PREDICTIVE-VALIDITY OF THE SUICIDE PROBABILITY SCALE AMONG ADOLESCENTS IN GROUP HOME TREATMENT

Objective: To determine the predictive validity of the Suicide Probabi lity Scale (SPS). Method: Prospective design, predicting subsequent su icide attempts, suicide verbalizations, and minor self-destructive beh aviors from SPS scores at admission to a group home in a sample of 855 adolescents. Results: SPS scores significantly predicted all three su icide-relevant measures. Only 48% of subsequent attempts could have be en predicted from SPS criteria that would have put 21% of newly admitt ed adolescents in the at-risk group. Although the prediction is far fr om perfect, it can prevent some suicide attempts when combined with ef fective suicide precautions. Conclusions: This is the first known evid ence of predictive validity of any measure of suicide risk in adolesce nts. Its predictive ability may have been reduced by interventions des igned to reduce suicide risk. Despite the large number of false-positi ves and modest predictive validity, a large body of literature indicat es that quantitative predictions perform better than clinical judgment s in predicting psychological outcomes. However, the SPS measures only a subset of factors predictive of suicide, including suicidal ideatio n, hopelessness, and social isolation. Risk factors not assessed by th e SPS include previous suicide attempts, conduct disorder, substance a buse, and reasons for living. These additional risk factors may be imp ortant to improve upon the predictive validity of the SPS.