Validez y confiabilidad de la escala afecto, cognición y comportamiento para tamizar el riesgo de suicidio en adultos

Accurate suicide risk assessment has proven elusive for clinical and research purposes. High false positive rates have pushed the discipline to reckon with inaccurate risk screening devices. Mounting suicide rates and strained resources in the Global South require brief, but accurate, self-report tools to ease and expedite screening. A good candidate is the public domain 8-item self-administered Suicidality Scale (SS) derived from the Suicidal Affect-Behavior-Cognition Scale (SABCS), a valid, theoretically-grounded suicidal scale with high predictive ability. Spanish translation, validation and evaluation of the scale’s psychometric properties were carried out in Colombia in a prospective transversal study, with a mixed sample of psychiatric patients and healthy community members (N = 313, 132 Female, aged 18 - 65). In addition, 6 mental health professionals (4 psychiatrists and 2 psychologists) assessed participants on a five-level clinical risk outcome (0 = no risk, 4 = extreme risk). Multiple models examined unidimensionality, internal consistency, and validity. Instrument bias was tested by sex, age, and psychiatric diagnosis. All models showed strong fit and low error for the SS, but did not support using an item on history of past suicide attempts to accurately reflect current risk. Internal consistency was high, (ωt = .96). Clinical suicide risk decisions correlated strongly with SS scores (r = .84), however, there was significant variance in suicidality at each clinical risk level. These results provide strong validation for the Colombian-Spanish version of SS. However, translating valid psychometric data into the most appropriate clinical decisions still requires additional longitudinal study.