Category: Suicide and Self-Injury

PS4- #B39 - Measuring Thwarted Belongingness and Perceived Burdensomeness in Clinically Depressed and Suicidal Youth: Interpersonal Needs Questionnaire

Friday, Nov 17
12:15 PM – 1:15 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Suicide | Adolescent Depression | Measurement

Objective: Suicide is the second leading cause of death among youth aged 15-24 years old in the U.S. Recently, researchers have emphasized the importance of theoretical models of suicide to better understand this phenomenon. One of these models is the Interpersonal-Psychological Theory of Suicide (IPTS), which provides a framework consisting of two interpersonal constructs that contribute to suicidal ideation (thwarted belongingness (TB) and perceived burdensomeness (PB)) in addition to the ability to overcome biological barriers promoting self-preservation and make a suicide attempt (acquired capability (AC)). The interpersonal constructs (i.e., TB, PB) are typically measured by the Interpersonal Needs Questionnaire (INQ). Hill and colleagues (2014) tested five versions of the INQ and none were found to have strong psychometric properties in youth. Fortunately, measurement methodology frameworks, such as Item Response Theory (IRT), can assist in refining and reducing existing measures to provide better test information, improve instrument reliability, and reduce questionnaire length to limit participant burden. This study examined the INQ within an IRT framework to evaluate the psychometric properties of the scale using a sample of clinically depressed and suicidal youth.



Methods:
Participants were 378 youth (Age M(SD) = 14.78(1.41), 82.54% female, 82.50% Caucasian, 77.25% Non-Hispanic, 70.00% inpatient, 78.00% diagnosed with MDD, 57.00% had at least one lifetime suicide attempt) who completed the INQ. The INQ contains 25 items across 2 subscales (i.e., TB, PB) that participants rate on a 7-point Likert-type response scale (1 = “Not at all true for me” to 7 = “Very true for me”). The current study applied IRT methodology to examine rating scale performance, dimensionality, model fit, and several instrument-level statistics of the INQ.



Results:
Subscale performance for the INQ was evaluated by applying a Partial Credit Model (PCM) in WINSTEPS. IRT scale reduction and refinement resulted in the INQ being reduced from 25 items to 16 items (8 items per subscale) and collapsing response options to four choices. Correlations between original items and refined items were large (r = .97 for PB; r = .98 for TB). Results suggest the newly refined INQ resulted in improved reliability and validity of the scale. Additional analyses examined item-level (e.g., fit, difficulty) and instrument-level (e.g., dimensionality) characteristics.  



Conclusions:
The newly refined INQ provides better test information, improved instrument reliability, and reduces burden on youth, clinicians, and researchers. With this improved measure, clinicians can more easily identify adolescent patients who may benefit from psychosocial interventions targeted at suicide prevention.

Ana F. El-Behadli

Doctoral Student in Clinical Psychology
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center
Dallas, Texas

Danette Beitra

Licensed Psychologist, Assistant Professor
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center
Dallas, Texas

Lucas Zullo

Doctoral Student in Clinical Psychology
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center
Dallas

Hayden Mbroh

Doctoral Student in Clinical Psychology
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center
Dallas, Texas

Sunita Stewart

Licensed Psychologist, Professor of Psychiatry
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center