Citation

Nandy K, Rush AJ, Slater H, Mayes TL, Minhajuddin A, Jha M, Blader JC, Brown R, Emslie G, Fuselier MN, Garza C, Gushanas K, Kennard B, Storch EA, Wakefield SM, Trivedi MH. J. Affect. Disord. 2023; 329: 548-556.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.jad.2023.02.018

PMID

36806661

Abstract

BACKGROUND: This study evaluated the psychometric properties of the 9-item Concise Health Risk Tracking Self-Report (CHRT-SR(9)), a measure of suicidality, in adolescent psychiatric outpatients.

METHODS: Altogether, 933 depressed or suicidal adolescents (12-20 years of age), receiving treatment at psychiatric outpatient clinics in Texas, completed the 16-item CHRT-SR at baseline and one month later. CHRT-SR(9) was extracted from CHRT-SR(16) using multigroup confirmatory factor analysis. Sex and age measurement invariance, classical test theory, item response theory (IRT), and concurrent validity analyses (against the suicidal ideation Item 9 of Patient Health Questionnaire-Adolescent (PHQ-A)) were conducted.

RESULTS: The CHRT-SR(9) demonstrated excellent model fit with four factors (pessimism, helplessness, despair, and suicidal thoughts). Measurement invariance was upheld. Acceptable item-total correlations (0.56-0.80) and internal consistency (Spearman-Brown 0.78-0.89) were revealed. IRT analyses showed a unidimensional instrument with excellent item performance. Using the CHRT-SR(9) total score as a measure of overall suicidality and comparing it against levels of PHQ-A Item 9, the mean (standard deviation) of CHRT-SR(9) total score was 8.64 (SD = 5.97) for no-risk (0 on Item 9), 17.05 (SD = 5.00) for mild, 23.16 (SD = 5.05) for moderate, and 26.96 (SD = 5.24) for severe-risk (3 on Item 9). Significant differences (p-value<0.0001) indicated that CHRT-SR(9) total score distinguished between levels of suicidal risk. Furthermore, CHRT-SR(9) was sensitive to change over a one-month period. LIMITATIONS: Whether CHRT-SR(9) predicts actual suicidal attempts in adolescents is not well defined.

CONCLUSION: The CHRT-SR(9) is an easy-to-administer, user-friendly self-report with good psychometric qualities which makes it an excellent screening measure of suicidal risk in adolescent psychiatric outpatients.

Language: en

Keywords

*Suicidal Ideation; *Suicide/psychology; Adolescent; Concise Health Risk Tracking Scale Self-Report (CHRT-SR); Depression; Depression/psychology; Humans; Outpatients; Psychiatric outpatients; Psychometrics; Reproducibility of Results; Self Report; Suicidal risk; Texas