Routinized Categorization of Suicide Risk into Actionable Strata: Establishing the Validity of an Existing Suicide Risk Assessment Framework in an Outpatient Sample

Abstract

Objective: The Suicide Risk Assessment and Management Decision Tree (DT) is a clinician-administered assessment that leads to risk categorizations that correspond with actionable strata. This study investigated the construct validity and test-retest reliability of the DT risk categories across two timepoints. Method: Outpatients (N = 731) completed a battery of self-report measures. Spearman’s correlations were used to examine the relationships between DT suicide risk level and suicidal symptoms, theory-based risk factors, psychiatric correlates, and DT suicide risk level a timepoint 2. Correlations were analyzed for significant differences to examine the divergent validity of the DT. Results: Results, overall, were in line with hypotheses, with the exception of depression and thwarted belongingness. Conclusions: Findings provide evidence for the reliability, convergent validity and discriminant validity of the DT. This clinician-administered suicide risk assessment may be useful for standardization of the assessment and management of suicide risk in outpatient clinical settings.

Validity of the modular assessment of risk for imminent suicide in predicting short‐term suicidality

“…Lastly, it is worth comparing the use of MARIS‐2 with other suicide risk assessment tools and considering how MARIS‐2 could be combined with other approaches to improve suicide risk assessment and prevention. Several other frameworks for suicide risk assessments exist, including the C‐SSRS 40 and the Decision Tree, 52,53 each of which has been widely implemented. Each of these tools has been validated for use in clinical practice and has demonstrated at least modest predictive utility in identifying who is at risk for suicidal behavior.…”

Examining Blunted Initial Response to Reward and Recent Suicidal Ideation in Children and Adolescents Using Event-Related Potentials: Failure to Conceptually Replicate Across Two Independent Samples

“…The use of a single-item assessment is particularly problematic given evidence that a non-negligible number of participants who endorse suicidal thoughts/behaviors on a single item do not meet standardized criteria for suicidal thoughts/behaviors if asked follow-up interview questions (Hom et al, 2016; Millner et al, 2015). Future work should ideally use validated multi-item interviews that allow for clarifying questions (e.g., Chu et al, 2015; Gallyer et al, 2020; Gratch et al, 2021; Joiner et al, 1999; Nock et al, 2007).…”