Screening for suicidal ideation in children and adolescents: methodological considerations

The prevalence of suicidal ideation and attempts varies considerably depending on (a) who the reporters are for youth suicidality, (b) the degree of retrospection required, and (c) the type of measure used to assess suicidality. The purpose of this study is to examine some of the methodological issues that should be considered when administering suicidal screening measures to children and adolescents. The risk group was comprised of offspring of depressed mothers (26 mothers with Bipolar Disorder, 42 mothers with Major Depressive Disorder). The comparison group was comprised of offspring of mothers without past or current psychiatric diagnosis (30 mothers). Two siblings from each family were recruited for participation (n = 192). Screening for youth suicidality was based on (a) structured diagnostic interviews with youth (yielding interval and lifetime reports), (b) youth self-reports, and (c) maternal reports. Assessments were made when the younger siblings were approximately 6, 9, and 14 years of age and older siblings were approximately 6, 9, 13, and 18 years of age. Mothers reported a lower prevalence of youth suicidal content than did youth. Discrepancies between mother and child report were more common in the risk group. When lifetime retrospection of suicidal content was assessed, fewer youth reported suicidal thoughts or actions than when suicidal content was assessed approximately every 3 years. Also, the prevalence of self-reported suicidal content was somewhat higher (7 to 13%) than when assessing suicidality within the context of an interview. Child and maternal characteristics were found to correspond to patterns of consistent and discrepant reporting.