Measurement Properties of the Suicidal Behaviour Questionnaire-Revised in Autistic Adults

Abstract

We explored the appropriateness and measurement properties of a suicidality assessment tool (SBQ-R) developed for the general population, in autistic adults-a high risk group for suicide. 188 autistic adults and 183 general population adults completed the tool online, and a sub-sample (n = 15) were interviewed while completing the tool. Multi-group factorial invariance analysis of the online survey data found evidence for metric non-invariance of the SBQ-R, particularly for items three (communication of suicidal intent) and four (likelihood of suicide attempt in the future). Cognitive interviews revealed that autistic adults did not interpret these items as intended by the tool designers. Results suggest autistic adults interpret key questions regarding suicide risk differently to the general population. Future research must adapt tools to better capture suicidality in autistic adults.

Development and Validation of the Suicide Behaviours Questionnaire – Autism Spectrum Conditions in Autistic, Possibly Autistic and Non-Autistic Adults.

“…A previous study had explored how autistic compared to non-autistic adults interpret and respond to the SBQ-R [19], to inform how to adapt this tool for autistic adults. The adapted SBQ-ASC was subsequently re ned through: a) Cognitive interviews with 9 autistic adults (who took part in the earlier study, [19]); and b) A survey completed by 251 autistic adults who provided qualitative feedback, and rated the clarity and importance of each item of the original SBQ-R and adapted SBQ-ASC (234 diagnosed, 17 awaiting assessment; 30.7% male; mean age=41.91, SD=13.44; mean age of ASC diagnosis=36.09, SD=14.03; 61.4% Asperger Syndrome diagnosis). Table 2 summarises the key issues identi ed with the SBQ-R by autistic adults across the interviews and online survey, and the subsequent adaptations incorporated into the SBQ-ASC to address these.…”

“…did not want to/really hoped to die; never/no chance at all). Results also suggested a worrying clinical picture, that autistic adults reported impulsively attempting suicide without a plan when the means to attempt suicide where present [19].…”

“…The SBQ-R has also been utilised in research with autistic adults [e.g. 3,27], with evidence that the structure and interpretation of the SBQ-R is different in autistic compared to non-autistic adults [19]. Cronbach's alpha for whole scale: Autistic group a=.739, possibly autistic group a=.755, non-autistic group a=.734.…”

“…One study has explored how autistic adults interpret and respond to the SBQ-R compared to non-autistic adults [19]. An online survey gathered responses to the SBQ-R in 188 autistic and 183 non-autistic adults matched on age and gender to compare the structure of the tool between the groups, and a subsample of 15 autistic adults were interviewed while completing the SBQ-R to explore how they interpreted and responded to the items.…”

“…Taken together these ndings suggest that the SBQ-R would bene t from adaptation to improve the clarity and relevance of the items to autistic adults. The current study thus aimed to adapt the SBQ-R, incorporating feedback from autistic adults from the earlier study [19], and re ning the adapted tool with additional interviews and an online survey. Subsequently, we assessed the appropriateness and measurement properties of the adapted Suicide Behaviours Questionnaire -Autism Spectrum Conditions (SBQ-ASC) in autistic adults in a new sample.…”