Cutoff scores and predictive validity of the Acute Suicidal Affective Disturbance Inventory (ASADI) for future...

Identification of individuals at elevated risk for suicidal behavior is an important component of suicide prevention efforts. This study aimed to examine the predictive validity of the Acute Suicidal Affective Disturbance Inventory (ASADI) and to explore potential cutoff scores in relation to subsequent suicidal outcomes.

We analyzed data from a community-based sample of 682 Korean adults who had experienced a drastic increase in suicide intent, of whom 373 completed a one-year follow-up assessment. Using one-year longitudinal data, receiver operating characteristics (ROC) analyses were conducted to examine cutoff scores in predicting future suicide attempts and suicidal ideation with intent. Potential cutoff scores were further evaluated by assessing their predictive performance after controlling for demographic and clinical covariates through multivariate logistic regression.

Higher ASADI scores were prospectively associated with suicide attempts and suicidal ideation with intent during the follow-up period. A cutoff score of 248 demonstrated the strongest discriminative performance for suicide attempts, with individuals scoring above this threshold showing an increased likelihood of attempting suicide over one year after adjusting for covariates. Additional cutoffs of 192 and 206 were associated with suicidal ideation with intent.

These findings provide preliminary, empirically derived cutoff scores for the ASADI and support its prospective relevance as a measure of identifying at-risk individuals who warrant closer monitoring.