8岁以下儿童自杀念头与行为的简易照护者报告筛选的初步效度

Laura Hennefield PhD , Christina Chen BA , Uchechukwu Agali BS , Joan L. Luby MD
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引用次数: 0

摘要

目的学龄前儿童就可能出现自杀念头和自杀行为。尽管呼吁加强青少年自杀风险筛查和评估,但我们缺乏工具来识别患有性传播感染的最年幼的儿童,他们可能有更高的自杀、自残和相关痛苦的风险。临床医生和护理人员对儿童自我报告性传播感染的能力持怀疑态度,并担心直接询问儿童性传播感染的负面影响,导致了这一差距。针对性传播感染的照料者报告措施可以解决这些问题,为提供者提供了评估幼儿性传播感染的急需工具。方法对来自不同社会人口背景的80名4 ~ 7岁儿童(平均[SD]年龄=6.06[1.12]岁)的照顾者进行电话问卷调查。大约3周后,护理人员和儿童独立完成了与年龄相适应的面对面临床诊断访谈,以评估性传播感染。有性传播感染史的儿童被过度抽样。相对于诊断访谈中检测到的性传播感染,计算阳性筛查的敏感性和特异性(护理人员至少认可1项),以评估筛查的心理测量特性。结果在80名自杀风险筛查者中,18人呈阳性。相对于对护理人员的诊断访谈,护理人员-性传播感染筛查在检测性传播感染风险方面的敏感性为85%,特异性为98.3%。相对于对照顾者或儿童的诊断性访谈,筛查显示68%的敏感性和98.2%的特异性,相对于仅对儿童的访谈,筛查显示50%的敏感性和80%的特异性。结论与参考标准相比,8岁以下儿童看护者-性传播疾病筛查具有良好的心理测量特性。如果进一步验证,这种筛查可以为临床医生提供一种新的简短工具来评估幼儿的自杀风险。它的高特异性表明,阳性筛查应被认真对待,作为风险指标,需要进一步随访。自杀的想法和行为(STBs)可能发生在学龄前的儿童身上,然而很少有工具来识别那些处于危险中的儿童。本研究对80名4至7岁儿童的自杀风险评估了一种新的4项护理员报告筛选,并将结果与临床诊断访谈进行了比较。筛查显示高特异性(98%)和良好的敏感性(85%),这意味着阳性筛查应被视为STB风险的指标。如果进一步验证,该工具可以帮助临床医生识别有自杀风险的幼儿,以确保他们得到适当的支持和干预。多样性和包容性声明在招募人类参与者时,我们努力确保性别和性别平衡。我们努力确保招募人类参与者的种族、民族和/或其他类型的多样性。我们努力确保研究问卷的编制具有包容性。本文的一位或多位作者自认为是科学中一个或多个历史上未被充分代表的种族和/或族裔群体的成员。本文的一位或多位作者自认为是科学界一个或多个历史上未被充分代表的性和/或性别群体的成员。本文的一位或多位作者获得了一个旨在增加少数族裔在科学领域代表性的项目的支持。我们积极地在我们的作者群体中促进性别和性别平衡。我们积极努力促进在我们的作者群体中纳入历史上代表性不足的种族和/或民族群体。在引用与本工作科学相关的参考文献的同时,我们也积极地在我们的参考文献列表中促进性别和性别平衡。在引用与本工作科学相关的参考文献的同时,我们还积极努力促进在我们的参考文献列表中纳入历史上代表性不足的种族和/或民族群体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preliminary Validity for a Brief Caregiver-Report Screener for Suicidal Thoughts and Behaviors in Children Under Age 8

Objective

Children as young as preschool age can experience suicidal thoughts and behaviors (STBs). Despite calls for increased youth suicide risk screening and assessment, we lack tools for identifying the youngest children experiencing STBs who might be at heightened risk for suicide, self-harm, and related distress. Clinician and caregiver skepticism about children’s ability to self-report STBs and concerns about negative effects of directly asking children about STBs contribute to this gap. A caregiver-report measure for STBs can address these concerns, offering providers a much-needed tool for assessing STBs in young children.

Method

A 4-item caregiver-report suicide risk screener was developed and administered by phone to caregivers of 80 children ages 4 to 7 years (mean [SD] age =6.06 [1.12] years) from diverse sociodemographic backgrounds. Approximately 3 weeks later, caregivers and children independently completed in-person age-appropriate clinical diagnostic interviews to assess STBs. Children with a history of STBs were oversampled. Sensitivity and specificity of positive screens (caregiver endorsed at least 1 item), relative to STBs detected in the diagnostic interview, were calculated to assess the psychometric properties of the screen.

Results

Of the 80 suicide risk screeners administered, 18 were positive. Relative to diagnostic interviews with caregivers, the caregiver-STBs screener showed 85% sensitivity and 98.3% specificity for detecting STBs risk. Relative to diagnostic interviews with either caregiver or child, the screener showed 68% sensitivity and 98.2% specificity, and relative to child-only interviews, the screener showed 50% sensitivity and 80% specificity.

Conclusion

The caregiver-STBs screener for children under age 8 demonstrates favorable psychometric properties compared with a reference standard. If further validated, this screener could offer clinicians a new brief tool to assess suicide risk in young children. Its high specificity suggests that positive screens should be taken seriously as indicators of risk, warranting further follow-up.

Plain language summary

Suicidal thoughts and behaviors (STBs) can occur in children as young as preschool age, yet there are few tools to identify those at risk. This study assessed a new 4-item caregiver-report screener for suicide risk in 80 children aged 4 to 7, comparing results to clinical diagnostic interviews. The screener showed high specificity (98%) and good sensitivity (85%), meaning positive screens should be taken seriously as indicators of STB risk. If further validated, this tool could help clinicians identify young children at risk for suicide to ensure they receive appropriate support and intervention.

Diversity & Inclusion Statement

We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.
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JAACAP open
JAACAP open Psychiatry and Mental Health
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