(PS11-25) Decreases in Suicide Intent from Pre- to Post-assessment Associates with Suicide Risk Indicators on the Suicide Status Form

Problem: It is a common misunderstanding that talking about suicide and suicide related topics can worsen or increase suicide thoughts or behaviors. Much research has been done in this area and a recent meta-analysis conducted in 2022 found that there were no harmful outcomes of asking and talking about suicide in the context of research (Polihronis et al., 2022). It is possible that suicide research involving a therapeutic assessment, such as the Suicide Status Form (SSF) from the Collaborative Assessment and Management of Suicidality (Jobes, 2023), may actually result in decreases in ratings of stress and suicide intentions from pre- to post-assessment. These changes may also be associated with indicators of suicide risk on the SSF. The aim of the current study was to examine changes in intent for suicide and stress level ratings from pre- to post-assessment. An additional aim was to examine correlations between key assessment ratings on the SSF and change scores.

Procedure: Data were from 97 adolescent inpatients in the southcentral region of the United States. Of the sample, 67.5% were female and 28.6% male, with a mean age of 14.6. The majority of participants were White (78.9%), with 7.9% identifying as Multi-ethnic, 3.9% identifying as Black, 2.6% identifying as Hispanic, and 1.3% identifying as Asian, Mexican, Puerto Rican, Middle Eastern, and Hawaiian. Data collection took place at an adolescent Crisis Stabilization Unit where participants were administered Part A of the Suicide Status Form. The key assessment items on the SSF included ratings of psychological pain, stress, agitation, hopelessness, self-hate, and overall risk of suicide (all rated from 1=low to 5=high). The University of Washington Risk Assessment Protocol (UWRAP) was administered before and after the full research protocol, and change scores were calculated from pre- to post-assessment for the items assessing intent to kill self and level of stress (rated at both times from 1=low to 7=high).

Results: Correlation analyses found that changes in suicide intent from UWRAP pre- to post-assessment were significantly and positively associated with changes in UWRAP stress scores (r=.228, p=.027). Also, change scores for suicide intent were significantly and negatively associated with SSF psychological pain (r=-.205, p=.047) and approached significance with a negative association to SSF self-hate (r=-.201, p=.052). Correlation analyses also found that changes in the UWRAP stress rating from pre- to post-assessment were significantly and negatively related to the SSF stress rating (r=-.335, p< .001).
Discussion: These results indicate that decreases in suicide intent were associated with decreases in stress levels on the UWRAP, indicating parallel reductions after completing the SSF and other self-report measures. When examining change scores on the UWRAP suicide intent rating, greater reductions in suicide intent were associated with lower ratings on the psychological pain and self-hate SSF items. There may be an alignment of greater reductions in suicide intent and some indicators of suicide risk. These results also indicate that reductions in UWRAP stress ratings were associated with lower stress ratings on the SSF, which makes sense as both measured current stress.