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Campos AI, Van Velzen LS, Veltman DJ, Pozzi E, Ambrogi S, Ballard ED, Banaj N, Başgöze Z, Bellow S, Benedetti F, Bollettini I, Brosch K, Canales-Rodríguez EJ, Clarke-Rubright EK, Colic L, Connolly CG, Courtet P, Cullen KR, Dannlowski U, Dauvermann MR, Davey CG, Deverdun J, Dohm K, Erwin-Grabner T, Goya-Maldonado R, Fani N, Fortea L, Fuentes-Claramonte P, Gonul AS, Gotlib IH, Grotegerd D, Harris MA, Harrison BJ, Haswell CC, Hawkins EL, Hill D, Hirano Y, Ho TC, Jollant F, Jovanovic T, Kircher T, Klimes-Dougan B, le Bars E, Lochner C, McIntosh AM, Meinert S, Mekawi Y, Melloni E, Mitchell P, Morey RA, Nakagawa A, Nenadić I, Olié E, Pereira F, Phillips RD, Piras F, Poletti S, Pomarol-Clotet E, Radua J, Ressler KJ, Roberts G, Rodriguez-Cano E, Sacchet MD, Salvador R, Sandu AL, Shimizu E, Singh A, Spalletta G, Steele JD, Stein DJ, Stein F, Stevens JS, Teresi GI, Uyar-Demir A, van der Wee NJ, van der Werff SJ, van Rooij SJ, Vecchio D, Verdolini N, Vieta E, Waiter GD, Whalley H, Whittle SL, Yang TT, Zarate CA, Thompson PM, Jahanshad N, van Harmelen AL, Blumberg HP, Schmaal L, Rentería ME. Concurrent validity and reliability of suicide risk assessment instruments: A meta-analysis of 20 instruments across 27 international cohorts. Neuropsychology 2023; 37:315-329. [PMID: 37011159 PMCID: PMC10132776 DOI: 10.1037/neu0000850] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVE A major limitation of current suicide research is the lack of power to identify robust correlates of suicidal thoughts or behavior. Variation in suicide risk assessment instruments used across cohorts may represent a limitation to pooling data in international consortia. METHOD Here, we examine this issue through two approaches: (a) an extensive literature search on the reliability and concurrent validity of the most commonly used instruments and (b) by pooling data (N ∼ 6,000 participants) from cohorts from the Enhancing NeuroImaging Genetics Through Meta-Analysis (ENIGMA) Major Depressive Disorder and ENIGMA-Suicidal Thoughts and Behaviour working groups, to assess the concurrent validity of instruments currently used for assessing suicidal thoughts or behavior. RESULTS We observed moderate-to-high correlations between measures, consistent with the wide range (κ range: 0.15-0.97; r range: 0.21-0.94) reported in the literature. Two common multi-item instruments, the Columbia Suicide Severity Rating Scale and the Beck Scale for Suicidal Ideation were highly correlated with each other (r = 0.83). Sensitivity analyses identified sources of heterogeneity such as the time frame of the instrument and whether it relies on self-report or a clinical interview. Finally, construct-specific analyses suggest that suicide ideation items from common psychiatric questionnaires are most concordant with the suicide ideation construct of multi-item instruments. CONCLUSIONS Our findings suggest that multi-item instruments provide valuable information on different aspects of suicidal thoughts or behavior but share a modest core factor with single suicidal ideation items. Retrospective, multisite collaborations including distinct instruments should be feasible provided they harmonize across instruments or focus on specific constructs of suicidality. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Adrian I. Campos
- Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Laura S. Van Velzen
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Dick J. Veltman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Elena Pozzi
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Sonia Ambrogi
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Elizabeth D. Ballard
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Zeynep Başgöze
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Sophie Bellow
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Francesco Benedetti
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Irene Bollettini
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy and CMBB, University of Marburg, Marburg, Germany
| | - Erick J. Canales-Rodríguez
- FIDMAG Germanes Hospitalaries research Foundation, Barcelona, Spain
- CIBERSAM, Barcelona, Spain
- Signal Processing Laboratory (LTS5), EPFL, Lausanne, Switzerland
| | | | - Lejla Colic
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- German Center for Mental Health, Halle-Jena-Magdeburg, Germany
| | - Colm G. Connolly
- Magnetic Resonance Imaging Facility and Department of Biomedical Sciences, Florida State University, Tallahassee, FL, USA
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Kathryn R. Cullen
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Maria R. Dauvermann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- King’s College London, London, United Kingdom
| | - Christopher G. Davey
- Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, VIC, Australia
| | - Jeremy Deverdun
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tracy Erwin-Grabner
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), Department of Psychiatry and Psychotherapy, University Medical Center Goettingen (UMG), Georg-August University, Von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - Roberto Goya-Maldonado
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), Department of Psychiatry and Psychotherapy, University Medical Center Goettingen (UMG), Georg-August University, Von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Lydia Fortea
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | | | - Ali Saffet Gonul
- SoCAT Lab, Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey
- Department of Neuroscience, Institute of Health Sciences, Ege University, Izmir, Turkey
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Mercer University Macon, GA, USA
| | - Ian H. Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Mathew A. Harris
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Ben J. Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Courtney C. Haswell
- Brain Imaging and Analysis Center, Duke University School of Medicine. Durham, NC, USA
| | - Emma L. Hawkins
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Dawson Hill
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Tiffany C. Ho
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
- Department of Psychology, Stanford University, Stanford, CA
- Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Fabrice Jollant
- Université de Paris, Paris, France
- GHU Paris Psychiatrie et Neurosciences, France
- McGill university, McGill Group for Suicide Studies, Montréal, Canada
- CHU Nîmes, department of psychiatrie, France
- Universitätsklinikum Jena, Germany
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy and CMBB, University of Marburg, Marburg, Germany
| | | | - Emmanuelle le Bars
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France
- Department of Neuroradiology, Montpellier University Hospital, Gui de Chauliac Hospital, Montpellier, France
| | - Christine Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry, Stellenbosch University, South Africa
| | - Andrew M. McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Yara Mekawi
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Elisa Melloni
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Philip Mitchell
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Rajendra A. Morey
- Brain Imaging and Analysis Center, Duke University School of Medicine. Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine. Durham, NC, USA
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy and CMBB, University of Marburg, Marburg, Germany
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Fabricio Pereira
- Departments of Radiology and Psychiatry, University Hospital Center of Nîmes, France
- MIPA, University of Nîmes, France
| | - Rachel D. Phillips
- Brain Imaging and Analysis Center, Duke University School of Medicine. Durham, NC, USA
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Sara Poletti
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalaries research Foundation, Barcelona, Spain
- CIBERSAM, Barcelona, Spain
| | - Joaquim Radua
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kerry J. Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Elena Rodriguez-Cano
- FIDMAG Germanes Hospitalaries research Foundation, Barcelona, Spain
- Benito Menni CASM, Sant Boi de Llobregat, Spain
| | - Matthew D. Sacchet
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Raymond Salvador
- FIDMAG Germanes Hospitalaries research Foundation, Barcelona, Spain
- CIBERSAM, Barcelona, Spain
| | - Anca-Larisa Sandu
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Aditya Singh
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), Department of Psychiatry and Psychotherapy, University Medical Center Goettingen (UMG), Georg-August University, Von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
- Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, U.S.A
| | - J. Douglas Steele
- Division of Imaging Science and Technology, Medical School, University of Dundee, Dundee, UK
| | - Dan J. Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy and CMBB, University of Marburg, Marburg, Germany
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Giana I. Teresi
- Department of Psychology, Stanford University, Stanford, CA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Aslihan Uyar-Demir
- SoCAT Lab, Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Nic J. van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- ResearchTheme Neuroscience and Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Sanne J.H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Norma Verdolini
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Gordon D. Waiter
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Heather Whalley
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Sarah L. Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Tony T. Yang
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Carlos A. Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Anne-Laura van Harmelen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Social Security and Resilience Programme, Education and Child Studies, Leiden University, Leiden, the Netherlands
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Radiology and Biomedical Imaging, Yale School of Medicine
- Child Study Center, Yale School of Medicine
| | - Lianne Schmaal
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Miguel E. Rentería
- Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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