Measurement Invariance and Response Consistency of Single-Item Assessments for Suicidal Thoughts and Behaviors

The present study aimed to expand the literature on single-item assessments for suicidal thoughts and behaviors (STBs) by examining measurement invariance of commonly used single-item assessments of suicidal ideation (SI), planning (SP), and attempts (SA) with respect to race and ethnicity. Predictive invariance with respect to depression, and multi-item measures of passive and active SI were also explored. Measurement invariance was examined across (a) Black and White respondents and (b) Hispanic/Latinx and non-Hispanic/-Latinx respondents. Participants (N = 1,624; 51.66% male) were recruited from Mechanical Turk and Prime Panels. Participants were administered four distinct single-item measures each for SI, SP, and SA across three timeframes (past month, past year, lifetime). Items were drawn from well-known large-scale studies (e.g., National Comorbidity Survey) and common suicide risk assessments. Multiple group confirmatory factor analysis was used to examine measurement invariance; regression with group by measure interactions were used to evaluate predictive invariance. Measurement invariance was observed for both Black (N = 534) and White (N = 1,089) respondents as well as Hispanic/Latinx (N = 335) and non-Hispanic/-Latinx (N = 1,288) respondents across single-item outcomes. Thus, SI, SP, and SA rates can be defensibly compared between Black and White and Hispanic/Latinx and non-Hispanic/-Latinx respondents within studies; however, comparison of SI and SP rates across studies with differing assessment prompts should be met with caution. Multiple single-item STB measures demonstrated predictive bias across race and ethnicity suggesting potential differential screening capabilities. Elevated SI, SP, and SA rates for Hispanic/Latinx individuals were also observed. Findings reiterate the importance of minor language differences in single-item STB assessments. Public Significance Statement This study advances understanding of how commonly used single-item measures of suicidal thoughts and behaviors perform across different demographic groups. Findings suggest that measures are not biased for the racial and ethnic groups studied here; however, the relationship of these instruments with important outcome variables, such as depression or more comprehensive suicide measures, functioned differently for individuals with minoritized racial or ethnic identities.