Psychometric evaluation of the 9-item Concise Health Risk Tracking - Self-Report (CHRT-SR9) (a measure of suicidal risk) in adolescent psychiatric outpatients in the Texas Youth Depression and Suicide Research Network (TX-YDSRN)

Karabi Nandy, A. John Rush, Holli Slater, Taryn L. Mayes, Abu Minhajuddin, Manish Jha, Joseph C. Blader, Ryan Brown, Graham Emslie, Madeleine N. Fuselier, Cynthia Garza, Kim Gushanas, Beth Kennard, Eric A. Storch, Sarah M. Wakefield, Madhukar H. Trivedi

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: This study evaluated the psychometric properties of the 9-item Concise Health Risk Tracking Self-Report (CHRT-SR9), a measure of suicidality, in adolescent psychiatric outpatients. Methods: Altogether, 933 depressed or suicidal adolescents (12–20 years of age), receiving treatment at psychiatric outpatient clinics in Texas, completed the 16-item CHRT-SR at baseline and one month later. CHRT-SR9 was extracted from CHRT-SR16 using multigroup confirmatory factor analysis. Sex and age measurement invariance, classical test theory, item response theory (IRT), and concurrent validity analyses (against the suicidal ideation Item 9 of Patient Health Questionnaire-Adolescent (PHQ-A)) were conducted. Results: The CHRT-SR9 demonstrated excellent model fit with four factors (pessimism, helplessness, despair, and suicidal thoughts). Measurement invariance was upheld. Acceptable item-total correlations (0.56–0.80) and internal consistency (Spearman-Brown 0.78–0.89) were revealed. IRT analyses showed a unidimensional instrument with excellent item performance. Using the CHRT-SR9 total score as a measure of overall suicidality and comparing it against levels of PHQ-A Item 9, the mean (standard deviation) of CHRT-SR9 total score was 8.64 (SD = 5.97) for no-risk (0 on Item 9), 17.05 (SD = 5.00) for mild, 23.16 (SD = 5.05) for moderate, and 26.96 (SD = 5.24) for severe-risk (3 on Item 9). Significant differences (p-value<0.0001) indicated that CHRT-SR9 total score distinguished between levels of suicidal risk. Furthermore, CHRT-SR9 was sensitive to change over a one-month period. Limitations: Whether CHRT-SR9 predicts actual suicidal attempts in adolescents is not well defined. Conclusion: The CHRT-SR9 is an easy-to-administer, user-friendly self-report with good psychometric qualities which makes it an excellent screening measure of suicidal risk in adolescent psychiatric outpatients.

Original languageEnglish (US)
Pages (from-to)548-556
Number of pages9
JournalJournal of Affective Disorders
Volume329
DOIs
StatePublished - May 15 2023

Keywords

  • Adolescent
  • Concise Health Risk Tracking Scale Self-Report (CHRT-SR)
  • Depression
  • Psychiatric outpatients
  • Psychometrics
  • Suicidal risk

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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