Using Cognitive Interviewing to Develop Rating Scales of Suicide Thoughts and Behaviors in Preadolescent Children

Despite the alarming rise of suicidal thoughts and behaviors (STBs), in preadolescent children over the last two decades, no scales have been developed and validated to assess these troubling tendencies in this population. We describe how we developed English and Spanish language versions of a new scale to assess STBs in children, the Suicide Risk and Ideation Scale for Kids - Child and Parent versions (S-RISK-C/P), using cognitive interviewing.

After creating item pools in English and Spanish, we elicited feedback from three clinician content experts and conducted cognitive interviews with 8 children (4 girls; Mage = 10.37 years; SDage = 1.19 years) and their parents (5 interviews in English, 3 in Spanish).

Children and parents readily understood the directions, items, and response options of the S-RISK-C/P and expressed high confidence in their responses. Cognitive interviews indicated only minor issues with wording and sequence of some items, which led to iterative revisions.

This is the first study to apply cognitive interviewing in child suicide research to ensure development of a scale that has clear and accessible language. We are currently undertaking measurement development and evaluation of S-RISK-C/P further by gathering data to determine the scale's item properties, reliability, and validity.