Inconsistent Reporting and Suicidality Prevalence: A 30-Year Analysis of the Youth Risk Behavior Survey (1993-2023)

Inconsistent reporting can bias suicidality research findings. This study focused on an overlooked pattern-endorsing suicide plans while denying suicidal ideation-and estimated its impact on suicidality prevalence in the Youth Risk Behavior Survey. Publicly available Youth Risk Behavior Survey data from 1993 to 2023 (n = 242,403) were analyzed. Four suicidality indicators were examined: active suicidal ideation, suicide plans, suicide attempts, and post-attempt medical treatment. Statistical analyses included proportion tests and Cohen's h. Overall, 3.1% of respondents reported suicide plans while denying suicidal ideation. Screening out inconsistent reporters systematically impacted the prevalence of suicide plans. By contrast, the prevalence of active suicidal ideation, suicide attempts, and post-attempt medical treatment was only marginally affected. Decisions to include or exclude participants who endorsed suicide plans while denying suicidal ideation should be explicitly justified. Findings underscore the importance of addressing inconsistent reporting and suggest that the suicide plan item may require wording revision to enhance its validity.