Careless and inconsistent reporting inflates suicidality prevalence and biases sex differences

This study examined how careless and inconsistent reporting affects adolescent suicidality prevalence and sex differences, a methodological issue often overlooked in self-report epidemiological research.

I used data from two nationally representative surveys of secondary-school students conducted in 2010 (n = 7640; 49.3 % female) and 2014 (n = 5592; 52.6 % female). Both surveys assessed depressive symptoms, suicidal ideation, suicide plans, suicide attempts, attempt recognition, and attempt disclosure. Three methods of prevalence computation were used: unadjusted estimates (M1); excluding fictitious drug endorsers and treating inconsistencies as missing (M2); and excluding all careless and inconsistent reporters (M3).

About 19 % of respondents were identified as careless or inconsistent. Compared to M1, M2 and M3 yielded lower prevalence estimates for most indicators. The largest reductions involved, on average, reports of unnoticed suicide attempts (-73.8 %), talking to no one about an attempt (-73.3 %), and reporting six or more suicide attempts (-35.9 %). Most sex differences were unaffected, except for the 'six or more suicide attempts' category and attempt recognition and disclosure items.

Overlooking misreporting may inflate adolescent suicidality prevalence and distort sex-difference estimates. Incorporating validity checks and data-cleaning procedures can improve the accuracy of epidemiological findings and the effectiveness of prevention programs.