Robert D Gibbons, Neal D Ryan, Fuchiang Rich Tsui, Jordan Harakal, Brandie George-Milford, Giovanna Porta, Johnny Berona, David A Brent
{"title":"K-CAT-SS 对高风险青少年和青年成人的预测效力。","authors":"Robert D Gibbons, Neal D Ryan, Fuchiang Rich Tsui, Jordan Harakal, Brandie George-Milford, Giovanna Porta, Johnny Berona, David A Brent","doi":"10.1016/j.jaac.2024.04.011","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Suicide is a leading cause of death in adolescents and young adults and has increased substantially in the past 15 years. Accurate suicide risk stratification based on rapid screening can help reverse these trends. This study aimed to assess the ability of the Kiddie Computerized Adaptive Test Suicide Scale (K-CAT-SS), a brief computerized adaptive test of suicidality, to predict suicide attempts (SAs) in high-risk youth.</p><p><strong>Method: </strong>A total of 652 participants (age range, 12-24 years), 78% of whom presented with suicidal ideation or behavior, were recruited within 1 month of mental health care contact. The K-CAT-SS, scaled from 0 to 100, was administered at baseline, and participants were assessed at about 1, 3, and 6 months after intake. Weekly incidence of SAs was assessed using the Adolescent Longitudinal Interval Follow-up Evaluation and Columbia-Suicide Severity Rating Scale. A secondary outcome was suicidal behavior, including aborted, interrupted, and actual SAs.</p><p><strong>Results: </strong>The K-CAT-SS showed a 4.91-fold increase in SAs for every 25-point increase in the baseline score (95% CI 2.83-8.52) and a 3.51-fold increase in suicidal behaviors (95% CI 2.32-5.30). These relations persisted following adjustment for prior attempts; demographic variables including age, sex, gender identity, sexual orientation, and race/ethnicity; and other measures of psychopathology. No moderating effects were identified. At 3 months, area under the receiver operating characteristic curve was 0.83 (95% CI 0.72-0.93) for 1 or more SAs.</p><p><strong>Conclusion: </strong>The K-CAT-SS is an excellent tool for suicide risk stratification, particularly in higher-risk populations where other measures have shown lower predictive validity.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":9.2000,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictive Validity of the K-CAT-SS in High-Risk Adolescents and Young Adults.\",\"authors\":\"Robert D Gibbons, Neal D Ryan, Fuchiang Rich Tsui, Jordan Harakal, Brandie George-Milford, Giovanna Porta, Johnny Berona, David A Brent\",\"doi\":\"10.1016/j.jaac.2024.04.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Suicide is a leading cause of death in adolescents and young adults and has increased substantially in the past 15 years. Accurate suicide risk stratification based on rapid screening can help reverse these trends. This study aimed to assess the ability of the Kiddie Computerized Adaptive Test Suicide Scale (K-CAT-SS), a brief computerized adaptive test of suicidality, to predict suicide attempts (SAs) in high-risk youth.</p><p><strong>Method: </strong>A total of 652 participants (age range, 12-24 years), 78% of whom presented with suicidal ideation or behavior, were recruited within 1 month of mental health care contact. The K-CAT-SS, scaled from 0 to 100, was administered at baseline, and participants were assessed at about 1, 3, and 6 months after intake. Weekly incidence of SAs was assessed using the Adolescent Longitudinal Interval Follow-up Evaluation and Columbia-Suicide Severity Rating Scale. A secondary outcome was suicidal behavior, including aborted, interrupted, and actual SAs.</p><p><strong>Results: </strong>The K-CAT-SS showed a 4.91-fold increase in SAs for every 25-point increase in the baseline score (95% CI 2.83-8.52) and a 3.51-fold increase in suicidal behaviors (95% CI 2.32-5.30). These relations persisted following adjustment for prior attempts; demographic variables including age, sex, gender identity, sexual orientation, and race/ethnicity; and other measures of psychopathology. No moderating effects were identified. At 3 months, area under the receiver operating characteristic curve was 0.83 (95% CI 0.72-0.93) for 1 or more SAs.</p><p><strong>Conclusion: </strong>The K-CAT-SS is an excellent tool for suicide risk stratification, particularly in higher-risk populations where other measures have shown lower predictive validity.</p>\",\"PeriodicalId\":17186,\"journal\":{\"name\":\"Journal of the American Academy of Child and Adolescent Psychiatry\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":9.2000,\"publicationDate\":\"2024-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Academy of Child and Adolescent Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jaac.2024.04.011\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Academy of Child and Adolescent Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jaac.2024.04.011","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Predictive Validity of the K-CAT-SS in High-Risk Adolescents and Young Adults.
Objective: Suicide is a leading cause of death in adolescents and young adults and has increased substantially in the past 15 years. Accurate suicide risk stratification based on rapid screening can help reverse these trends. This study aimed to assess the ability of the Kiddie Computerized Adaptive Test Suicide Scale (K-CAT-SS), a brief computerized adaptive test of suicidality, to predict suicide attempts (SAs) in high-risk youth.
Method: A total of 652 participants (age range, 12-24 years), 78% of whom presented with suicidal ideation or behavior, were recruited within 1 month of mental health care contact. The K-CAT-SS, scaled from 0 to 100, was administered at baseline, and participants were assessed at about 1, 3, and 6 months after intake. Weekly incidence of SAs was assessed using the Adolescent Longitudinal Interval Follow-up Evaluation and Columbia-Suicide Severity Rating Scale. A secondary outcome was suicidal behavior, including aborted, interrupted, and actual SAs.
Results: The K-CAT-SS showed a 4.91-fold increase in SAs for every 25-point increase in the baseline score (95% CI 2.83-8.52) and a 3.51-fold increase in suicidal behaviors (95% CI 2.32-5.30). These relations persisted following adjustment for prior attempts; demographic variables including age, sex, gender identity, sexual orientation, and race/ethnicity; and other measures of psychopathology. No moderating effects were identified. At 3 months, area under the receiver operating characteristic curve was 0.83 (95% CI 0.72-0.93) for 1 or more SAs.
Conclusion: The K-CAT-SS is an excellent tool for suicide risk stratification, particularly in higher-risk populations where other measures have shown lower predictive validity.
期刊介绍:
The Journal of the American Academy of Child & Adolescent Psychiatry (JAACAP) is dedicated to advancing the field of child and adolescent psychiatry through the publication of original research and papers of theoretical, scientific, and clinical significance. Our primary focus is on the mental health of children, adolescents, and families.
We welcome unpublished manuscripts that explore various perspectives, ranging from genetic, epidemiological, neurobiological, and psychopathological research, to cognitive, behavioral, psychodynamic, and other psychotherapeutic investigations. We also encourage submissions that delve into parent-child, interpersonal, and family research, as well as clinical and empirical studies conducted in inpatient, outpatient, consultation-liaison, and school-based settings.
In addition to publishing research, we aim to promote the well-being of children and families by featuring scholarly papers on topics such as health policy, legislation, advocacy, culture, society, and service provision in relation to mental health.
At JAACAP, we strive to foster collaboration and dialogue among researchers, clinicians, and policy-makers in order to enhance our understanding and approach to child and adolescent mental health.