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

Adrian I Campos; Laura S Van Velzen; Dick J Veltman; Elena Pozzi; Sonia Ambrogi; Elizabeth D Ballard; Nerisa Banaj; Zeynep Başgöze; Sophie Bellow; Francesco Benedetti; Irene Bollettini; Katharina Brosch; Erick J Canales-Rodríguez; Emily K Clarke-Rubright; Lejla Colic; Colm G Connolly; Philippe Courtet; Kathryn R Cullen; Udo Dannlowski; Maria R Dauvermann; Christopher G Davey; Jeremy Deverdun; Katharina Dohm; Tracy Erwin-Grabner; Roberto Goya-Maldonado; Negar Fani; Lydia Fortea; Paola Fuentes-Claramonte; Ali Saffet Gonul; Ian H Gotlib; Dominik Grotegerd; Mathew A Harris; Ben J Harrison; Courtney C Haswell; Emma L Hawkins; Dawson Hill; Yoshiyuki Hirano; Tiffany C Ho; Fabrice Jollant; Tanja Jovanovic; Tilo Kircher; Bonnie Klimes-Dougan; Emmanuelle le Bars; Christine Lochner; Andrew M McIntosh; Susanne Meinert; Yara Mekawi; Elisa Melloni; Philip Mitchell; Rajendra A Morey; Akiko Nakagawa; Igor Nenadić; Emilie Olié; Fabricio Pereira; Rachel D Phillips; Fabrizio Piras; Sara Poletti; Edith Pomarol-Clotet; Joaquim Radua; Kerry J Ressler; Gloria Roberts; Elena Rodriguez-Cano; Matthew D Sacchet; Raymond Salvador; Anca-Larisa Sandu; Eiji Shimizu; Aditya Singh; Gianfranco Spalletta; J Douglas Steele; Dan J Stein; Frederike Stein; Jennifer S Stevens; Giana I Teresi; Aslihan Uyar-Demir; Nic J van der Wee; Steven J van der Werff; Sanne J H van Rooij; Daniela Vecchio; Norma Verdolini; Eduard Vieta; Gordon D Waiter; Heather Whalley; Sarah L Whittle; Tony T Yang; Carlos A Zarate; Paul M Thompson; Neda Jahanshad; Anne-Laura van Harmelen; Hilary P Blumberg; Lianne Schmaal; Miguel E Rentería

doi:10.1101/2021.09.15.21263562v1

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

Adrian I Campos, Laura S Van Velzen, Dick J Veltman, Elena Pozzi, Sonia Ambrogi, Elizabeth D Ballard, Nerisa Banaj, Zeynep Başgöze, Sophie Bellow, Francesco Benedetti, Irene Bollettini, Katharina Brosch, Erick J Canales-Rodríguez, Emily K Clarke-Rubright, Lejla Colic, Colm G Connolly, Philippe Courtet, Kathryn R Cullen, Udo Dannlowski, Maria R DauvermannChristopher G Davey, Jeremy Deverdun, Katharina Dohm, Tracy Erwin-Grabner, Roberto Goya-Maldonado, Negar Fani, Lydia Fortea, Paola Fuentes-Claramonte, Ali Saffet Gonul, Ian H Gotlib, Dominik Grotegerd, Mathew A Harris, Ben J Harrison, Courtney C Haswell, Emma L Hawkins, Dawson Hill, Yoshiyuki Hirano, Tiffany C Ho, Fabrice Jollant, Tanja Jovanovic, Tilo Kircher, Bonnie Klimes-Dougan, Emmanuelle le Bars, Christine Lochner, Andrew M McIntosh, Susanne Meinert, Yara Mekawi, Elisa Melloni, Philip Mitchell, Rajendra A Morey, Akiko Nakagawa, Igor Nenadić, Emilie Olié, Fabricio Pereira, Rachel D Phillips, Fabrizio Piras, Sara Poletti, Edith Pomarol-Clotet, Joaquim Radua, Kerry J Ressler, Gloria Roberts, Elena Rodriguez-Cano, Matthew D Sacchet, Raymond Salvador, Anca-Larisa Sandu, Eiji Shimizu, Aditya Singh, Gianfranco Spalletta, J Douglas Steele, Dan J Stein, Frederike Stein, Jennifer S Stevens, Giana I Teresi, Aslihan Uyar-Demir, Nic J van der Wee, Steven J van der Werff, Sanne J H van Rooij, Daniela Vecchio, Norma Verdolini, Eduard Vieta, Gordon D Waiter, Heather Whalley, Sarah L Whittle, Tony T Yang, Carlos A Zarate, Paul M Thompson, Neda Jahanshad, Anne-Laura van Harmelen, Hilary P Blumberg, Lianne Schmaal, Miguel E Rentería

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

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. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Original language	English
Pages (from-to)	315-329
Number of pages	15
Journal	Neuropsychology
Volume	37
Issue number	3
DOIs	https://doi.org/10.1101/2021.09.15.21263562v1 https://doi.org/10.1037/neu0000850
Publication status	Published - Mar 2023

Bibliographical note

Acknowledgements: MER received support from the Australian National Health and Medical Research Council (NHMRC) Centre for Research Excellence on Suicide Prevention (CRESP) [GNT1042580]. LS, LvV, LC, HPB, ALvH, SB and MD were supported by the MQ Brighter Futures Award MQBFC/2. LvV, LS and NJ were supported by the National Institute of Mental Health of the National Institutes of Health under Award Number R01MH117601. LS is supported by a NHMRC Career Development Fellowship (1140764). HPB was additionally supported by: R61MH111929RC1MH088366, R01MH070902, R01MH069747, American Foundation for Suicide Prevention, International Bipolar Foundation, Brain and Behavior Research Foundation,
For the Love of Travis Foundation and Women’s Health Research at Yale. LC was additionally supported by Interdisziplinäres Zentrum für Klinische Forschung, UKJ. PMT was supported in part by NIH grant R01 MH116147. FJ would like to thank dr. S. Richard-Devantoy for his assistance during data collection. This work was supported by the CIBERSAM and the Catalonian Government (2014-SGR-1573 and 2017-SGR-1271 to FIDMAG). PF-C is funded by the Instituto de Salud Carlos III, co-funded by European Union (ERDF/ESF, “Investing in your future”): Sara Borrell contract (CD19/00149). The researchers based in Milan were supported
by an Italian Ministry of Health grant RF-2011-02349921. ALvH was funded through the Leiden University Social Safety and Resilience Programme. The NIMH-ETPB team was supported by the Intramural Research Program at the National Institute of Mental Health, National Institutes of Health (IRP-NIMH-NIH; ZIAMH002927). MS is supported by the Phyllis and Jerome Lyle Rappaport Foundation, Ad Astra Chandaria Foundation, BIAL Foundation, Brain and Behavior Research Foundation, Anonymous donors, and the Center for Depression, Anxiety, and Stress Research at McLean Hospital. The team based at the University of
Minnesota was supported by the National Institute of Mental Health (K23MH090421), the National Alliance for Research on Schizophrenia and Depression, the University of Minnesota Graduate School, the Minnesota Medical Foundation, and the Biotechnology Research Center (P41 RR008079 to the Center for Magnetic Resonance Research), University of Minnesota, and the Deborah E. Powell Center for Women’s Health Seed Grant. IHG was supported by the National Institute of Mental Health grant R37MH101495. EV thanks the support of the Spanish Ministry of Science and Innovation (PI15/00283, PI18/00805) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. NV thanks the support of a BITRECS project that has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 754550 and from “La Caixa” Foundation (ID 100010434), under the agreement LCF/PR/GN18/50310006.
For the team in Nimes, CINES grants access to HPC facilities (A0100311413). The team based in Rome was supported by an Italian Ministry of Health grant RC17-18-19-20-21/A. Support for the TIGER study includes the Klingenstein Third Generation Foundation, the National Institute of Mental Health (K01MH117442), the Stanford Maternal Child Health Research Institute, and the Stanford Center for Cognitive and Neurobiological Imaging. TCH receives partial support from the Ray and Dagmar Dolby Family Fund. The UCSF site was supported by the National Center for Complementary and Integrative Health (NCCIH) R21AT009173 and R61AT009864 to TTY; by the National Center for Advancing Translational Sciences (CTSI), National Institutes
of Health, through UCSF-CTSI UL1TR001872 to TTY; by the American Foundation for Suicide Prevention (AFSP) SRG-1-141-18 to TTY; by UCSF Research Evaluation and Allocation Committee (REAC) and J. Jacobson Fund to TTY; by the National Institute of Mental Health (NIMH) R01MH085734 and the Brain and Behavior Research Foundation (formerly NARSAD) to TTY. The team at Duke University/Durham VA medical center were supported by the VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC). The Moral Dilemma study was supported by the Brain & Behavior Research Foundation, and by the National Health and Medical Research Council (ID 1125504 to SLW). The FOR2107 Marburg site was
supported by the German Research Foundation (DFG, grant FOR2107 KI588/14-1 and FOR2107 KI588/14-2 to Tilo Kircher, Marburg). The FOR2107 Muenster site was supported by the German Research Foundation (DFG, grant FOR2107 DA1151/5-1 and DA1151/5-2 to UD; SFB-TRR58, Projects C09 and Z02 to UD) and the Interdisciplinary Center for Clinical Research (IZKF) of the medical faculty of Münster (grant Dan3/012/17 to UD). CGD and BJH were supported by the National Health and Medical Research Council of Australia (NHMRC) Project Grants (1064643 and 1024570). NF was supported by the National Institute of Mental Health (MH111671) and National Center for Complementary and Integrative Health (R01AT011267). TJ was
supported by the National Institutes Health Project Grants (MH098212) to TJ. JR and LF thank the support of the Spanish Ministry of Science and Innovation (PI19/00394 and CPII19/00009) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM). YH, AN, ES were supported by AMED Brain/MINDS Beyond program Grant No. 20dm0307002, YH was supported by JSPS KAKENHI Grants No. 19K03309.

Keywords

Humans
Depressive Disorder, Major/diagnosis
Reproducibility of Results
Retrospective Studies
Suicidal Ideation
Risk Assessment

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Campos, A. I., Van Velzen, L. S., Veltman, D. J., Pozzi, E., Ambrogi, S., Ballard, E. D., Banaj, N., Başgöze, Z., Bellow, S., Benedetti, F., Bollettini, I., Brosch, K., Canales-Rodríguez, E. J., Clarke-Rubright, E. K., Colic, L., Connolly, C. G., Courtet, P., Cullen, K. R., Dannlowski, U., ... Rentería, M. E. (2023). Concurrent validity and reliability of suicide risk assessment instruments: A meta-analysis of 20 instruments across 27 international cohorts. Neuropsychology, 37(3), 315-329. https://doi.org/10.1101/2021.09.15.21263562v1, https://doi.org/10.1037/neu0000850

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, Connolly, CG, Courtet, P, Cullen, KR, Dannlowski, U, Dauvermann, MR, Davey, CG, Deverdun, J, Dohm, K, Erwin-Grabner, T, Goya-Maldonado, R, Fani, N, Fortea, L, Fuentes-Claramonte, P, Gonul, AS, Gotlib, IH, Grotegerd, D, Harris, MA, Harrison, BJ, Haswell, CC, Hawkins, EL, Hill, D, Hirano, Y, Ho, TC, Jollant, F, Jovanovic, T, Kircher, T, Klimes-Dougan, B, le Bars, E, Lochner, C, McIntosh, AM, Meinert, S, Mekawi, Y, Melloni, E, Mitchell, P, Morey, RA, Nakagawa, A, Nenadić, I, Olié, E, Pereira, F, Phillips, RD, Piras, F, Poletti, S, Pomarol-Clotet, E, Radua, J, Ressler, KJ, Roberts, G, Rodriguez-Cano, E, Sacchet, MD, Salvador, R, Sandu, A-L, Shimizu, E, Singh, A, Spalletta, G, Steele, JD, Stein, DJ, Stein, F, Stevens, JS, Teresi, GI, Uyar-Demir, A, van der Wee, NJ, van der Werff, SJ, van Rooij, SJH, Vecchio, D, Verdolini, N, Vieta, E, Waiter, GD, Whalley, H, Whittle, SL, Yang, TT, Zarate, CA, Thompson, PM, Jahanshad, N, van Harmelen, A-L, Blumberg, HP, Schmaal, L & Rentería, ME 2023, 'Concurrent validity and reliability of suicide risk assessment instruments: A meta-analysis of 20 instruments across 27 international cohorts', Neuropsychology, vol. 37, no. 3, pp. 315-329. https://doi.org/10.1101/2021.09.15.21263562v1, https://doi.org/10.1037/neu0000850

@article{c5de8c5deef1477da50e2565a7fa626c,

title = "Concurrent validity and reliability of suicide risk assessment instruments: A meta-analysis of 20 instruments across 27 international cohorts",

abstract = "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. (PsycInfo Database Record (c) 2023 APA, all rights reserved).",

keywords = "Humans, Depressive Disorder, Major/diagnosis, Reproducibility of Results, Retrospective Studies, Suicidal Ideation, Risk Assessment",

author = "Campos, {Adrian I} and {Van Velzen}, {Laura S} and Veltman, {Dick J} and Elena Pozzi and Sonia Ambrogi and Ballard, {Elizabeth D} and Nerisa Banaj and Zeynep Ba{\c s}g{\"o}ze and Sophie Bellow and Francesco Benedetti and Irene Bollettini and Katharina Brosch and Canales-Rodr{\'i}guez, {Erick J} and Clarke-Rubright, {Emily K} and Lejla Colic and Connolly, {Colm G} and Philippe Courtet and Cullen, {Kathryn R} and Udo Dannlowski and Dauvermann, {Maria R} and Davey, {Christopher G} and Jeremy Deverdun and Katharina Dohm and Tracy Erwin-Grabner and Roberto Goya-Maldonado and Negar Fani and Lydia Fortea and Paola Fuentes-Claramonte and Gonul, {Ali Saffet} and Gotlib, {Ian H} and Dominik Grotegerd and Harris, {Mathew A} and Harrison, {Ben J} and Haswell, {Courtney C} and Hawkins, {Emma L} and Dawson Hill and Yoshiyuki Hirano and Ho, {Tiffany C} and Fabrice Jollant and Tanja Jovanovic and Tilo Kircher and Bonnie Klimes-Dougan and {le Bars}, Emmanuelle and Christine Lochner and McIntosh, {Andrew M} and Susanne Meinert and Yara Mekawi and Elisa Melloni and Philip Mitchell and Morey, {Rajendra A} and Akiko Nakagawa and Igor Nenadi{\'c} and Emilie Oli{\'e} and Fabricio Pereira and Phillips, {Rachel D} and Fabrizio Piras and Sara Poletti and Edith Pomarol-Clotet and Joaquim Radua and Ressler, {Kerry J} and Gloria Roberts and Elena Rodriguez-Cano and Sacchet, {Matthew D} and Raymond Salvador and Anca-Larisa Sandu and Eiji Shimizu and Aditya Singh and Gianfranco Spalletta and Steele, {J Douglas} and Stein, {Dan J} and Frederike Stein and Stevens, {Jennifer S} and Teresi, {Giana I} and Aslihan Uyar-Demir and {van der Wee}, {Nic J} and {van der Werff}, {Steven J} and {van Rooij}, {Sanne J H} and Daniela Vecchio and Norma Verdolini and Eduard Vieta and Waiter, {Gordon D} and Heather Whalley and Whittle, {Sarah L} and Yang, {Tony T} and Zarate, {Carlos A} and Thompson, {Paul M} and Neda Jahanshad and {van Harmelen}, Anne-Laura and Blumberg, {Hilary P} and Lianne Schmaal and Renter{\'i}a, {Miguel E}",

note = "Acknowledgements: MER received support from the Australian National Health and Medical Research Council (NHMRC) Centre for Research Excellence on Suicide Prevention (CRESP) [GNT1042580]. LS, LvV, LC, HPB, ALvH, SB and MD were supported by the MQ Brighter Futures Award MQBFC/2. LvV, LS and NJ were supported by the National Institute of Mental Health of the National Institutes of Health under Award Number R01MH117601. LS is supported by a NHMRC Career Development Fellowship (1140764). HPB was additionally supported by: R61MH111929RC1MH088366, R01MH070902, R01MH069747, American Foundation for Suicide Prevention, International Bipolar Foundation, Brain and Behavior Research Foundation, For the Love of Travis Foundation and Women{\textquoteright}s Health Research at Yale. LC was additionally supported by Interdisziplin{\"a}res Zentrum f{\"u}r Klinische Forschung, UKJ. PMT was supported in part by NIH grant R01 MH116147. FJ would like to thank dr. S. Richard-Devantoy for his assistance during data collection. This work was supported by the CIBERSAM and the Catalonian Government (2014-SGR-1573 and 2017-SGR-1271 to FIDMAG). PF-C is funded by the Instituto de Salud Carlos III, co-funded by European Union (ERDF/ESF, “Investing in your future”): Sara Borrell contract (CD19/00149). The researchers based in Milan were supported by an Italian Ministry of Health grant RF-2011-02349921. ALvH was funded through the Leiden University Social Safety and Resilience Programme. The NIMH-ETPB team was supported by the Intramural Research Program at the National Institute of Mental Health, National Institutes of Health (IRP-NIMH-NIH; ZIAMH002927). MS is supported by the Phyllis and Jerome Lyle Rappaport Foundation, Ad Astra Chandaria Foundation, BIAL Foundation, Brain and Behavior Research Foundation, Anonymous donors, and the Center for Depression, Anxiety, and Stress Research at McLean Hospital. The team based at the University of Minnesota was supported by the National Institute of Mental Health (K23MH090421), the National Alliance for Research on Schizophrenia and Depression, the University of Minnesota Graduate School, the Minnesota Medical Foundation, and the Biotechnology Research Center (P41 RR008079 to the Center for Magnetic Resonance Research), University of Minnesota, and the Deborah E. Powell Center for Women{\textquoteright}s Health Seed Grant. IHG was supported by the National Institute of Mental Health grant R37MH101495. EV thanks the support of the Spanish Ministry of Science and Innovation (PI15/00283, PI18/00805) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirecci{\'o}n General de Evaluaci{\'o}n and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d{\textquoteright}Universitats i Recerca del Departament d{\textquoteright}Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. NV thanks the support of a BITRECS project that has received funding from the European Union{\textquoteright}s Horizon 2020 research and innovation programme under the Marie Sk{\l}odowska-Curie grant agreement No 754550 and from “La Caixa” Foundation (ID 100010434), under the agreement LCF/PR/GN18/50310006. For the team in Nimes, CINES grants access to HPC facilities (A0100311413). The team based in Rome was supported by an Italian Ministry of Health grant RC17-18-19-20-21/A. Support for the TIGER study includes the Klingenstein Third Generation Foundation, the National Institute of Mental Health (K01MH117442), the Stanford Maternal Child Health Research Institute, and the Stanford Center for Cognitive and Neurobiological Imaging. TCH receives partial support from the Ray and Dagmar Dolby Family Fund. The UCSF site was supported by the National Center for Complementary and Integrative Health (NCCIH) R21AT009173 and R61AT009864 to TTY; by the National Center for Advancing Translational Sciences (CTSI), National Institutes of Health, through UCSF-CTSI UL1TR001872 to TTY; by the American Foundation for Suicide Prevention (AFSP) SRG-1-141-18 to TTY; by UCSF Research Evaluation and Allocation Committee (REAC) and J. Jacobson Fund to TTY; by the National Institute of Mental Health (NIMH) R01MH085734 and the Brain and Behavior Research Foundation (formerly NARSAD) to TTY. The team at Duke University/Durham VA medical center were supported by the VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC). The Moral Dilemma study was supported by the Brain & Behavior Research Foundation, and by the National Health and Medical Research Council (ID 1125504 to SLW). The FOR2107 Marburg site was supported by the German Research Foundation (DFG, grant FOR2107 KI588/14-1 and FOR2107 KI588/14-2 to Tilo Kircher, Marburg). The FOR2107 Muenster site was supported by the German Research Foundation (DFG, grant FOR2107 DA1151/5-1 and DA1151/5-2 to UD; SFB-TRR58, Projects C09 and Z02 to UD) and the Interdisciplinary Center for Clinical Research (IZKF) of the medical faculty of M{\"u}nster (grant Dan3/012/17 to UD). CGD and BJH were supported by the National Health and Medical Research Council of Australia (NHMRC) Project Grants (1064643 and 1024570). NF was supported by the National Institute of Mental Health (MH111671) and National Center for Complementary and Integrative Health (R01AT011267). TJ was supported by the National Institutes Health Project Grants (MH098212) to TJ. JR and LF thank the support of the Spanish Ministry of Science and Innovation (PI19/00394 and CPII19/00009) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirecci{\'o}n General de Evaluaci{\'o}n and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM). YH, AN, ES were supported by AMED Brain/MINDS Beyond program Grant No. 20dm0307002, YH was supported by JSPS KAKENHI Grants No. 19K03309. ",

year = "2023",

month = mar,

doi = "10.1101/2021.09.15.21263562v1",

language = "English",

volume = "37",

pages = "315--329",

journal = "Neuropsychology",

issn = "0894-4105",

publisher = "American Psychological Association Inc.",

number = "3",

}

TY - JOUR

T1 - Concurrent validity and reliability of suicide risk assessment instruments

T2 - A meta-analysis of 20 instruments across 27 international cohorts

AU - Campos, Adrian I

AU - Van Velzen, Laura S

AU - Veltman, Dick J

AU - Pozzi, Elena

AU - Ambrogi, Sonia

AU - Ballard, Elizabeth D

AU - Banaj, Nerisa

AU - Başgöze, Zeynep

AU - Bellow, Sophie

AU - Benedetti, Francesco

AU - Bollettini, Irene

AU - Brosch, Katharina

AU - Canales-Rodríguez, Erick J

AU - Clarke-Rubright, Emily K

AU - Colic, Lejla

AU - Connolly, Colm G

AU - Courtet, Philippe

AU - Cullen, Kathryn R

AU - Dannlowski, Udo

AU - Dauvermann, Maria R

AU - Davey, Christopher G

AU - Deverdun, Jeremy

AU - Dohm, Katharina

AU - Erwin-Grabner, Tracy

AU - Goya-Maldonado, Roberto

AU - Fani, Negar

AU - Fortea, Lydia

AU - Fuentes-Claramonte, Paola

AU - Gonul, Ali Saffet

AU - Gotlib, Ian H

AU - Grotegerd, Dominik

AU - Harris, Mathew A

AU - Harrison, Ben J

AU - Haswell, Courtney C

AU - Hawkins, Emma L

AU - Hill, Dawson

AU - Hirano, Yoshiyuki

AU - Ho, Tiffany C

AU - Jollant, Fabrice

AU - Jovanovic, Tanja

AU - Kircher, Tilo

AU - Klimes-Dougan, Bonnie

AU - le Bars, Emmanuelle

AU - Lochner, Christine

AU - McIntosh, Andrew M

AU - Meinert, Susanne

AU - Mekawi, Yara

AU - Melloni, Elisa

AU - Mitchell, Philip

AU - Morey, Rajendra A

AU - Nakagawa, Akiko

AU - Nenadić, Igor

AU - Olié, Emilie

AU - Pereira, Fabricio

AU - Phillips, Rachel D

AU - Piras, Fabrizio

AU - Poletti, Sara

AU - Pomarol-Clotet, Edith

AU - Radua, Joaquim

AU - Ressler, Kerry J

AU - Roberts, Gloria

AU - Rodriguez-Cano, Elena

AU - Sacchet, Matthew D

AU - Salvador, Raymond

AU - Sandu, Anca-Larisa

AU - Shimizu, Eiji

AU - Singh, Aditya

AU - Spalletta, Gianfranco

AU - Steele, J Douglas

AU - Stein, Dan J

AU - Stein, Frederike

AU - Stevens, Jennifer S

AU - Teresi, Giana I

AU - Uyar-Demir, Aslihan

AU - van der Wee, Nic J

AU - van der Werff, Steven J

AU - van Rooij, Sanne J H

AU - Vecchio, Daniela

AU - Verdolini, Norma

AU - Vieta, Eduard

AU - Waiter, Gordon D

AU - Whalley, Heather

AU - Whittle, Sarah L

AU - Yang, Tony T

AU - Zarate, Carlos A

AU - Thompson, Paul M

AU - Jahanshad, Neda

AU - van Harmelen, Anne-Laura

AU - Blumberg, Hilary P

AU - Schmaal, Lianne

AU - Rentería, Miguel E

N1 - Acknowledgements: MER received support from the Australian National Health and Medical Research Council (NHMRC) Centre for Research Excellence on Suicide Prevention (CRESP) [GNT1042580]. LS, LvV, LC, HPB, ALvH, SB and MD were supported by the MQ Brighter Futures Award MQBFC/2. LvV, LS and NJ were supported by the National Institute of Mental Health of the National Institutes of Health under Award Number R01MH117601. LS is supported by a NHMRC Career Development Fellowship (1140764). HPB was additionally supported by: R61MH111929RC1MH088366, R01MH070902, R01MH069747, American Foundation for Suicide Prevention, International Bipolar Foundation, Brain and Behavior Research Foundation, For the Love of Travis Foundation and Women’s Health Research at Yale. LC was additionally supported by Interdisziplinäres Zentrum für Klinische Forschung, UKJ. PMT was supported in part by NIH grant R01 MH116147. FJ would like to thank dr. S. Richard-Devantoy for his assistance during data collection. This work was supported by the CIBERSAM and the Catalonian Government (2014-SGR-1573 and 2017-SGR-1271 to FIDMAG). PF-C is funded by the Instituto de Salud Carlos III, co-funded by European Union (ERDF/ESF, “Investing in your future”): Sara Borrell contract (CD19/00149). The researchers based in Milan were supported by an Italian Ministry of Health grant RF-2011-02349921. ALvH was funded through the Leiden University Social Safety and Resilience Programme. The NIMH-ETPB team was supported by the Intramural Research Program at the National Institute of Mental Health, National Institutes of Health (IRP-NIMH-NIH; ZIAMH002927). MS is supported by the Phyllis and Jerome Lyle Rappaport Foundation, Ad Astra Chandaria Foundation, BIAL Foundation, Brain and Behavior Research Foundation, Anonymous donors, and the Center for Depression, Anxiety, and Stress Research at McLean Hospital. The team based at the University of Minnesota was supported by the National Institute of Mental Health (K23MH090421), the National Alliance for Research on Schizophrenia and Depression, the University of Minnesota Graduate School, the Minnesota Medical Foundation, and the Biotechnology Research Center (P41 RR008079 to the Center for Magnetic Resonance Research), University of Minnesota, and the Deborah E. Powell Center for Women’s Health Seed Grant. IHG was supported by the National Institute of Mental Health grant R37MH101495. EV thanks the support of the Spanish Ministry of Science and Innovation (PI15/00283, PI18/00805) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. NV thanks the support of a BITRECS project that has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 754550 and from “La Caixa” Foundation (ID 100010434), under the agreement LCF/PR/GN18/50310006. For the team in Nimes, CINES grants access to HPC facilities (A0100311413). The team based in Rome was supported by an Italian Ministry of Health grant RC17-18-19-20-21/A. Support for the TIGER study includes the Klingenstein Third Generation Foundation, the National Institute of Mental Health (K01MH117442), the Stanford Maternal Child Health Research Institute, and the Stanford Center for Cognitive and Neurobiological Imaging. TCH receives partial support from the Ray and Dagmar Dolby Family Fund. The UCSF site was supported by the National Center for Complementary and Integrative Health (NCCIH) R21AT009173 and R61AT009864 to TTY; by the National Center for Advancing Translational Sciences (CTSI), National Institutes of Health, through UCSF-CTSI UL1TR001872 to TTY; by the American Foundation for Suicide Prevention (AFSP) SRG-1-141-18 to TTY; by UCSF Research Evaluation and Allocation Committee (REAC) and J. Jacobson Fund to TTY; by the National Institute of Mental Health (NIMH) R01MH085734 and the Brain and Behavior Research Foundation (formerly NARSAD) to TTY. The team at Duke University/Durham VA medical center were supported by the VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC). The Moral Dilemma study was supported by the Brain & Behavior Research Foundation, and by the National Health and Medical Research Council (ID 1125504 to SLW). The FOR2107 Marburg site was supported by the German Research Foundation (DFG, grant FOR2107 KI588/14-1 and FOR2107 KI588/14-2 to Tilo Kircher, Marburg). The FOR2107 Muenster site was supported by the German Research Foundation (DFG, grant FOR2107 DA1151/5-1 and DA1151/5-2 to UD; SFB-TRR58, Projects C09 and Z02 to UD) and the Interdisciplinary Center for Clinical Research (IZKF) of the medical faculty of Münster (grant Dan3/012/17 to UD). CGD and BJH were supported by the National Health and Medical Research Council of Australia (NHMRC) Project Grants (1064643 and 1024570). NF was supported by the National Institute of Mental Health (MH111671) and National Center for Complementary and Integrative Health (R01AT011267). TJ was supported by the National Institutes Health Project Grants (MH098212) to TJ. JR and LF thank the support of the Spanish Ministry of Science and Innovation (PI19/00394 and CPII19/00009) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM). YH, AN, ES were supported by AMED Brain/MINDS Beyond program Grant No. 20dm0307002, YH was supported by JSPS KAKENHI Grants No. 19K03309.

PY - 2023/3

Y1 - 2023/3

N2 - 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. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

AB - 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. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

KW - Humans

KW - Depressive Disorder, Major/diagnosis

KW - Reproducibility of Results

KW - Retrospective Studies

KW - Suicidal Ideation

KW - Risk Assessment

U2 - 10.1101/2021.09.15.21263562v1

DO - 10.1101/2021.09.15.21263562v1

M3 - Article

C2 - 37011159

SN - 0894-4105

VL - 37

SP - 315

EP - 329

JO - Neuropsychology

JF - Neuropsychology

IS - 3

ER -

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

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