Assessing knowledge of suicide: a systematic review of available instruments

Abstract

Objective. Literacy of suicide is the corner stone of numerous prevention programs but is a difficult construct to appraise. To bring methodological and epistemological clarifications, we aimed to investigate the actual content and psychometric properties of the available tools designed to inquire knowledge of suicide.Methods. We conducted a systematic review of the literature. Electronic databases were searched for questionnaire assessing literacy, attitudes, knowledge or misconceptions about suicide. After checking the quality of validation procedures, we exhaustively collected the psychometric properties of the scales. Contents were submitted to a qualitative thematic analysis.Results. We identified 18 unique instruments from 48 papers. On the metrological level, general poor to fair compliance with validation standards and variability of psychometric properties stand out as the most prominent results. As regards to the constructs that instruments appraise, we derived 6 thematic categories of knowledge: epidemiology, consequences of media coverage and 4 common myths about the presumed monocausality, unpredictability, harmlessness and unpreventability of suicidal behaviors. Overall, five scales emerge as robust and/or valid enough tools to probe knowledge of suicide.Limitations. We chose selection criteria based on a priori conceptions of literacy. This may have restricted the scope of retrievable scales and limited our inferences about what is explored under the labels “knowledge” or “literacy”.Conclusions. To design refined instruments about literacy of suicide, scholars should consider differentiating the types of knowledge under exploration. Adapted rating procedure with clearer standards about the truthfulness of statements could improve psychometric quality and interpretability.