Reliability and Validity of the Korean Version of the Ask Suicide-Screening Questions (ASQ)

Suicide Risk Screening Tools for Pediatric Patients: A Systematic Review of Test Accuracy

CONTEXT

Health care settings have increasingly adopted universal suicide risk screening tools into nonpsychiatric pediatric care; however, a systematic review examining the accuracy of these tools does not yet exist.

OBJECTIVE

Identify and review research on the test accuracy of suicide risk screening tools for pediatric patients in nonpsychiatric medical settings.

DATA SOURCES

PubMed and PsycINFO were searched to identify peer-reviewed articles published before March 23, 2023.

STUDY SELECTION

Articles that quantified the accuracy of a suicide risk screening tool (eg, sensitivity, specificity) in a nonpsychiatric medical setting (eg, primary care, specialty care, inpatient or surgical units, or the emergency department) were included.

DATA EXTRACTION

A total of 13 studies were included in this review. Screening tool psychometric properties and study risk of bias were evaluated.

RESULTS

Sensitivity among individual studies ranged from 50% to 100%, and specificity ranged from 58.8% to 96%. Methodological quality was relatively varied, and applicability concerns were low. When stratifying results by screening tool, the Ask Suicide-Screening Questions and Computerized Adaptive Screen for Suicidal Youth had the most robust evidence base.

LIMITATIONS

Because of considerable study heterogeneity, a meta-analytic approach was deemed inappropriate. This prevented us from statistically testing for differences between identified screening tools.

CONCLUSIONS

The Ask Suicide-Screening Questions and Computerized Adaptive Screen for Suicidal Youth exhibit satisfactory test accuracy and appear promising for integration into clinical practice. Although initial findings are promising, additional research targeted at examining the accuracy of screening tools among diverse populations is needed to ensure the equity of screening efforts.

Validity and reliability of a Chinese language suicide screening questionnaire-observer rating (CL-SSQ-OR) assessment for children/adolescents

Background

A Suicide Screening Questionnaire-Observer Rating (SSQ-OR) has been used to assess risk of suicide among individuals and to help clinicians identify and rescue individuals attempting suicide. To prevent the risk of suicide in China, a Chinese language SSQ-OR (CL-SSQ-OR) needs to be introduced.

Objective

To test the validity and reliability of a CL-SSQ-OR.

Method

A total of 250 individuals were enrolled in this study. Each completed a CL-SSQ-OR assessment, Patient Health Questionnaire-9, and the Beck Scale for Suicide Ideation. Confirmatory factor analysis (CFA) was adopted to determine structural validity. Spearman correlation coefficients were adopted to determine criterion validity. An internal correlation coefficient (ICC) was used to test inter-consistency and Cronbach's α coefficient was used to test split-half reliability.

Results

CFA was conducted with use of the maximum variance method to evaluate the item results. All of the items received scores >0.40. In addition, good model fit indices were observed for the two-factor structure RMSEA = 0.046, TLI = 0.965, CFI = 0.977. The items' factor loading of the CL-SSQ-OR in the first factor ranged from 0.443 to 0.878. The items' factor loading of the CL-SSQ-OR in the second factor ranged from 0.400 to 0.810. The ICC of the total CL-SSQ-OR was 0.855. Cronbach's α was 0.873.

Conclusion

The CL-SSQ-OR described here demonstrates ideal psychometric properties and is found to be a suitable tool for screening Chinese children/adolescents who are at risk of suicide.