A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience
Issue link: http://innovationscns.epubxp.com/i/425963
[ V O L U M E 1 1 , N U M B E R 9 – 1 0 , S E P T E M B E R – O C T O B E R 2 0 1 4 ] Innovations in CLINICAL NEUROSCIENCE 145 methodology (http://www.ispor. org/workpaper/practices_index.asp). Sitting with and surveying parents and children within the age ranges of t hese clusters and discussing with them the choice and understanding of each question along the lines outlined by Wild et al 14 and by Henning and Pickett 15 will assist in adapting the current pediatric versions of the S-STS for different ethnic, cultural, and at- risk groups. Pediatric versions of the S- STS need to be tested in a broad range of demographic, socioeconomic, ethnic, and cultural settings and in those with various disabilities. Since there is no gold standard pediatric suicidality scale that is linguistically validated, psychometric validation studies at this early stage may be premature and difficult to interpret. While there are other scales assessing different aspects of pediatric suicidality, 16 such as risk factors for suicidal ideation, psychometric validation needs to be done to compare scales that have some face equivalence and that have similar goals and focus. When linguistically validated pediatric suicidality scales with a similar focus and goals emerge, then psychometric validation studies need to be done. However, reliability studies can and should now be done to test the inter-rater reliability of clinician-rated versus clinician-rated, clinician-rated versus self-rated, and both clinician- and self-rated versions compared to a version that reconciles any differences between the two from the same interview (reconciliation version). Test-retest reliability studies can now be done on the current versions. Much work remains to be done and will involve collaboration and feedback from a broad alliance of clinicians and researchers in many countries and cultures to continue to make the pediatric versions of S-STS more reliable, more generalizable, and more useful. Linguistic validation using the process described above with cognitive debriefing to develop pediatric suicidality scales from their psychometrically validated adult versions alone is not sufficient to address the needs of the field. A similar linguistic validation p rocess may not be possible in some languages where no similar linguistic validation analyses, dictionaries, and reading specialists are available. We understand that French, German, Spanish, and Japanese are among those languages where a similar process is possible based on similar existing empirical language analyses and reading specialists. The use of empirically based, age- appropriate, linguistic validation of pediatric suicide scales is a necessary step in enhancing their accuracy and comprehension within a single language. The method discussed provides a model for such an approach. We hope this will start a process that may protect children and adolescents and reduce the tragic loss of life internationally from this silent and often preventable epidemic. ACKNOWLEDGMENTS The authors wish to acknowledge the contribution of JM Giddens for editorial assistance in the preparation of the manuscript and related documents and for input into the development of all versions of the S- STS. REFERENCES 1. Stone M, Laughren T, Jones ML et al. Risk of suicidality in clinical trials of antidepressants in adults: analysis of proprietary data submitted to US Food and Drug Administration. BMJ. 2009 Aug 11;339:b2880. 2. Hammed T, Laughren T, Racoosin JA. Suicidality in pediatric patients treated with antidepressant drugs. 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