Hedley Darren, Williams Zachary J, Deady Mark, Batterham Philip J, Bury Simon M, Brown Claire M, Robinson Jo, Trollor Julian N, Uljarević Mirko, Stokes Mark A
La Trobe University, Australia.
Deakin University, Australia.
Autism. 2025 Mar;29(3):766-787. doi: 10.1177/13623613241289493. Epub 2024 Oct 19.
The increased prevalence of suicide among autistic people highlights the need for validated clinical suicide screening and assessment instruments that are accessible and meet the unique language and communication needs of this population. We describe the preliminary preregistered psychometric validation of the Suicide Assessment Kit-Modified Interview, in a sample of 98 autistic adults (58% women, 34% men, 7% nonbinary; 41.65, 12.96). A four-item negative affect score derived from the Suicide Assessment Kit-Modified Interview demonstrated adequate reliability (ω = 0.796, BCa 95% confidence interval = [0.706, 0.857]), as well as good convergent validity with related measures. Ordinal Suicide Assessment Kit-Modified Interview "categories" (1-5) demonstrated divergent validity (s = -0.067 to 0.081) and good convergent validity, strongly correlating with mental health (s = 0.446 to 0.744) and suicide assessment instruments (s = 0.576 to 0.696). Suicide Assessment Kit-Modified Interview categories showed strong ability to predict participants identified by clinicians as "above low risk" of future suicide attempt (area under the curve = 0.887, posterior = 0.889, 95% credible interval = [0.810, 0.954], = 0.976). Suicide Assessment Kit-Modified Interview classifications > "Category 3" provided an observed sensitivity of 0.750 ( = 0.810, [0.669, 0.948], = 0.544) and an observed specificity of 0.895 ( = 0.899, [0.833, 0.956], = 0.995) for "above low risk" status. Our findings indicate that the Suicide Assessment Kit-Modified Interview is a psychometrically strong clinical assessment tool for suicidal behavior that can be validly administered to autistic adults without intellectual disability.Lay AbstractPeople with a diagnosis of autism are at increased risk of death by suicide. There is a need for clinical instruments that are adapted to the needs of autistic people. In this study, we modified and evaluated a clinical suicide interview (Suicide Assessment Kit-Modified Interview) for use with autistic people who do not have an intellectual disability. Autistic people helped us to modify the original version of the instrument by improving the questions, providing explanations for difficult terms or concepts, and recommending that we use different rating scales. Our results support the use of Suicide Assessment Kit-Modified Interview for assessing autistic adults without intellectual disability for suicidal thoughts and behavior. In the future, we will test how well Suicide Assessment Kit-Modified Interview works in clinical settings and with different clinical populations.
自闭症患者自杀率的上升凸显了对经过验证的临床自杀筛查和评估工具的需求，这些工具应易于获取，并满足该人群独特的语言和沟通需求。我们描述了自杀评估工具修订版访谈在98名自闭症成年人样本（58%为女性，34%为男性，7%为非二元性别；年龄41.65岁，标准差12.96）中的初步预注册心理测量学验证。从自杀评估工具修订版访谈中得出的一个四项消极情绪得分显示出足够的信度（ω = 0.796，偏差校正95%置信区间 = [0.706, 0.857]），以及与相关测量指标良好的收敛效度。顺序性的自杀评估工具修订版访谈“类别”（1 - 5）显示出区分效度（斯皮尔曼相关系数s = -0.067至0.081）和良好的收敛效度，与心理健康（s = 0.446至0.744）及自杀评估工具（s = 0.576至0.696）高度相关。自杀评估工具修订版访谈类别显示出很强的能力来预测临床医生认定为未来自杀企图“高于低风险”的参与者（曲线下面积 = 0.887，后验概率 = 0.889，95%可信区间 = [0.810, 0.954]，卡方值 = 0.976）。自杀评估工具修订版访谈分类 > “第3类”对“高于低风险”状态的观察敏感性为0.750（卡方值 = 0.810，[0.669, 0.948]，Phi系数 = 0.544），观察特异性为0.895（卡方值 = 0.899，[0.833, 0.956]，Phi系数 = 0.995）。我们的研究结果表明，自杀评估工具修订版访谈是一种心理测量学上强大的自杀行为临床评估工具，可有效地应用于无智力残疾的自闭症成年人。
被诊断患有自闭症的人自杀死亡风险增加。需要有适合自闭症患者需求的临床工具。在本研究中，我们对一种临床自杀访谈（自杀评估工具修订版访谈）进行了修改和评估，以用于没有智力残疾的自闭症患者。自闭症患者通过改进问题、解释难懂的术语或概念以及建议使用不同的评分量表来帮助我们修改该工具的原始版本。我们的结果支持使用自杀评估工具修订版访谈来评估无智力残疾的自闭症成年人的自杀想法和行为。未来，我们将测试自杀评估工具修订版访谈在临床环境以及不同临床人群中的效果。
