Measurement Properties of the Suicidal Behaviour Questionnaire-Revised in Autistic Adults.
Sarah A Cassidy, Louise Bradley, Heather Cogger-Ward and 5 others
PMID 32125569WHAT IT FOUND
The SBQ-R suicide questionnaire does not measure suicidality the same way in autistic adults as in the general population.
Items about telling others and future intent work differently, so comparing total scores between these groups is invalid without adaptation.
Key findings
01Measurement invariance analysis showed the SBQ-R does not measure the same construct equivalently in autistic and non-autistic adults, specifically for items regarding communicating suicide threat and future likelihood.
02Autistic adults found the item about communicating suicide threat less relevant due to social isolation, while the item about future likelihood was harder to answer due to difficulties predicting the future.
03Because the tool's structure differs between groups, total SBQ-R scores cannot be directly compared between autistic and general population adults.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample consisted of autistic adults without intellectual disability who were diagnosed in adulthood, which may not represent the wider autistic population, particularly those diagnosed in childhood or with intellectual disability. The autistic group had a lower proportion of males (40%) than is typical in the wider autistic population, potentially affecting generalisability. The study focused on measurement properties for research comparison; it did not test the tool's clinical predictive validity for suicide attempts. Results are limited to the specific items tested in the SBQ-R and may not apply to other suicidality tools.
Declared interests
Funded by the Economic and Social Research Council and Autistica.
The easy way to misread this
Do not use the SBQ-R total score to compare suicide risk levels between autistic and non-autistic patients. The tool measures different underlying constructs in each group, so a higher score in an autistic patient does not necessarily mean they are 'more suicidal' than a non-autistic patient with the same score.