title: Development and psychometric properties of the Suicidality: Treatment Occurring in Paediatrics (STOP) Suicidality Assessment Scale (STOP-SAS) in children and adolescents.
abstract: To create a self-reported, internet-based questionnaire for the assessment of suicide risk in children and adolescents.
  
  
  
  As part of the EU project 'Suicidality: Treatment Occurring in Paediatrics' (STOP project), we developed web-based Patient Reported Outcome Measures (PROMs) for children and adolescents and for proxy reports by parents and clinicians in order to assess suicidality. Based on a literature review, expert panels and focus groups of patients, we developed the items of the STOP Suicidality Assessment Scale (STOP-SAS) in Spanish and English, translated it into four more languages, and optimized it for web-based presentation using the HealthTrackerTMplatform. Of the total 19 questions developed for the STOP-SAS, four questions that assess low-level suicidality were identified as screening questions (three of them for use with children, and all four for use with adolescents, parents and clinicians). A total of 395 adolescents, 110 children, 637 parents and 716 clinicians completed the questionnaire using the HealthTrackerTM, allowing us to evaluate the internal consistency and convergent validity of the STOP-SAS with the clinician-rated Columbia Suicide Severity Rating Scale (C-SSRS). Validity was also assessed with the receiver operating characteristic (ROC) area of the STOP-SAS with the C-SSRS.
  
  
  
  The STOP-SAS comprises 19 items in its adolescent, parent, and clinician versions, and 14 items in its children's version. Good internal consistency was found for adolescents (Cronbach's alpha: 0.965), children (Cronbach's alpha: 0.922), parents (Cronbach's alpha: 0.951) and clinicians (Cronbach's alpha: 0.955) versions. A strong correlation was found between the STOP-SAS and the C-SSRS for adolescents (r:0.670), parents (r:0.548), clinicians (r:0.863) and children (r:0.654). The ROC area was good for clinicians' (0.917), adolescents' (0.834) and parents' (0.756) versions but only fair (0.683) for children's version.
  
  
  
  The STOP-SAS is a comprehensive, web-based PROM developed on the HealthTrackerTMplatform, and co-designed for use by adolescents, children, parents and clinicians. It allows the evaluation of aspects of suicidality and shows good reliability and validity.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, SGR1119, Institut Clinic de Neurociències, Hospital Clínic Universitari of Barcelona, Fundació Clínic per la Recerca Biomèdica, C/Villarroel, 170, Barcelona, 08036, Spain. itziar.flamarike@gmail.com.|Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain. itziar.flamarike@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Flamarique
authors.affiliation: Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.|Centre for Interventional Paediatric Psychopharmacology, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Santosh
authors.affiliation: Department of Biomedical Sciences, Cagliari University Hospital, University of Cagliari, Cagliari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Zuddas
authors.affiliation: Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Arango
authors.affiliation: CHRU Montpellier, Hôpital Saint Eloi, Médecine Psychologique de l'Enfant et de l'Adolescent, Montpellier, France.|INSERM U894-Team 1. Center of Psychiatry and Neurosciences, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Purper-Ouakil
authors.affiliation: Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: Hoekstra
authors.affiliation: University of Dundee, Dundee, UK.
authors.forename: D
authors.initials: D
authors.lastname: Coghill
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Schulze
authors.affiliation: Paediatric Psychopharmacology, Department of Child and Adolescent Psychiatry, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: R W
authors.initials: RW
authors.lastname: Dittmann
authors.affiliation: Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.
authors.forename: J K
authors.initials: JK
authors.lastname: Buitelaar
authors.affiliation: Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Lievesley
authors.affiliation: Department of Biomedical Sciences, Cagliari University Hospital, University of Cagliari, Cagliari, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Frongia
authors.affiliation: Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Llorente
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, SGR1119, Institut Clinic de Neurociències, Hospital Clínic Universitari of Barcelona, Fundació Clínic per la Recerca Biomèdica, C/Villarroel, 170, Barcelona, 08036, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Méndez
authors.affiliation: Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Sala
authors.affiliation: Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
authors.forename: F
authors.initials: F
authors.lastname: Fiori
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, SGR1119, Institut Clinic de Neurociències, Hospital Clínic Universitari of Barcelona, Fundació Clínic per la Recerca Biomèdica, C/Villarroel, 170, Barcelona, 08036, Spain.|Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.|Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain.|Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Castro-Fornieles
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D017144:Focus Groups; D006801:Humans; D020407:Internet; D008297:Male; D000071066:Patient Reported Outcome Measures; D010372:Pediatrics; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D057566:Self Report; D013405:Suicide / Q000523:psychology; D000092864:Suicide Prevention
keywords: Adolescents; Adverse events; Assessment; Children; Parents; Scale; Suicidality