Department of Psychiatry at UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9119, United States.
UT Southwestern Medical Center and the Department of Psychiatry at Children's Health Systems of Texas, Children's Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9119, United States.
J Affect Disord. 2018 Aug 1;235:45-51. doi: 10.1016/j.jad.2018.03.007. Epub 2018 Mar 26.
Several self-report rating scales have been developed to assess suicidal ideation, yet few examine other factors related to increased suicidal risk, and even fewer have been validated in both adolescents and adults. We evaluate the 14-item Concise Health Risk Tracking - Self Report (CHRT-SR), a measure previously validated in adults, in a sample of adolescents at risk for suicide.
Data are from a retrospective chart review of adolescents treated in an intensive outpatient program for youth with severe suicidality. Teens completed the CHRT-SR and Quick Inventory of Depressive Symptomatology - Adolescents (QIDS-A) at baseline and discharge. The CHRT-SR was evaluated to determine the factor validity, internal consistency, construct validity, and sensitivity to change.
Adolescents (n = 271) completed the CHRT-SR prior to treatment, and 231 completed the CHRT-SR at discharge. Three factors were identified with excellent model fit: Propensity, Impulsivity, and Suicidal Thoughts. Internal consistency reliability coefficients were good-to-excellent for the total score and all three factors at baseline (a = 0.774-0.915) and exit (a = 0.849-0.941). The total score and all three factors significantly correlated with overall depression severity and suicidal ideation as rated by teens and parent (p = .704-0.756, all p < .001). The CHRT-SR was sensitive to change, with moderate to large effect sizes (Cohen's d = 0.599-1.062).
Study limitations include generalizability, lack of a control group, and retrospective data from a sample of opportunity.
The CHRT-SR is a reliable and valid measure for examining severity of suicidal thoughts and associated risk factors, and is sensitive to change following an intervention in adolescents.
已经开发出几种自评量表来评估自杀意念，但很少有量表检查与自杀风险增加相关的其他因素，甚至更少的量表在青少年和成人中都得到了验证。我们评估了先前在成人中验证过的 14 项简明健康风险追踪-自评量表（CHRT-SR），该量表在有自杀风险的青少年样本中进行了评估。
数据来自对在青少年严重自杀倾向强化门诊计划中接受治疗的青少年进行的回顾性图表审查。青少年在基线和出院时完成了 CHRT-SR 和青少年抑郁症状快速清单（QIDS-A）。评估 CHRT-SR 以确定其因子有效性、内部一致性、结构有效性和对变化的敏感性。
有 271 名青少年在治疗前完成了 CHRT-SR，有 231 名青少年在出院时完成了 CHRT-SR。有三个因素被确定为具有极好的模型拟合度：倾向、冲动和自杀念头。在基线时，总分和所有三个因素的内部一致性可靠性系数均为良好至优秀（a=0.774-0.915），在出院时的可靠性系数也为良好至优秀（a=0.849-0.941）。总分和所有三个因素均与青少年和家长评估的总体抑郁严重程度和自杀意念显著相关（p=0.704-0.756，均 p<0.001）。CHRT-SR 对变化敏感，具有中等至较大的效应量（Cohen's d=0.599-1.062）。
研究的局限性包括普遍性、缺乏对照组以及机会样本的回顾性数据。
CHRT-SR 是一种可靠有效的评估自杀意念严重程度和相关风险因素的工具，并且在干预后对变化敏感。
