Psychometrics of the Concise Health Risk Tracking Self-Report (CHRT-SR16) assessment of suicidality in a sample of adults with moderate to severe methamphetamine use disorder: Findings from the ADAPT-2 randomized trial.

The co-occurrence of suicidality and substance use disorders has been well established, but rating scales to examine suicidal behavior and risk are sparse among participants with substance use disorders. In this study, part of the CTN ADAPT-2 protocol (CTN-0068), researchers examined the psychometric properties of the 16-item Concise Health Risk Tracking Scale – Self Report (CHRT-SR16) to measure suicidality among adults with moderate-to-severe methamphetamine use disorder.

Participants (n = 403) with moderate-to-severe methamphetamine use disorder completed the CHRT-SR16 as part of a randomized, double-blind, placebo-controlled pharmacotherapy trial. The CHRT-SR16 factor structure was assessed using confirmatory factor analysis (CFA). Internal consistency was estimated with coefficients alpha (a) and omega ( ), test-retest reliability with intraclass correlation coefficient (ICC) and standard error of measurement, and convergent validity using Spearman’s rank order correlation coefficient test between CHRT-SR16 factors and the Patient Health Questionnaire (PHQ-9). The analyses utilized baseline and week 1 data (for test-retest reliability only).

CFA revealed a seven-factor model of Pessimism, Helplessness, Social Support, Despair, Impulsivity, Irritability, and Suicidal Thoughts as the best-fitting model. The CHRT-SR16 also exhibited strong internal consistency (a = 0.89; = 0.89), test-retest reliability (ICC = 0.78) and convergent validity with the PHQ-9 total score ( = 0.62).

Conclusions: The results of this study offer evidence for strong reliability and convergent validity of the CHRT-SR16, among the first validated instruments to measure Suicidal Thoughts and behavior in a population that is disproportionately experiencing overdose and death due to methamphetamine use. The CHRT-SR16 builds upon prior work with the CHRT-SR and allows for the novel assessment of impulsivity and irritability as possible risk factors for suicidal behavior.

Related protocols: CTN-0068