Predictive Validity of the MAYSI-2 and PAI-A for Suicide-Related Behavior and Nonsuicidal Self-Injury Among Adjudicated Adolescent Offenders on Probation

Abstract

Suicide-related behavior (SRB), defined as any behavior undertaken with the deliberate intent to end life (e.g., plans, attempts, completed suicide), and non-suicidal self-injury (NSSI), defined as any self-destructive behavior undertaken to damage or harm oneself without the intention of dying (e.g., cutting, burning, biting; Nock, Joiner, Gordon, Lloyd-Richardson, & Prinstein, 2006), are major health concerns among justice-involved youth (Dixon-Gordon, Harrison & Roesch, 2012; Hayes, 2004). SRB and NSSI among justice-involved youth have been attributed, in part, to elevated rates of mental disorder and emotional distress (Teplin, Abram, McClelland, Dulcan, & Mericle, 2002). Compared to the general population of adolescents, justice-involved youth have higher prevalence rates of depression, anxiety, anger problems, somatic complains, trauma, substance use, and borderline personality traits. Features of these disorders, such as suicidal ideation, hopelessness, emotional dysregulation, and impulsivity, can lead to SRB (Hayes, 2004) or NSSI (Dixon-Gordon et al., 2012). In addition, comorbid disorders are common (Teplin et al., 2002), with the risk for SRB and NSSI increasing with multiple diagnoses (Fleischmann et al., 2005). The evaluation of mental health needs on entry to the youth justice system may assist in identification of youth at risk for SRB or NSSI. However, it is unclear how justice agencies should best identify mental health needs in adolescents. Although clinician-administered tools are available for assessing mental health problems in youth (e.g., the Diagnostic Interview Schedule for Children, Version Four, Shaffer et al., 2000), these tools may be inappropriate for routine use in youth justice settings (National Action Alliance for Suicide Prevention, 2013). For instance, comprehensive clinician-rated measures require trained and experienced clinical staff with expertise in scoring and interpretation. Moreover, clinician-rated measures can be timeconsuming to administer and score and therefore may be difficult or impractical to implement for every youth. Although briefer assessment tools have been developed (e.g., the Beck Depression Inventory-II; Beck, Steer, & Brown, 1996), these tools often focus on a single problem area and thus are too limited in scope to identify the full range of mental health problems that can occur in adolescence. To address these concerns, standardized, multidimensional self-report screening measures of mental health have been developed. These measures are intended to identify adolescents in need of a more comprehensive clinician-administered evaluation, or to screen out relatively lower risk adolescents who do not require resource-intensive assessments. In addition, these measures can assist in determining whether monitoring (e.g., suicide monitoring) is required. Some of these tools, such as the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2; Grisso & Barnum, 2006), a 15-minute screening measure of mental health, were specifically developed for use wi...

Do suicidal thoughts and behavior persist following juvenile justice involvement?

“…Butler et al (2007) found that scores in the Caution/Warning range on the Angry-Irritable, Somatic Complaints, Depressed-Anxious, and SI scales of the MAYSI significantly predicted placement on suicide watch of adjudicated male youth at a residential treatment center. However, other research assessing nonincarcerated youth indicated that the MAYSI-2 subscales at initial screening were not predictive of future suicidal behaviors, though clinically significant SI and Thought Disturbance scores did predict NSSI at 3-month follow-up for youth on probation (Shaffer et al, 2018).…”

Applying the Stress Process Theory to Assess Correlates of Suicide Ideation-to-Action Among Persons on Parole in the United States

“…In terms of mental health, acute stress has been associated with higher rates of suicidality, but was not the sole variable impacting the likelihood of suicide attempts (López-Díaz et al, 2018). In addition to the gap in physical health services, studies show that individuals on parole often lack mental health services aimed at addressing suicide-related behaviors, non-suicidal self-injury, and a multitude of behavioral health concerns (Bryson et al, 2019;Houser et al, 2019;Shaffer et al, 2018;Timmer & Nowotny, 2021;Van Deinse et al, 2019). For example, some estimates suggest that as many as 29% of persons on parole experience risk factors associated with suicide, such as depression, psychological distress, and episodes of major depression (Bryson et al, 2019;Visher & Courtney, 2007;Yu et al, 2014).…”

Statewide Trends of Trauma History, Suicidality, and Mental Health Among Youth Entering the Juvenile Justice System

“…Also, while the dichotomized measures of mental health problems and suicide risk do not reflect the complexity of the problem, the findings of the study show that the PACT may be a good screening tool to identify a need for a psychiatric evaluation. Future studies should test construct and predictive validity of the PACT in screening suicidal ideation and behaviors in comparison with other suicide-specific screening tools such as the Suicide Behavior Questionnaire [40].…”