|Number of pages||12|
|Journal||Journal of Psychopathology and Behavioral Assessment|
|Early online date||15 Aug 2016|
|Publication status||Published - 2017|
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Reevaluating suicidal behaviors : Comparing assessment methods to improve risk evaluations. / Harris, K. M.; Lello, Owen D; Willcox, Christopher H.In: Journal of Psychopathology and Behavioral Assessment, Vol. 39, No. 1, 2017, p. 128-139.
Research output: Contribution to journal › Article
TY - JOUR
T1 - Reevaluating suicidal behaviors
T2 - Comparing assessment methods to improve risk evaluations
AU - Harris, K. M.
AU - Lello, Owen D
AU - Willcox, Christopher H
N1 - Export Date: 25 April 2017 CODEN: JPBAE Correspondence Address: Harris, K.M.; School of Medicine, University of Tasmania, TAS, Australia; email: KHarris@psy.uq.edu.au References: Akaike, H., Likelihood of a model and information criteria (1981) J Econ, 16 (1), pp. 3-14; Alwin, D.F., (2007) Margins of error: A study of reliability in survey measurement, , Wiley, Hoboken, NJ; Baca-Garcia, E., Perez-Rodriguez, M.M., Oquendo, M.A., Keyes, K.M., Hasin, D.S., Grant, B.F., Blanco, C., Estimating risk for suicide attempt: Are we asking the right questions?: Passive suicidal ideation as a marker for suicidal behavior (2011) J Affect Disord, 134 (1-3), pp. 327-332. , PID: 21784532; Beautrais, A.L., Subsequent mortality in medically serious suicide attempts: A 5 year follow-up (2003) Aust N Z J Psychiatry, 37 (5), pp. 595-599. , PID: 14511088; Beck, R.W., Morris, J.B., Beck, A.T., Cross-validation of the Suicidal Intent Scale (1974) Psychol Rep, 34 (2), pp. 445-446. , PID: 4820501; Beck, A.T., Kovacs, M., Weissman, A., Assessment of suicidal intention: The Scale for Suicide Ideation (1979) J Consult Clin Psychol, 47 (2), pp. 343-352. , PID: 469082; Beck, A.T., Brown, G.K., Steer, R.A., Dahlsgaard, K.K., Grisham, J.R., Suicide ideation at its worst point: A predictor of eventual suicide in psychiatric outpatients (1999) Suicide Life Threat Behav, 29 (1), pp. 1-9. , PID: 10322616; Bernert, R.A., Hom, M.A., Roberts, L.W., A review of multidisciplinary clinical practice guidelines in suicide prevention: Toward an emerging standard in suicide risk assessment and management, training and practice (2014) Acad Psychiatry, 38 (5), pp. 585-592. , PID: 25142247; Bevans, K.B., Diamond, G., Levy, S., Screening for adolescents' internalizing symptoms in primary care: Item response theory analysis of the behavior health screen depression, anxiety, and suicidal risk scales (2012) J Dev Behav Pediatr, 33 (4), pp. 283-290. , PID: 22395125; Böhnke, J.R., Croudace, T.J., Factors of psychological distress: Clinical value, measurement substance, and methodological artefacts (2015) Soc Psychiatry Psychiatr Epidemiol, 50 (4), pp. 515-524. , PID: 25682108; Bolton, C., Gooding, P., Kapur, N., Barrowclough, C., Tarrier, N., Developing psychological perspectives of suicidal behaviour and risk in people with a diagnosis of schizophrenia: We know they kill themselves but do we understand why? 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PY - 2017
Y1 - 2017
N2 - This study examined suicide assessment validity by comparing methods of measuring current risk associated with past suicidal behaviors. Three independent samples (Ns = 359, 1007, and 713; aged 18–76 years) all included participants covering a broad spectrum of suicidality. Information theory, item response theory, general linear modeling, and linear regression modeling tested seven competing methods/models of assessing past suicidal behaviors in relation to current suicidality. In contrast to contemporary theories, ANOVA results showed suicide plans can indicate higher risk than suicide attempts when intent to die is higher. Contrary to popular practice, evidence demonstrated that defining risk by suicide ideation (yes/no), attempts or serious attempts (yes/no), are false dichotomies, were the least valid models tested, and failed to explain substantial explainable variance in suicidality/risk. A newly proposed model, differentiating behaviors with or without intent to die, was the most efficacious dichotomous method. However, as predicted, continuous variables were superior to dichotomous. The proposed suicidal barometer model (SBM) exhibited robust evidence as the best available model for evaluating suicidal behaviors in all samples (100 % probability), explaining 47–61 % of suicidality variance and provided incremental improvement in risk evaluations. Findings were consistent by sample, sex, age-group, ethnicity, and psychiatric history. This study, and related evidence, demonstrate that there is a clear and present need for updating measures, clinical training and core competencies, for valid assessment and risk formulation. © 2016, Springer Science+Business Media New York.
AB - This study examined suicide assessment validity by comparing methods of measuring current risk associated with past suicidal behaviors. Three independent samples (Ns = 359, 1007, and 713; aged 18–76 years) all included participants covering a broad spectrum of suicidality. Information theory, item response theory, general linear modeling, and linear regression modeling tested seven competing methods/models of assessing past suicidal behaviors in relation to current suicidality. In contrast to contemporary theories, ANOVA results showed suicide plans can indicate higher risk than suicide attempts when intent to die is higher. Contrary to popular practice, evidence demonstrated that defining risk by suicide ideation (yes/no), attempts or serious attempts (yes/no), are false dichotomies, were the least valid models tested, and failed to explain substantial explainable variance in suicidality/risk. A newly proposed model, differentiating behaviors with or without intent to die, was the most efficacious dichotomous method. However, as predicted, continuous variables were superior to dichotomous. The proposed suicidal barometer model (SBM) exhibited robust evidence as the best available model for evaluating suicidal behaviors in all samples (100 % probability), explaining 47–61 % of suicidality variance and provided incremental improvement in risk evaluations. Findings were consistent by sample, sex, age-group, ethnicity, and psychiatric history. This study, and related evidence, demonstrate that there is a clear and present need for updating measures, clinical training and core competencies, for valid assessment and risk formulation. © 2016, Springer Science+Business Media New York.
KW - Assessment Core competencies Psychometrics Risk evaluation Suicide prevention Test validity Theory
U2 - 10.1007/s10862-016-9566-6
DO - 10.1007/s10862-016-9566-6
M3 - Article
VL - 39
SP - 128
EP - 139
JO - Journal of Psychopathology and Behavioral Assessment
JF - Journal of Psychopathology and Behavioral Assessment
SN - 0882-2689
IS - 1