Rodríguez-Quiroga A 1, Flamarique I 2, Castro-Fornieles J 2,3,4, Lievesley K 5,6, Buitelaar JK 7,8, Coghill D 9,10,11, Díaz-Caneja CM 1, Dittmann RW 12, Gupta A 13,14, Hoekstra PJ 15, Kehrmann L 1, Llorente C 1, Purper-Ouakil D 16, Schulze UME 17, Zuddas A 18,19, Sala R 5, Singh J 5,20, Fiori F 5,6,20, Arango C 1, Santosh P 21,22,23; STOP Consortium.
- 1 Child
and Adolescent Psychiatry Department, Instituto de Investigación
Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Hospital General
Universitario Gregorio Marañón, CIBERSAM, Universidad Complutense,
Madrid, Spain.
2 Child and Adolescent Psychiatry and Psychology Department, 2014SGR489, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, Barcelona, Spain.
3 Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain. - 4 Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain.
- 5 Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK.
- 6 HealthTracker Ltd, Gillingham, Kent, UK.
- 7 Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.
- 8 Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.
- 9 Department of Paediatrics and Psychiatry, School of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
- 10 Murdoch Children's Research Institute, Melbourne, Australia.
- 11 Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK.
- 12 Paediatric Psychopharmacology, Department of Child and Adolescent Psychiatry, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
- 13 Department of Paediatric Respiratory Medicine, Kings College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
- 14 Department of Paediatric Respiratory Medicine, Kings College London, London, UK.
- 15 Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- 16 Hôpital Saint Eloi, Médecine Psychologique de l'Enfant et de l'Adolescent, CHRU Montpellier, Montpellier, France.
- 17 Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
- 18 Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.
- 19 "A. Cao" Paediatric Hospital, "G. Brotzu" Hospital Trust, Cagliari University Hospital, Cagliari, Italy.
- 20 Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK.
- 21 Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK. paramala.1.santosh@kcl.ac.uk.
- 22 HealthTracker Ltd, Gillingham, Kent, UK. paramala.1.santosh@kcl.ac.uk.
- 23 Centre
for Interventional Paediatric Psychopharmacology and Rare Diseases,
South London and Maudsley NHS Foundation Trust, London, UK.
paramala.1.santosh@kcl.ac.uk.
Eur Child Adolesc Psychiatry. 2019 May 3. doi: 10.1007/s00787-019-01328-2. [Epub ahead of print]
Abstract
Suicidality
in the child and adolescent population is a major public health
concern. There is, however, a lack of developmentally sensitive valid
and reliable instruments that can capture data on risk, and clinical and
psychosocial mediators of suicidality in young people. In this study,
we aimed to develop and assess the validity of instruments evaluating
the psychosocial risk and protective factors for suicidal behaviours in
the adolescent population. In Phase 1, based on a systematic literature
review of suicidality, focus groups, and expert panel advice, the risk
factors and protective factors (resilience factors) were identified and
the adolescent, parent, and clinician versions of the STOP-Suicidality
Risk Factors Scale (STOP-SRiFS) and the Resilience Factors Scale
(STOP-SReFS) were developed. Phase 2 involved instrument validation and
comprised of two samples (Sample 1 and 2). Sample 1 consisted of 87
adolescents, their parents/carers, and clinicians from the various
participating centres, and Sample 2 consisted of three sub-samples:
adolescents (n = 259) who completed STOP-SRiFS and/or the STOP-SReFS
scales, parents (n = 213) who completed one or both of the scales, and
the clinicians who completed the scales (n = 254). The STOP-SRiFS
demonstrated a good construct validity-the Cronbach Alpha for the
adolescent (α = 0.864), parent (α = 0.842), and clinician (α = 0.722)
versions of the scale. Test-retest reliability, inter-rater reliability,
and content validity were good for all three versions of the
STOP-SRiFS. The sub-scales generated using Exploratory Factor Analysis
(EFA) were the (1) anxiety and depression risk, (2) substance misuse
risk, (3) interpersonal risk, (4) chronic risk, and (5) risk due to life
events. For the STOP-SRiFS, statistically significant correlations were
found between the Columbia-Suicide Severity Rating Scale (C-SSRS) total
score and the adolescent, parent, and clinical versions of the
STOP-SRiFS sub-scale scores. The STOP-SRiFS showed good psychometric
properties. This study demonstrated a good construct validity for the
STOP-SReFS-the Cronbach Alpha for the three versions were good
(adolescent: α = 0.775; parent: α = 0.808; α = clinician: 0.808). EFA
for the adolescent version of the STOP-SReFS, which consists of 9
resilience factors domains, generated two factors (1) interpersonal
resilience and (2) cognitive resilience. The STOP-SReFS Cognitive
Resilience sub-scale for the adolescent was negatively correlated
(r = - 0.275) with the C-SSRS total score, showing that there was lower
suicidality in those with greater Cognitive Resilience. The STOP-SReFS
Interpersonal resilience sub-scale correlations were all negative, but
none of them were significantly different to the C-SSRS total scores for
either the adolescent, parent, or clinician versions of the scales.
This is not surprising, because the items in this sub-scale capture a
much larger time-scale, compared to the C-SSRS rating period. The
STOP-SReFS showed good psychometric properties. The STOP-SRiFS and
STOP-SReFS are instruments that can be used in future studies about
suicidality in children and adolescents.
KEYWORDS:
Adolescents; Children; Psychosocial; Questionnaire development and validation; Resilience; Risk; Suicidality
https://www.ncbi.nlm.nih.gov/pubmed/31054125
Adolescents; Children; Psychosocial; Questionnaire development and validation; Resilience; Risk; Suicidality
https://www.ncbi.nlm.nih.gov/pubmed/31054125