The Concise Health Risk Tracking ‐ Self‐Report (CHRT‐SR)—A measure of suicidal risk: Performance in adolescent outpatients

Abstract

Objectives The Concise Health Risk Tracking Self‐Report (CHRT‐SR) assesses the risk of suicidal behavior. We report its psychometric properties in a representative sample of adolescent outpatients. Methods A sample (n = 657) of adolescents (<18 years of age) in primary or psychiatric care completed the 14‐item version of CHRT‐SR at both baseline and within 3 months. To identify an optimal brief solution for the scale, we evaluated the factor structure of CHRT‐SR using multigroup confirmatory factor analysis, and testing measurement invariance across age and gender. The item response theory and classical test theory characteristics of the optimal solution were evaluated. Concurrent validity (both cross‐sectional and as a change measure over time) of the optimal solution was assessed by comparing it to another suicide measure. Results Confirmatory factor analysis identified the 9‐item CHRT‐SR (CHRT‐SR9) as the optimal solution. Classical test theory and item response theory indicated excellent fit. Concurrent validity analyses revealed that it can measure both improvement/worsening of suicidality over time. Conclusion The CHRT‐SR9 is a brief self‐report with excellent psychometric properties in a sample of adolescents that is sensitive to changes in suicidality over time. Its performance in other populations and ability to predict future suicidal events deserves study.

The 9-item Concise Health Risk Tracking – Self-Report (CHRT-SR9) measure of suicidal risk: Performance in adult primary care patients

“…In a large sample of adults seen in primary care practices, the brief, 9-item version of the CHRT-SR was identified and evaluated. These nine known items were identical to those identified by similar methods in a representative sample of adolescent outpatients (9). In addition, the performance of the total scale and the subscales were highly comparable to results found in the adolescent population.…”

“…Prior reports on the psychometric properties of the CHRT-SR have largely been in adult samples acquired in the conduct of clinical trials, with the exception of our report in adolescents who were enrolled in a tertiary care suicide prevention program (9). There have been attempts to explore a variety of versions of the CHRT-SR to facilitate implementation in practice and research studies, with different versions allowing for assessment of specific symptoms (i.e., impulsivity and irritability), as well as shortening of the scale.…”

“…This report evaluates a shortened version of the 14-item Concise Health Risk Tracking Self Report (CHRT-SR) ( 8 ). The original version included constructs such as pessimism, helplessness, social support, despair, impulsivity, and suicidal thoughts, measured on 5-point likert scales from “0: Strongly Disagree” to “4: Strongly Agree.” Recent work in a representative sample of adolescent outpatients revealed that a 9-item scale was psychometrically the best and most preferred of the various versions ( 9 ). These 9 items include items measuring pessimism (items 1 and 2), helplessness (items 3 and 4), despair (items 8 and 9), and current suicidal thought and plans (items 12, 13, and 14) from the 14-item CHRT-SR ( Figure 1 ).…”

Suicidal thoughts and behaviors in youth seeking mental health treatment in Texas: Youth Depression and Suicide Network research registry

“…A total score is also calculated, ranging from 0 to 64. Psychometric properties of the CHRT-SR have been well-established in children and adolescents (Mayes et al, 2018;Nandy et al, 2022Nandy et al, , 2023.…”