Gate questions in psychiatric interviewing: the case of suicide assessment

Gate questions are commonly used to shorten structured interviews, by not p robing negative responses with more detailed questions. This study quantifi ed cases of aborted suicide attempts that would have been missed, if we had skipped detailed questions following a gate. To accomplish this, we interv iewed a random sample of 135 adult psychiatric inpatients concerning their past suicidal behavior. Using our structured interview, subjects were asked a general question about aborted suicide attempts, and then asked method-s pecific questions regardless of their response to the general "gate" questi on. Of the seventy subjects who were found to have histories of aborted att empts. 44.3% answered "no" to the gate question. Comparing these "false neg ative" subjects to "true positives." who had answered "yes" to the gate que stion and reported bona fide aborted attempts yielded no significant associ ations with demographics, psychiatric diagnoses, or reported histories of a ctual suicide attempts. Thus, a large number of subjects with aborted attem pts would have been missed if a negative response to the gate question had not been probed. Clinical and reasearch implications generally, as well as implications for suicide assessment, are discussed. (C) 2001 Elsevier Scien ce Ltd. All rights reserved.