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The ABCs of suicide risk assessment: applying a tripartite approach to individual evaluations


Harris, KM and Syu, J and Lello, OD and Chew, YLE and Willcox, H and Ho, RHM, The ABC's of suicide risk assessment: applying a tripartite approach to individual evaluations, PLoS One, 10, (6) Article e0127442. ISSN 1932-6203 (2015) [Refereed Article]


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Copyright The Authors Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.1371/journal.pone.0127442


There is considerable need for accurate suicide risk assessment for clinical, screening, and research purposes. This study applied the tripartite affect-behavior-cognition theory, the suicidal barometer model, classical test theory, and item response theory (IRT), to develop a brief self-report measure of suicide risk that is theoretically-grounded, reliable and valid. An initial survey (n=359) employed an iterative process to an item pool, resulting in the six-item Suicidal Affect-Behavior-Cognition Scale (SABCS). Three additional studies tested the SABCS and a highly endorsed comparison measure. Studies included two online surveys (n=1007, and n=713), and one prospective clinical survey (n=72; Time 2, n=54). Factor analyses demonstrated SABCS construct validity through unidimensionality. Internal reliability was high (α=.86-.93, split-half = .90-.94)). The scale was predictive of future suicidal behaviors and suicidality (r=.68, .73, respectively), showed convergent validity, and the SABCS-4 demonstrated clinically relevant sensitivity to change. IRT analyses revealed the SABCS captured more information than the comparison measure, and better defined participants at low, moderate, and high risk. The SABCS is the first suicide risk measure to demonstrate no differential item functioning by sex, age, or ethnicity. In all comparisons, the SABCS showed incremental improvements over a highly endorsed scale through stronger predictive ability, reliability, and other properties. The SABCS is in the public domain, with this publication, and is suitable for clinical evaluations, public screening, and research.

Item Details

Item Type:Refereed Article
Keywords:adult affect behavior cognition theory aged Article behavior assessment classical test theory construct validity convergent validity factorial analysis female human item response theory major clinical study male normal human predictive validity relia
Research Division:Psychology
Research Group:Biological psychology
Research Field:Behavioural neuroscience
Objective Division:Health
Objective Group:Provision of health and support services
Objective Field:Mental health services
UTAS Author:Harris, KM (Dr Keith Harris)
ID Code:110312
Year Published:2015
Web of Science® Times Cited:39
Deposited By:Medicine
Deposited On:2016-07-24
Last Modified:2017-11-07
Downloads:142 View Download Statistics

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