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Reevaluating suicidal behaviors: comparing assessment methods to improve risk evaluations


Harris, KM and Lello, OD and Wilcox, CH, Reevaluating suicidal behaviors: comparing assessment methods to improve risk evaluations, Journal of Psychopathology and Behavioral Assessment, 39, (1) pp. 128-139. ISSN 0882-2689 (2017) [Refereed Article]

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Copyright Springer Science+Business Media

DOI: doi:10.1007/s10862-016-9566-6


This study examined suicide assessment validity by comparing methods of measuring current risk associated with past suicidal behaviors. Three independent samples (Ns = 359, 1007, and 713; aged 1876 years) all included participants covering a broad spectrum of suicidality. Information theory, item response theory, general linear modeling, and linear regression modeling tested seven competing methods/models of assessing past suicidal behaviors in relation to current suicidality. In contrast to contemporary theories, ANOVA results showed suicide plans can indicate higher risk than suicide attempts when intent to die is higher. Contrary to popular practice, evidence demonstrated that defining risk by suicide ideation (yes/no), attempts or serious attempts (yes/no), are false dichotomies, were the least valid models tested, and failed to explain substantial explainable variance in suicidality/risk. A newly proposed model, differentiating behaviors with or without intent to die, was the most efficacious dichotomous method. However, as predicted, continuous variables were superior to dichotomous. The proposed suicidal barometer model (SBM) exhibited robust evidence as the best available model for evaluating suicidal behaviors in all samples (100 % probability), explaining 47-61 % of suicidality variance and provided incremental improvement in risk evaluations. Findings were consistent by sample, sex, age-group, ethnicity, and psychiatric history. This study, and related evidence, demonstrate that there is a clear and present need for updating measures, clinical training and core competencies, for valid assessment and risk formulation.

Item Details

Item Type:Refereed Article
Keywords:assessment, core competencies, psychometrics, risk evaluation, suicide prevention, test validity, theory
Research Division:Psychology
Research Group:Clinical and health psychology
Research Field:Health psychology
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:111150
Year Published:2017 (online first 2016)
Web of Science® Times Cited:7
Deposited By:Medicine
Deposited On:2016-09-01
Last Modified:2018-03-07

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