Development and psychometric properties of the “Suicidality: Treatment Occurring in Paediatrics (STOP) Risk and Resilience Factors Scales” in adolescents

The STOP Consortium, A. Rodríguez-Quiroga, I. Flamarique, J. Castro-Fornieles, K. Lievesley, J. K. Buitelaar, D. Coghill, C. M. Díaz-Caneja, R. W. Dittmann, A. Gupta, P. J. Hoekstra, L. Kehrmann, C. Llorente, D. Purper-Ouakil, U. M. E. Schulze, A. Zuddas, R. Sala, J. Singh, F. Fiori, C. Arango

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    Abstract

    Suicidality in the child and adolescent population is a major public health concern. There is, however, a lack of developmentally sensitive valid and reliable instruments that can capture data on risk, and clinical and psychosocial mediators of suicidality in young people. In this study, we aimed to develop and assess the validity of instruments evaluating the psychosocial risk and protective factors for suicidal behaviours in the adolescent population. In Phase 1, based on a systematic literature review of suicidality, focus groups, and expert panel advice, the risk factors and protective factors (resilience factors) were identified and the adolescent, parent, and clinician versions of the STOP-Suicidality Risk Factors Scale (STOP-SRiFS) and the Resilience Factors Scale (STOP-SReFS) were developed. Phase 2 involved instrument validation and comprised of two samples (Sample 1 and 2). Sample 1 consisted of 87 adolescents, their parents/carers, and clinicians from the various participating centres, and Sample 2 consisted of three sub-samples: adolescents (n = 259) who completed STOP-SRiFS and/or the STOP-SReFS scales, parents (n = 213) who completed one or both of the scales, and the clinicians who completed the scales (n = 254). The STOP-SRiFS demonstrated a good construct validity—the Cronbach Alpha for the adolescent (α = 0.864), parent (α = 0.842), and clinician (α = 0.722) versions of the scale. Test–retest reliability, inter-rater reliability, and content validity were good for all three versions of the STOP-SRiFS. The sub-scales generated using Exploratory Factor Analysis (EFA) were the (1) anxiety and depression risk, (2) substance misuse risk, (3) interpersonal risk, (4) chronic risk, and (5) risk due to life events. For the STOP-SRiFS, statistically significant correlations were found between the Columbia-Suicide Severity Rating Scale (C-SSRS) total score and the adolescent, parent, and clinical versions of the STOP-SRiFS sub-scale scores. The STOP-SRiFS showed good psychometric properties. This study demonstrated a good construct validity for the STOP-SReFS—the Cronbach Alpha for the three versions were good (adolescent: α = 0.775; parent: α = 0.808; α = clinician: 0.808). EFA for the adolescent version of the STOP-SReFS, which consists of 9 resilience factors domains, generated two factors (1) interpersonal resilience and (2) cognitive resilience. The STOP-SReFS Cognitive Resilience sub-scale for the adolescent was negatively correlated (r = − 0.275) with the C-SSRS total score, showing that there was lower suicidality in those with greater Cognitive Resilience. The STOP-SReFS Interpersonal resilience sub-scale correlations were all negative, but none of them were significantly different to the C-SSRS total scores for either the adolescent, parent, or clinician versions of the scales. This is not surprising, because the items in this sub-scale capture a much larger time-scale, compared to the C-SSRS rating period. The STOP-SReFS showed good psychometric properties. The STOP-SRiFS and STOP-SReFS are instruments that can be used in future studies about suicidality in children and adolescents.

    Original languageEnglish
    Number of pages13
    JournalEuropean Child and Adolescent Psychiatry
    DOIs
    Publication statusE-pub ahead of print - 3 May 2019

    Fingerprint

    Psychometrics
    Pediatrics
    Therapeutics
    Suicide
    Statistical Factor Analysis
    Parents
    Adolescent Behavior
    Focus Groups
    Reproducibility of Results
    Caregivers
    Population
    Anxiety
    Public Health

    Keywords

    • Adolescents
    • Children
    • Psychosocial
    • Questionnaire development and validation
    • Resilience
    • Risk
    • Suicidality

    Cite this

    The STOP Consortium ; Rodríguez-Quiroga, A. ; Flamarique, I. ; Castro-Fornieles, J. ; Lievesley, K. ; Buitelaar, J. K. ; Coghill, D. ; Díaz-Caneja, C. M. ; Dittmann, R. W. ; Gupta, A. ; Hoekstra, P. J. ; Kehrmann, L. ; Llorente, C. ; Purper-Ouakil, D. ; Schulze, U. M. E. ; Zuddas, A. ; Sala, R. ; Singh, J. ; Fiori, F. ; Arango, C. / Development and psychometric properties of the “Suicidality: Treatment Occurring in Paediatrics (STOP) Risk and Resilience Factors Scales” in adolescents. In: European Child and Adolescent Psychiatry. 2019.
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    abstract = "Suicidality in the child and adolescent population is a major public health concern. There is, however, a lack of developmentally sensitive valid and reliable instruments that can capture data on risk, and clinical and psychosocial mediators of suicidality in young people. In this study, we aimed to develop and assess the validity of instruments evaluating the psychosocial risk and protective factors for suicidal behaviours in the adolescent population. In Phase 1, based on a systematic literature review of suicidality, focus groups, and expert panel advice, the risk factors and protective factors (resilience factors) were identified and the adolescent, parent, and clinician versions of the STOP-Suicidality Risk Factors Scale (STOP-SRiFS) and the Resilience Factors Scale (STOP-SReFS) were developed. Phase 2 involved instrument validation and comprised of two samples (Sample 1 and 2). Sample 1 consisted of 87 adolescents, their parents/carers, and clinicians from the various participating centres, and Sample 2 consisted of three sub-samples: adolescents (n = 259) who completed STOP-SRiFS and/or the STOP-SReFS scales, parents (n = 213) who completed one or both of the scales, and the clinicians who completed the scales (n = 254). The STOP-SRiFS demonstrated a good construct validity—the Cronbach Alpha for the adolescent (α = 0.864), parent (α = 0.842), and clinician (α = 0.722) versions of the scale. Test–retest reliability, inter-rater reliability, and content validity were good for all three versions of the STOP-SRiFS. The sub-scales generated using Exploratory Factor Analysis (EFA) were the (1) anxiety and depression risk, (2) substance misuse risk, (3) interpersonal risk, (4) chronic risk, and (5) risk due to life events. For the STOP-SRiFS, statistically significant correlations were found between the Columbia-Suicide Severity Rating Scale (C-SSRS) total score and the adolescent, parent, and clinical versions of the STOP-SRiFS sub-scale scores. The STOP-SRiFS showed good psychometric properties. This study demonstrated a good construct validity for the STOP-SReFS—the Cronbach Alpha for the three versions were good (adolescent: α = 0.775; parent: α = 0.808; α = clinician: 0.808). EFA for the adolescent version of the STOP-SReFS, which consists of 9 resilience factors domains, generated two factors (1) interpersonal resilience and (2) cognitive resilience. The STOP-SReFS Cognitive Resilience sub-scale for the adolescent was negatively correlated (r = − 0.275) with the C-SSRS total score, showing that there was lower suicidality in those with greater Cognitive Resilience. The STOP-SReFS Interpersonal resilience sub-scale correlations were all negative, but none of them were significantly different to the C-SSRS total scores for either the adolescent, parent, or clinician versions of the scales. This is not surprising, because the items in this sub-scale capture a much larger time-scale, compared to the C-SSRS rating period. The STOP-SReFS showed good psychometric properties. The STOP-SRiFS and STOP-SReFS are instruments that can be used in future studies about suicidality in children and adolescents.",
    keywords = "Adolescents, Children, Psychosocial, Questionnaire development and validation, Resilience, Risk, Suicidality",
    author = "{The STOP Consortium} and A. Rodr{\'i}guez-Quiroga and I. Flamarique and J. Castro-Fornieles and K. Lievesley and Buitelaar, {J. K.} and D. Coghill and D{\'i}az-Caneja, {C. M.} and Dittmann, {R. W.} and A. Gupta and Hoekstra, {P. J.} and L. Kehrmann and C. Llorente and D. Purper-Ouakil and Schulze, {U. M. E.} and A. Zuddas and R. Sala and J. Singh and F. Fiori and C. Arango and Paramala Santosh and Alastair Sutcliffe and Sarah Curran and Laura Selema and Robert Flanagan and Ian Craig and Nathan Parnell and Keren Yeboah and Gideon Lack and Florence Pupier and Loes Vinkenvleugel and Jeffrey Glennon and Mireille Bakker and Cora Drent and Elly Bloem and Steenhuis, {Mark Peter} and Ruth Berg and Alexander H{\"a}ge and Dau, {Mahmud Ben} and Konstantin Mechler and Sylke Rauscher and Sonja Aslan and Simon Schlanser and Ferdinand Keller and Alexander Schneider and Paul Plener and Fegert, {J{\"o}rg M.} and Jacqui Paton and Macey Murray and Noha Iessa and Alfred Kolozsvari",
    year = "2019",
    month = "5",
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    doi = "10.1007/s00787-019-01328-2",
    language = "English",
    journal = "European Child & Adolescent Psychiatry",
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    The STOP Consortium, Rodríguez-Quiroga, A, Flamarique, I, Castro-Fornieles, J, Lievesley, K, Buitelaar, JK, Coghill, D, Díaz-Caneja, CM, Dittmann, RW, Gupta, A, Hoekstra, PJ, Kehrmann, L, Llorente, C, Purper-Ouakil, D, Schulze, UME, Zuddas, A, Sala, R, Singh, J, Fiori, F & Arango, C 2019, 'Development and psychometric properties of the “Suicidality: Treatment Occurring in Paediatrics (STOP) Risk and Resilience Factors Scales” in adolescents', European Child and Adolescent Psychiatry. https://doi.org/10.1007/s00787-019-01328-2

    Development and psychometric properties of the “Suicidality: Treatment Occurring in Paediatrics (STOP) Risk and Resilience Factors Scales” in adolescents. / The STOP Consortium; Rodríguez-Quiroga, A.; Flamarique, I.; Castro-Fornieles, J.; Lievesley, K.; Buitelaar, J. K.; Coghill, D.; Díaz-Caneja, C. M.; Dittmann, R. W.; Gupta, A.; Hoekstra, P. J.; Kehrmann, L.; Llorente, C.; Purper-Ouakil, D.; Schulze, U. M. E.; Zuddas, A.; Sala, R.; Singh, J.; Fiori, F.; Arango, C.

    In: European Child and Adolescent Psychiatry, 03.05.2019.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Development and psychometric properties of the “Suicidality: Treatment Occurring in Paediatrics (STOP) Risk and Resilience Factors Scales” in adolescents

    AU - The STOP Consortium

    AU - Rodríguez-Quiroga, A.

    AU - Flamarique, I.

    AU - Castro-Fornieles, J.

    AU - Lievesley, K.

    AU - Buitelaar, J. K.

    AU - Coghill, D.

    AU - Díaz-Caneja, C. M.

    AU - Dittmann, R. W.

    AU - Gupta, A.

    AU - Hoekstra, P. J.

    AU - Kehrmann, L.

    AU - Llorente, C.

    AU - Purper-Ouakil, D.

    AU - Schulze, U. M. E.

    AU - Zuddas, A.

    AU - Sala, R.

    AU - Singh, J.

    AU - Fiori, F.

    AU - Arango, C.

    AU - Santosh, Paramala

    AU - Sutcliffe, Alastair

    AU - Curran, Sarah

    AU - Selema, Laura

    AU - Flanagan, Robert

    AU - Craig, Ian

    AU - Parnell, Nathan

    AU - Yeboah, Keren

    AU - Lack, Gideon

    AU - Pupier, Florence

    AU - Vinkenvleugel, Loes

    AU - Glennon, Jeffrey

    AU - Bakker, Mireille

    AU - Drent, Cora

    AU - Bloem, Elly

    AU - Steenhuis, Mark Peter

    AU - Berg, Ruth

    AU - Häge, Alexander

    AU - Dau, Mahmud Ben

    AU - Mechler, Konstantin

    AU - Rauscher, Sylke

    AU - Aslan, Sonja

    AU - Schlanser, Simon

    AU - Keller, Ferdinand

    AU - Schneider, Alexander

    AU - Plener, Paul

    AU - Fegert, Jörg M.

    AU - Paton, Jacqui

    AU - Murray, Macey

    AU - Iessa, Noha

    AU - Kolozsvari, Alfred

    PY - 2019/5/3

    Y1 - 2019/5/3

    N2 - Suicidality in the child and adolescent population is a major public health concern. There is, however, a lack of developmentally sensitive valid and reliable instruments that can capture data on risk, and clinical and psychosocial mediators of suicidality in young people. In this study, we aimed to develop and assess the validity of instruments evaluating the psychosocial risk and protective factors for suicidal behaviours in the adolescent population. In Phase 1, based on a systematic literature review of suicidality, focus groups, and expert panel advice, the risk factors and protective factors (resilience factors) were identified and the adolescent, parent, and clinician versions of the STOP-Suicidality Risk Factors Scale (STOP-SRiFS) and the Resilience Factors Scale (STOP-SReFS) were developed. Phase 2 involved instrument validation and comprised of two samples (Sample 1 and 2). Sample 1 consisted of 87 adolescents, their parents/carers, and clinicians from the various participating centres, and Sample 2 consisted of three sub-samples: adolescents (n = 259) who completed STOP-SRiFS and/or the STOP-SReFS scales, parents (n = 213) who completed one or both of the scales, and the clinicians who completed the scales (n = 254). The STOP-SRiFS demonstrated a good construct validity—the Cronbach Alpha for the adolescent (α = 0.864), parent (α = 0.842), and clinician (α = 0.722) versions of the scale. Test–retest reliability, inter-rater reliability, and content validity were good for all three versions of the STOP-SRiFS. The sub-scales generated using Exploratory Factor Analysis (EFA) were the (1) anxiety and depression risk, (2) substance misuse risk, (3) interpersonal risk, (4) chronic risk, and (5) risk due to life events. For the STOP-SRiFS, statistically significant correlations were found between the Columbia-Suicide Severity Rating Scale (C-SSRS) total score and the adolescent, parent, and clinical versions of the STOP-SRiFS sub-scale scores. The STOP-SRiFS showed good psychometric properties. This study demonstrated a good construct validity for the STOP-SReFS—the Cronbach Alpha for the three versions were good (adolescent: α = 0.775; parent: α = 0.808; α = clinician: 0.808). EFA for the adolescent version of the STOP-SReFS, which consists of 9 resilience factors domains, generated two factors (1) interpersonal resilience and (2) cognitive resilience. The STOP-SReFS Cognitive Resilience sub-scale for the adolescent was negatively correlated (r = − 0.275) with the C-SSRS total score, showing that there was lower suicidality in those with greater Cognitive Resilience. The STOP-SReFS Interpersonal resilience sub-scale correlations were all negative, but none of them were significantly different to the C-SSRS total scores for either the adolescent, parent, or clinician versions of the scales. This is not surprising, because the items in this sub-scale capture a much larger time-scale, compared to the C-SSRS rating period. The STOP-SReFS showed good psychometric properties. The STOP-SRiFS and STOP-SReFS are instruments that can be used in future studies about suicidality in children and adolescents.

    AB - Suicidality in the child and adolescent population is a major public health concern. There is, however, a lack of developmentally sensitive valid and reliable instruments that can capture data on risk, and clinical and psychosocial mediators of suicidality in young people. In this study, we aimed to develop and assess the validity of instruments evaluating the psychosocial risk and protective factors for suicidal behaviours in the adolescent population. In Phase 1, based on a systematic literature review of suicidality, focus groups, and expert panel advice, the risk factors and protective factors (resilience factors) were identified and the adolescent, parent, and clinician versions of the STOP-Suicidality Risk Factors Scale (STOP-SRiFS) and the Resilience Factors Scale (STOP-SReFS) were developed. Phase 2 involved instrument validation and comprised of two samples (Sample 1 and 2). Sample 1 consisted of 87 adolescents, their parents/carers, and clinicians from the various participating centres, and Sample 2 consisted of three sub-samples: adolescents (n = 259) who completed STOP-SRiFS and/or the STOP-SReFS scales, parents (n = 213) who completed one or both of the scales, and the clinicians who completed the scales (n = 254). The STOP-SRiFS demonstrated a good construct validity—the Cronbach Alpha for the adolescent (α = 0.864), parent (α = 0.842), and clinician (α = 0.722) versions of the scale. Test–retest reliability, inter-rater reliability, and content validity were good for all three versions of the STOP-SRiFS. The sub-scales generated using Exploratory Factor Analysis (EFA) were the (1) anxiety and depression risk, (2) substance misuse risk, (3) interpersonal risk, (4) chronic risk, and (5) risk due to life events. For the STOP-SRiFS, statistically significant correlations were found between the Columbia-Suicide Severity Rating Scale (C-SSRS) total score and the adolescent, parent, and clinical versions of the STOP-SRiFS sub-scale scores. The STOP-SRiFS showed good psychometric properties. This study demonstrated a good construct validity for the STOP-SReFS—the Cronbach Alpha for the three versions were good (adolescent: α = 0.775; parent: α = 0.808; α = clinician: 0.808). EFA for the adolescent version of the STOP-SReFS, which consists of 9 resilience factors domains, generated two factors (1) interpersonal resilience and (2) cognitive resilience. The STOP-SReFS Cognitive Resilience sub-scale for the adolescent was negatively correlated (r = − 0.275) with the C-SSRS total score, showing that there was lower suicidality in those with greater Cognitive Resilience. The STOP-SReFS Interpersonal resilience sub-scale correlations were all negative, but none of them were significantly different to the C-SSRS total scores for either the adolescent, parent, or clinician versions of the scales. This is not surprising, because the items in this sub-scale capture a much larger time-scale, compared to the C-SSRS rating period. The STOP-SReFS showed good psychometric properties. The STOP-SRiFS and STOP-SReFS are instruments that can be used in future studies about suicidality in children and adolescents.

    KW - Adolescents

    KW - Children

    KW - Psychosocial

    KW - Questionnaire development and validation

    KW - Resilience

    KW - Risk

    KW - Suicidality

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    U2 - 10.1007/s00787-019-01328-2

    DO - 10.1007/s00787-019-01328-2

    M3 - Article

    JO - European Child & Adolescent Psychiatry

    JF - European Child & Adolescent Psychiatry

    SN - 1018-8827

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