Global cross-cultural validation of a brief measure for identifying potential suicide risk in 42 countries

OBJECTIVES

This study aimed to examine the psychometric properties of the P4 suicide screener in a multinational sample. The primary goal was to evaluate the reliability and validity of the scale and investigate its convergent validity by analyzing its correlation with depression, anxiety, and substance use.

STUDY DESIGN

The study design is a cross-sectional self-report study conducted across 42 countries.

METHODS

A cross-sectional, self-report study was conducted in 42 countries, with a total of 82,243 participants included in the final data set.

RESULTS

The study provides an overview of suicide ideation rates across 42 countries and confirms the structural validity of the P4 screener. The findings indicated that sexual and gender minority individuals exhibited higher rates of suicidal ideation. The P4 screener showed adequate reliability, convergence, and discriminant validity, and a cutoff score of 1 is recommended to identify individuals at risk of suicidal behavior.

CONCLUSIONS

The study supports the reliability and validity of the P4 suicide screener across 42 diverse countries, highlighting the importance of using a cross-cultural suicide risk assessment to standardize the identification of high-risk individuals and tailoring culturally sensitive suicide prevention strategies.

Factors associated with self- and other-directed aggression in Slovak adolescents

Background

We investigated differences in intrapersonal and interpersonal characteristics of adolescents with and without reported aggressive behaviours (AB). We distinguished two types of intrapersonal factors (self-esteem (SE), self-control (SC)) and three types of interpersonal factors (prosocial peers (PP), supportive relationships at home (SRH), supportive relationships at school (SRS)). We separately examined self-directed aggressive behaviours (self-destructive thoughts, self-destructive behaviour) and other-directed aggressive behaviours (using vulgar words, fighting, physical harm, intimidation, mockery of classmates).

Methods

A representative sample of 1101 adolescents (50.1% female, mean age of 13.5 years) was collected from primary schools in Slovakia. The respondents completed the SE Scale, the SC Scale, the Resilience and Youth Development scale and they were also asked about the frequency of AB. In each form of AB (self- and other-directed) two groups were created: those who reported some AB and those who did not report any AB. Descriptive statistics and nonparametric tests were used for the data analysis.

Results

Almost 75% of the adolescents reported some AB towards others and 41% reported self-harming thoughts or behaviours. Statistically significant differences were observed for both self-directed AB (SE: p<.001, SC: p<.001, PP: p<.001, SRH: p=.013, SRS: p<.001) and other-directed AB (SE: p=.034, SC: p<.001, PP: p<.001, SRH: p=.039, SRS: p=.016). In all cases adolescents who reported AB typically had a lower level of intrapersonal and interpersonal variables compared to those who did not report AB.

Conclusions

The study contributed to the understanding of factors linked to aggressive behaviour of adolescents and confirmed the associations with self-esteem, self-control, supportive relationships at home and at school and having prosocial peers.

Key messages

Aggressive behaviour of adolescents can be linked to interpersonal and intrapersonal relationships. The above holds for both self- and other-directed aggression.

What should parents do to emphasise their disapproval of adolescents’ substance use?

Background

Previous research has shown that one of the strongest predictor of smoking and alcohol consumption in early adolescence is perceived parental approval of such behaviour. The aim of the present study is to explore which parenting practices predict the probability of perceiving parental disapproval of smoking and alcohol consumption in adolescence.

Methods

A representative sample of 1133 early adolescents (mean age = 12.9, SD 0.77) filled in questionnaires including sociodemographic characteristics (3 items), perceived parental risk behaviour (alcohol consumption at least once a week, drunkenness once a month and daily smoking); substance specific conversations with parents (1 item); both emotional and controlling aspects of parenting (6 items), and perceived parental disapproval of adolescents’ smoking and alcohol consumption as dependent variables. Logistic regression was used to analyse the data.

Results

The most important predictor of perceived parental disapproval of alcohol use was behavioural control (setting rules) (OR 2.34), followed by parental non-drinking (OR 1.81) and alcohol specific communication (OR 1.28). Regarding smoking disapproval, the significant predictors were parental non-smoking (OR 1.92); behavioural control (OR 1.79); time spent with a child (OR 1.44) and lower psychological control (guild induction, pressuring, manipulation) (OR 0.69).

Conclusions

Decreasing adolescents’ substance use via increasing their perceived parental disapproval of such behaviour seems to be substance specific. The most salient strategy both for smoking and drinking seems to be the use of behavioural control characterized by clear rules setting and lack of parental own substance use.

Key messages

Decreasing adolescents’ substance use via increasing their perceived parental disapproval of such behaviour seems to be substance specific. The most salient strategy to increase perceived parental disapproval of smoking and alcohol consumption seems to be the use of behavioural control characterized by clear rules setting.