Informant Discrepancies in Suicidality Screening Tools Among School Age Youth

As the rate of death by suicide in youth ages 6 to 12 rises, it is imperative to better understand informant discrepancies when screening for suicidality. Accordingly, this study investigated associations among youth-, caregiver-, and clinician-reports of youth’s suicidality and their associations with youth- and caregiver-reports of youth’s depressive symptoms. Participants were 161 6- to 12-year-old youth presenting for outpatient psychological services at a Midwest training clinic between 2014 and 2019. More than 1 in 4 youth had at least one informant report some suicidal concerns. Results indicated that all informants’ reports of suicidality were correlated with one another, with youth- and clinician-report being most strongly linked and caregiver- and clinician-report having the weakest correlation. Clinician- and youth-reports of suicidality were associated with youth-report, (but not caregiver-report) of depressive symptoms. Caregiver-report of suicidality was not associated with youth- or caregiver-report of depressive symptoms. When youth-report of depressive symptoms was regressed on sex, age, and youth-, caregiver-, and clinician-reports of suicidality, there was a trend that youth-report of suicidality was positively associated with youth-report of depressive symptoms. No informant’s report of suicidality was uniquely associated with caregiver-report of depressive symptoms. Findings indicate that youth- and clinician-reports at intake are more strongly linked with one another than with caregiver-reports. Further, youth-reports on suicidality screening tools are more strongly associated with depressive symptoms than caregiver-report, suggesting that caregiver-reports are insufficient to assess concerns of suicidality at intake among school age youth.