Multimethod assessment of suicidality in adolescent psychiatric inpatients: Preliminary results

Objective: To examine agreement among multiple assessments of adolescent su icidal ideation and suicidal behavior for adolescent psychiatric inpatients , including pencil/paper checklists; structured and unstructured interviews ; and adolescent, clinician, and parent reports, and to provide suggestions for the accurate and reliable assessment of suicidality in adolescence. Me thod: Participants included 153 adolescent psychiatric inpatients (54 boys, 99 girls) between the ages of 12 and 17 years. Measurement of suicidal ide ation and behavior included common assessment instruments and standard clin ical practices, including the Suicidal Ideation Questionnaire, NIMH Diagnos tic Interview Schedule for Children, clinician interview, and parent report (Behavior Assessment Scale for Children). Results: Results revealed signif icantly different rates of suicidallty across each instrument and poor to m oderate agreement between similar measures of adolescent suicidal ideation and suicidal behavior. Agreement between measures was generally best for bo ys, for older adolescents, and for assessments relying on a single informan t. Reporters were most likely to agree on the presence of suicidality for m ore severely suicidal adolescents; this finding suggests that agreement in itself may be a useful marker for adolescent suicide. Conclusions: Results of this preliminary study supported the use of multiple measurement approac hes when examining adolescent suicidality, particularly those that rely on clinician judgment and adolescents' own reports. Implications for future re search and for clinical practice are also discussed.