Examining the Properties of the Suicidal Ideation Attributes Scale within a Text-Based Intervention Service Triage

Area of Science:

• Psychiatry
• Clinical Psychology
• Digital Health

Background:

• Text-based crisis services are crucial for suicide prevention.
• Triage tools are essential for identifying high-risk individuals in crisis.
• The Suicidal Ideation Attributes Scale (SIDAS) is used to assess suicide risk.

Purpose of the Study:

• Evaluate the psychometric properties of the SIDAS in a real-world setting.
• Assess the SIDAS's predictive validity for identifying high-risk users in text-based crisis services.
• Determine if combining the SIDAS with a suicidal intent question improves high-risk user detection.

Main Methods:

• 1,480 users of a text-based crisis service completed the French SIDAS and a suicidal intent question.
• Confirmatory factor analysis and ROC analysis were used to evaluate psychometric properties.
• Predictive validity was assessed using counselors' risk assessments.

Main Results:

• The SIDAS demonstrated good internal consistency (ω = .80) and a unifactorial structure.
• Sensitivity and specificity for differentiating high-risk users were low.
• Adding the SIDAS to the suicidal intent question provided a statistically significant but modest increase in explained variance.

Conclusions:

• The SIDAS exhibits comparable psychometric performance in real-world text-based crisis services.
• The clinical utility of the SIDAS for identifying high-risk individuals appears limited.
• Further discussion is needed on the SIDAS's utility and revised cutoffs for triage in digital mental health interventions.