Brief Measure Reliable/Valid in Assessing Suicidality in People with Stimulant Use Disorder
- Suicide is a serious public health issue, with evidence of an increase in the prevalence over the last ten years. In response, the National Institute of Health has begun to emphasize the importance of suicidal assessment and monitoring.
- The Concise Health Risk Tracking Scale Self-Report (CHRT-SR), a brief, self-report measure of suicidality, is one tool developed to assist with this task, assessing suicidal thinking and several factors associated with a propensity to act.
- The scale has been found to be both valid and reliable in samples of patients with mood disorders, but has not been evaluated in other populations with high risk of suicide, like patients with substance use disorders.
Stimulant use disorders are common and associated with suicidal ideation and attempts. This secondary analysis assessed the CHRT-SR in 302 stimulant-abusing patients who had participated in a clinical trial (NIDA Clinical Trials Network protocol CTN-0037, Stimulant Reduction Intervention Using Dosed Exercise (STRIDE)).
A confirmatory factor analysis (CFA) was conducted to assess the factor validity of the 12-item CHRT-SR model with a second-order Propensity factor. The CHRT-SR total score and 2 factor scores (Propensity and Suicidal Thoughts) demonstrated acceptable internal consistency (i.e., different items probing the same construct produced similar results) and test-retest reliabilities (i.e., administering the same test twice to a group produced similar results).
These two subscales and the total score were modestly but significantly associated with measures of depression and life satisfaction, demonstrating construct validity (the scale measures what it claims to measure). Two additional items assessing Impulsivity were also analyzed, and demonstrated acceptable internal consistency, test-retest reliability, and construct validity.
Conclusions: The CHRT-SR appears to be a reliable and valid tool to assess suicidality in persons with stimulant use disorder. The value of a brief self-report measure of suicidal risk with promising psychometric properties has strong implications for practice and for clinical trials. The CHRT-SR is straightforward, requiring minimal clinician time to train and administer, and offers particular utility as a simple and quick assessment of helplessness and pessimism, symptoms common among people with chronic stimulant use, a population who should be closely monitored for suicide.
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