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23-02-2023 | Original Article

Using Behavioral Measures to Assess Suicide Risk in the Psychiatric Emergency Department for Youth

Auteurs: Ki Eun Shin, Argelinda Baroni, Ruth S. Gerson, Kerri-Anne Bell, Olivia H. Pollak, Katherine Tezanos, Anthony Spirito, Christine B. Cha

Gepubliceerd in: Child Psychiatry & Human Development

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Abstract

Suicide screening is critical in pediatric emergency departments (EDs). Behavioral measures of suicide risk may complement self-report measures. The current study examines suicide-specific behavioral measures and tests their potential short-term within-person effects among respondents, ability to discriminate future suicide attempt from suicidal ideation, and translation into interpretable categorical composite scores. The sample included 167 youth (10–17 years), presenting for suicide-related reasons to a pediatric psychiatric ED. During their ED visit, participants completed the Death/Life Implicit Association Test (IAT) and the Suicide Stroop Task. Recurrent suicidal thoughts and attempts were assessed within 6 months of the ED visit via medical records and email surveys. Youth displayed a decrease in the levels of distress and self-injurious desires (negative mood, desire to hurt themselves, and desire to die) after completing the behavioral tasks. The Death/Life IAT prospectively differentiated with 68% accuracy between youth who attempted suicide after their ED visit and those who had suicidal ideation but no attempt, p = 0.04, OR = 5.65, although this effect became marginally significant after controlling for self-report and demographic covariates. Neither the Suicide Stroop Task, nor the categorical composite scores predicted suicide attempts, ps = 0.08–0.87, ORs = 0.96–3.95. Behavioral measures of suicide risk administered in the ED do not appear to increase distress or self-injurious desires. They may be able to distinguish those who go on to attempt suicide (vs. consider suicide) within six months after discharge.
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Because several demographic and self-report covariates predicted the 6-month outcomes at the level of p < .10, we ran supplemental analyses while including a broader range of covariates (age, gender, sexual orientation, HSC total score, lifetime suicide attempt presence, autism spectrum disorder diagnosis, and patient prediction of a future suicide attempt). The distinction between the suicide attempt group and the suicidal ideation-only group stayed marginally significant, p = .06, aOR = 6.64, 95% CI [0.94, 46.68]. Covariates did not have significant effects, ps = .08-.99. Relative to the univariate model, adding the demographic and self-report measure covariates did not significantly improve prediction accuracy, AUC = .74, 95% CI = [.62, .86].
 
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Metagegevens
Titel
Using Behavioral Measures to Assess Suicide Risk in the Psychiatric Emergency Department for Youth
Auteurs
Ki Eun Shin
Argelinda Baroni
Ruth S. Gerson
Kerri-Anne Bell
Olivia H. Pollak
Katherine Tezanos
Anthony Spirito
Christine B. Cha
Publicatiedatum
23-02-2023
Uitgeverij
Springer US
Gepubliceerd in
Child Psychiatry & Human Development
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI
https://doi.org/10.1007/s10578-023-01507-y