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

• Published in: Frontiers in psychiatry Vol. 14; p. 1014766
• Main Authors: Nandy, Karabi, Rush, A John, Carmody, Thomas J, Mayes, Taryn L, Trivedi, Madhukar H
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 14.02.2023
• Subjects: adults; concise health risk tracking scale self-report (CHRT-SR); depression; Psychiatry; psychometrics; suicidal risk; suicidality; psychometrics; suicidal risk; suicidality; depression; adults; concise health risk tracking scale self-report (CHRT-SR)
• ISSN: 1664-0640; 1664-0640
• DOI: 10.3389/fpsyt.2023.1014766

To evaluate the psychometric properties of a 9-item Concise Health Risk Tracking Self-Report (or CHRT-SR ) to assess suicidal risk in adult primary care outpatients. Overall, 369 adults completed the original 14-item version of CHRT-SR at baseline and within 4 months thereafter, from which the CHRT-SR was extracted using multigroup confirmatory factor analysis. Measurement invariance (across age and sex) and classical test theory characteristics of the CHRT-SR were evaluated. Concurrent validity was assessed by comparing CHRT-SR responses to those of the suicide item in the Patient Health Questionnaire (PHQ-9), both cross-sectionally and as a change measure over time. Confirmatory factor analysis identified the CHRT-SR as the optimal solution. Factors included pessimism, helplessness, despair (2 items each) and suicidal thoughts (3 items). Measurement invariance held across sex and age groups, indicating that mean differences among sub-groups were real and not attributable to measurement bias. Classical test theory revealed acceptable item-total correlations overall (0.57-0.79) and internal consistency (Spearman-Brown from 0.76 to 0.90). Concurrent validity analyses revealed that the CHRT-SR can measure both improvement and worsening of suicidality over time. A PHQ-9 response of 0, 1, 2, and 3 on the suicide item corresponded to 7.82 (5.53), 16.80 (4.99), 20.71 (5.36), and 25.95 (7.30) (mean and SD) on CHRT-SR total score, respectively. The CHRT-SR is a brief self-report evaluating suicidality with excellent psychometric properties that is sensitive to change over time.