suicidal Ideation Questionnaire score and demographic characteristics, comorbid psychopathology, personality traits and alcohol use. RESULTS Depression and anxiety symptom severity, and trait anxiety, independently predicted higher suicidal ideation, after adjusting for the effects of time, demographics, affective instability, non-suicidal self-injury and alcohol use. CONCLUSIONS Both state and trait anxiety are important longitudinal correlates of suicidal ideation in depressed young people receiving cognitive behavioural therapy, independent of depression severity. Reducing acute psychological distress, through reducing depression and anxiety symptom severity, is important, but interventions aimed at treating trait anxiety could also potentially be an effective intervention approach for suicidal ideation in young people with depression.
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Affiliation(s)
- Carl I Moller
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Paul B Badcock
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah E Hetrick
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Simon Rice
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health and Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Katrina Witt
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew M Chanen
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Olivia M Dean
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health and Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Caroline Gao
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sue M Cotton
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher G Davey
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
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Katz CC, Gopalan G, Wall E, Leoni-Hughes H, Pargiter T, Collins D. Screening and Assessment of Suicidal Behavior in Transition-Age Youth with Foster Care Involvement. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2023:1-13. [PMID: 36687511 PMCID: PMC9838394 DOI: 10.1007/s10560-023-00913-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
Transition-age youth with foster care involvement (TAY, ages 17-22) are at heightened risk for suicidal behavior. Despite this, mental health screenings are not standardized across child welfare (CW) systems and existing assessment tools are not designed for use with this specific population. As such, TAY are unlikely to be adequately screened for suicide risk and connected with needed services. In this paper, we sought to identify screening and assessment tools that could be effective for use with TAY in CW settings. Using PubMed and PsycINFO, we conducted a search of the current literature to identify some of the most commonly used screening and assessment tools for youth. We then narrowed our focus to those tools that met predefined inclusion criteria indicating appropriateness of use for TAY in CW settings. As a result of this process, we identified one brief screening tool (the ASQ) and four assessments (the SIQ-JR, the C-SSRS, the SHBQ, and the SPS) that demonstrated specific promise for use with TAY. The strengths and limitations of the tools are discussed in detail, as well as the ways that each could be used most effectively in CW settings. We highlight three key points intended to guide social work practice and policy: (1) systematic, routine assessment of mental health and suicide risk across CW settings is critical; (2) the protocol for assessing suicidal behavior in TAY must account for the wide variations in context and service provision; and (3) CW workers administering assessments must be thoughtfully trained on risk identification and the protocol implementation.
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Affiliation(s)
- Colleen C. Katz
- Silberman School of Social Work, Hunter College, CUNY, 2180 3rd Avenue, New York, NY 10035 USA
| | - Geetha Gopalan
- Silberman School of Social Work, Hunter College, CUNY, 2180 3rd Avenue, New York, NY 10035 USA
| | - Eden Wall
- Mount Sinai Adolescent Health Center, New York, NY USA
| | - Hannah Leoni-Hughes
- Silberman School of Social Work, Hunter College, CUNY, 2180 3rd Avenue, New York, NY 10035 USA
| | - Tamsin Pargiter
- Silberman School of Social Work, Hunter College, CUNY, 2180 3rd Avenue, New York, NY 10035 USA
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Choi YH, Yook V, Yang K, Cho Y, Lee DH, Lee HJ, Lee DH, Jeon HJ. Development and validation study of the suicide screening questionnaire-observer rating (SSQ-OR). Front Psychiatry 2022; 13:945051. [PMID: 36032221 PMCID: PMC9411983 DOI: 10.3389/fpsyt.2022.945051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Observer rating scales are necessary to evaluate the risk of suicide because individuals at risk for suicide are often unwilling to seek help on their own. Reliability and validity were evaluated for the newly developed Suicide Screening Questionnaire-Observer Rating (SSQ-OR). METHODS Preliminary items were assessed by 251 experts online and 25 questions were selected. 328 individuals at high-risk and 661 controls from 12 Crisis Response Centers and 5 university counseling centers were recruited to complete SSQ-OR, Beck Scale for Suicide Ideation (BSSI) and Patient Health Questionnaire-9 (PHQ-9). In a 6 months follow-up, we reached out to 176 participants to ask whether they had experienced a suicidal thought, plan, or attempt since the baseline assessment. Cronbach's α, Mann-Whitney U test, Spearman's correlation, factor analyses, Receiver operating characteristic (ROC) analysis and logistic regression analysis were used to verify the SSQ-OR. RESULTS Structural validity was supported by a two-factor solution using exploratory and confirmatory factor analyses. Excellent model fit indices for the two-factor structure using exploratory factor analysis were confirmed (RMSEA = 0.033, TLI = 0.980, CFI = 0.983). The SSQ-OR demonstrated strong internal consistency. The concurrent validity based on the correlations with other self-reported indicators of suicidal potential-BSSI and PHQ-9- revealed substantial relationships. The high-risk group was effectively characterized by a cut-off point of 4, with a sensitivity of 0.73 and a specificity of 0.79. The SSQ-OR scores were significant predictors of suicidal thoughts and behaviors within 6 months. CONCLUSIONS The SSQ-OR exhibits sound psychometric properties, and could be used as a complement to a self-report or clinical-administered scale to screen suicide risk comprehensively.
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Affiliation(s)
- Young-Hwan Choi
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Vidal Yook
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyojin Yang
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yaehee Cho
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Deok Hee Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University College of Education, Seoul, South Korea
| | - Hwa Jung Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University College of Education, Seoul, South Korea
| | - Dong Hun Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University College of Education, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
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Rosario-Williams B, Kaur S, Miranda R. Examining decentering as a moderator in the relation between non-suicidal self-injury and suicide ideation via cognitive-affective factors. Suicide Life Threat Behav 2021; 51:741-754. [PMID: 33724535 PMCID: PMC8387333 DOI: 10.1111/sltb.12747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/09/2020] [Accepted: 01/14/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Given the high prevalence of self-injury but low treatment-seeking among young adults, brief, accessible interventions might help reduce risk of self-injurious thoughts and behavior in this population. This cross-sectional study examined the moderating effects of decentering-a cognitive-affective regulation strategy-in the relation between non-suicidal self-injury (NSSI) and suicide ideation via cognitive-affective factors that increase risk for both NSSI and suicide ideation. METHODS College students (N = 125, 79% women), ages 18-27, pre-screened for moderate levels of depression and anxiety, completed self-report measures of NSSI, decentering, rumination, hopelessness, depressive symptoms, and suicide ideation. RESULTS Young adults with past-year non-suicidal self-injury scored lower on decentering than their peers without NSSI. Decentering was associated with lower levels of all cognitive-affective risk factors and moderated the relation between NSSI and rumination, but not the relation between NSSI and hopelessness and depressive symptoms. Decentering moderated the indirect effect of past-year non-suicidal self-injury on past-week suicide ideation via rumination, but not via hopelessness or depressive symptoms. CONCLUSIONS Decentering is a potential cognitive-affective regulation strategy for targeting factors that increase risk of self-injurious thoughts and behaviors. Future studies should examine decentering as a buffer against risk using designs that allow for conclusions about temporal order of effects.
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Affiliation(s)
| | - Simran Kaur
- Hunter College, City University of New York, New York City, NY, USA
| | - Regina Miranda
- Hunter College and The Graduate Center, City University of New York, New York City, NY, USA
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Taswell C, Donohue C, Mastwyk MT, Louey AG, Giummarra J, Robertson J, Darby DG, Masters CL, Rowe CC. Avoiding methodological bias in studies of amyloid imaging results disclosure. Alzheimers Res Ther 2019; 11:52. [PMID: 31159862 PMCID: PMC6547470 DOI: 10.1186/s13195-019-0495-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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