Concurrent validity and reliability of suicide risk assessment instruments: A meta-analysis of 20 instruments across 27 international cohorts.

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; Courtet P; Connolly CG; Dannlowski U; Cullen KR; Davey CG; Dauvermann MR; Dohm K; Deverdun J; Goya-Maldonado R; Erwin-Grabner T; Fortea L; Fani N; Gonul AS; Fuentes-Claramonte P; Grotegerd D; Gotlib IH; Haswell CC; Hawkins EL; Harris MA; Harrison BJ; Ho TC; Jollant F; Hill D; Hirano Y; Klimes-Dougan B; le Bars E; Jovanovic T; Kircher T; Meinert S; Mekawi Y; Lochner C; McIntosh AM; Nakagawa A; Morey RA; Mitchell P; Melloni E; Phillips RD; Pereira F; Olié E; Nenadić I; Radua J; Pomarol-Clotet E; Poletti S; Piras F; Sacchet MD; Rodriguez-Cano E; Roberts G; Ressler KJ; Spalletta G; Steele JD; Stein DJ; Stein F; Salvador R; Sandu AL; Shimizu E; Singh A; van der Werff SJ; van Rooij SJH; Vecchio D; Verdolini N; Stevens JS; Teresi GI; Uyar-Demir A; van der Wee NJ; Zarate CA; Yang TT; Jahanshad N; Thompson PM; Waiter GD; Vieta E; Whittle SL; Whalley H; Blumberg HP; van Harmelen AL; Rentería ME; Schmaal L

Abstract

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.; 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.; 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).; 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. - METHOD - OBJECTIVE - CONCLUSIONS - RESULTS