Concurrent Validity and Reliability of Suicide Risk Assessment Instruments: A Meta-Analysis of 20 Instruments Across 27 International Cohorts

• Published in: Neuropsychology 2023-03, Vol.37 (3), p.315-329
• Main Authors: Campos, Adrian I., Van Velzen, Laura S., Veltman, Dick J., Pozzi, Elena, Ambrogi, Sonia, Ballard, Elizabeth D., Banaj, Nerisa, Başgöze, Zeynep, Bellow, Sophie, Benedetti, Francesco, Bollettini, Irene, Brosch, Katharina, Canales-Rodríguez, Erick J., Clarke-Rubright, Emily K., Colic, Lejla, Connolly, Colm G., Courtet, Philippe, Cullen, Kathryn R., Dannlowski, Udo, Dauvermann, Maria R., Davey, Christopher G., Deverdun, Jeremy, Dohm, Katharina, Erwin-Grabner, Tracy, Goya-Maldonado, Roberto, Fani, Negar, Fortea, Lydia, Fuentes-Claramonte, Paola, Gonul, Ali Saffet, Gotlib, Ian H., Grotegerd, Dominik, Harris, Mathew A., Harrison, Ben J., Haswell, Courtney C., Hawkins, Emma L., Hill, Dawson, Hirano, Yoshiyuki, Ho, Tiffany C., Jollant, Fabrice, Jovanovic, Tanja, Kircher, Tilo, Klimes-Dougan, Bonnie, le Bars, Emmanuelle, Lochner, Christine, McIntosh, Andrew M., Meinert, Susanne, Mekawi, Yara, Melloni, Elisa, Mitchell, Philip, Morey, Rajendra A., Nakagawa, Akiko, Nenadić, Igor, Olié, Emilie, Pereira, Fabricio, Phillips, Rachel D., Piras, Fabrizio, Poletti, Sara, Pomarol-Clotet, Edith, Radua, Joaquim, Ressler, Kerry J., Roberts, Gloria, Rodriguez-Cano, Elena, Sacchet, Matthew D., Salvador, Raymond, Sandu, Anca-Larisa, Shimizu, Eiji, Singh, Aditya, Spalletta, Gianfranco, Steele, J. Douglas, Stein, Dan J., Stein, Frederike, Stevens, Jennifer S., Teresi, Giana I., Uyar-Demir, Aslihan, van der Wee, Nic J., van der Werff, Steven J., van Rooij, Sanne J. H., Vecchio, Daniela, Verdolini, Norma, Vieta, Eduard, Waiter, Gordon D., Whalley, Heather, Whittle, Sarah L., Yang, Tony T., Zarate, Carlos A., Thompson, Paul M., Jahanshad, Neda, van Harmelen, Anne-Laura, Blumberg, Hilary P., Schmaal, Lianne, Rentería, Miguel E.
• Format: Article
• Language: English
• Subjects: Concurrent Validity; Depressive Disorder, Major - diagnosis; Human; Human health and pathology; Humans; Life Sciences; Medicin och hälsovetenskap; Methodology; Neurons and Cognition; Psychiatrics and mental health; Psychological Assessment; Psychology and behavior; Psychometrics; Reproducibility of Results; Retrospective Studies; Risk Assessment; Santé publique et épidémiologie; Statistics; Suicidal Ideation; Suicidality; Suicide; Suicide Risk Assessment; Test Reliability
• ISSN: 0894-4105; 1931-1559; 1931-1559
• DOI: 10.1037/neu0000850

Objective: 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. Method: 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. Results: 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. Conclusions: 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. Key Points Question: To inform future suicide research in multisite international consortia, it is important to examine how different suicide measures relate to each other and whether they can be used interchangeably. Findings: Findings suggest that detailed instruments (such as the Columbia Suicide Severity Rating Scale and Beck Scale for Suicidal Ideation) provide valuable information on suicidal thoughts and behavior and share a core factor with items on suicidal ideation from depression severity rating scale (such as the Hamilton Depression Rating Scale or the Beck Depression Inventory). Importance: Results from i