Development of a Scale to Assess Suicide Thoughts and Behaviors among Preteens

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Project Summary This 2-site (Florida International University, Yale University) proposed Administrative Supplement to Pettit/Silverman R01MH119299-01, Targeting Attention Orienting to Social Threat to Reduce Social Anxiety in Youth, aims to refine and evaluate developmentally and culturally sensitive child and parent rating scales of suicide thoughts and behaviors (STB) among preteens ages 9 to 12 years. As highlighted in NOT-MH-22-085, there is critical need reconsider and adapt measures and methods used to assess STB in adolescents and adults for preteens at risk. Toward addressing this need, we had designed an initial version of a child self-rating scale of STB, the Suicide Risk and Ideation Scale for Kids (S-RISK), grounded in the most prominent empirically supported ideation-to-action theories of suicide. A cornerstone of ideation-to-action is the distinction made between suicide ideation versus suicide action. Accumulating data support this cornerstone theoretical distinction in adults and adolescents, highlighting the need to distinguish between suicide ideation and suicide action in screening and risk assessment approaches. In this Supplement, we propose to develop a parent-rated version of the S-RISK and collect critically needed data on the S-RISK Child and Parent versions in preteens and their parents. These preteens are ages 9 to 12, meet for a diagnosis of an anxiety disorder, and are largely from minoritized backgrounds (49% Hispanic, 15% Multiracial, 10% Black). In a pilot phase, we will use a mixed methods approach including cognitive response interviewing to obtain data on the S-RISK Child and Parent in N = 10 preteens and their parents, ensuring clear and simple language that is accessible to preteens and parents from diverse backgrounds. In a test phase, we will administer the refined S-RISK Child and Parent to an independent sample of N = 100 preteens and their parents. We will examine the scale's item properties, reliability, and concurrent validity by leveraging three assessments of STB we already administer. We also will use measures collected in the Parent Grant to examine how child and parent characteristics relate to scores on the S-RISK Child and Parent, including sociodemographic characteristics, child burdensomeness and belongingness, family history of mental illness, and parent experiences of depression and anxiety. Overall, data from this Supplement will result in a scale assessing preteen STB and position us to pursue a future theory- driven scale development R01 including evaluation of factorial validity, predictive validity, and generalization of psychometric properties across subgroups of preteens. Further, this Supplement will advance understanding of STB in preteens with social anxiety and related disorders and enable developmentally and culturally sensitive testing of ideation-to-action theories of suicide.