Global cross-cultural validation of a brief measure for identifying potential suicide risk in 42 countries

Gewirtz-Meydan A 1 , Koós M 2 , Nagy L 3 , Kraus SW 4 , Demetrovics Z 5 , Potenza MN 6 Show all authors , Ballester-Arnal R 7 , Batthyány D 8 , Bergeron S 9 , Billieux J 10 , Burkauskas J 11 , Cárdenas-López G 12 , Carvalho J 13 , Castro-Calvo J 14 , Chen L 15 , Ciocca G 16 , Corazza O 17 , Csako R 18 , Fernandez DP 19 , Fujiwara H 20 , Fernandez EF 21 , Fuss J 22 , Gabrhelík R 23 , Gjoneska B 24 , Gola M 25 , Grubbs JB 26 , Hashim HT 27 , Islam MS 28 , Ismail M 27 , Jiménez-Martínez MC 29 , Jurin T 30 , Kalina O 31 , Klein V 32 , Költő A 33 , Lee SK 34 , Lewczuk K 35 , Lin CY 36 , Lochner C 37 , López-Alvarado S 38 , Lukavská K 39 , Mayta-Tristán P 40 , Miller DJ 41 , Orosová O 42 , Orosz G 43 , Sungkyunkwan University's research team NA 44 , Ponce FP 45 , Quintana GR 46 , Quintero Garzola GC 47 , Ramos-Diaz J 48 , Rigaud K 43 , Rousseau A 49 , De Tubino Scanavino M 50 , Schulmeyer MK 51 , Sharan P 52 , Shibata M 53 , Shoib S 54 , Sigre-Leirós V 55 , Sniewski L 56 , Spasovski O 57 , Steibliene V 11 , Stein DJ 58 , Strong C 59 , Ünsal BC 3 , Vaillancourt-Morel MP 60 , Van Hout MC 61 , Bőthe B 62

Affiliations 

  • 1 School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel. Electronic address: Agewirtz-@univ.haifa.ac.il
  • 2 Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Forensic Psychiatry and Sex Research, University of Duisburg-Essen, Essen, Germany
  • 3 Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
  • 4 Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
  • 5 Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
  • 6 Yale University School of Medicine, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA
  • 7 Departmento de Psicología Básica, Clínica y Psicobiología, University Jaume I of Castellón, Spain
  • 8 Institute for Behavioural Addictions, Sigmund Freud University Vienna, Austria
  • 9 Département de Psychologie, Université de Montréal, Montréal, Canada
  • 10 Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
  • 11 Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
  • 12 Virtual Teaching and Cyberpsychology Laboratory, School of Psychology, National Autonomous University of Mexico, Mexico
  • 13 William James Center for Research, Departamento de Educação e Psicologia, Universidade de Aveiro, Aveiro, Portugal
  • 14 Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain
  • 15 Department of Psychology, College of Humanity and Social Science, Fuzhou University, China
  • 16 Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
  • 17 Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, UK; Department of Psychology and Cognitive Science, University of Trento, Italy
  • 18 Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
  • 19 Nottingham Trent University, UK
  • 20 Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Decentralized Big Data Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
  • 21 HELP University, Malaysia
  • 22 Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
  • 23 Charles University, First Faculty of Medicine, Department of Addictology, Prague, Czech Republic; General University Hospital in Prague, Department of Addictology, Czech Republic
  • 24 Macedonian Academy of Sciences and Arts, Macedonia
  • 25 Institute of Psychlogy, Polish Academy of Sciences, Poland; Institute for Neural Computations, University of California San Diego, USA
  • 26 University of New Mexico, Albuquerque, USA; Center for Alcohol, Substance Use, And Addiction (CASAA), University of New Mexico, Albuquerque, USA
  • 27 University of Baghdad, College of Medicine, Iraq
  • 28 Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; Centre for Advanced Research Excellence in Public Health, Savar, Dhaka 1342, Bangladesh
  • 29 Universidad Pedagógca y Tecnológica de Colombia, Colombia; Grupo de Investigación Biomédica y de Patología, Colombia
  • 30 Department of Psychology, Humanities and Social Sciences, University of Zagreb, Croatia
  • 31 Department of Educational Psychology and Psychology of Health, Pavol Jozef Safarik University in Kosice, Slovakia
  • 32 School of Psychology, University of Southampton, UK
  • 33 Health Promotion Research Centre, University of Galway, Ireland, UK
  • 34 Department of Psychiatry, Hallym University Chuncheon Sacred Heart Hospital, South Korea; Chuncheon Addiction Management Center, South Korea
  • 35 Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland
  • 36 Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  • 37 SAMRC Unit on Risk & Resilience in Mental Disorders, Stellenbosch University, South Africa
  • 38 Faculty of Psychology, University of Cuenca, Cuenca, Ecuador
  • 39 Charles University, First Faculty of Medicine, Department of Addictology, Prague, Czech Republic; Charles University, Faculty of Education, Department of Psychology, Prague, Czech Republic
  • 40 Facultad de Medicina, Universidad Científica del Sur, Lima, Peru
  • 41 College of Healthcare Sciences, James Cook University, Australia
  • 42 Pavol Jozef Safarik University in Kosice, Department of Educational Psychology and Psychology of Health, Slovakia
  • 43 Artois University, France
  • 44 Department of Psychology, Sungkyunkwan University, South Korea
  • 45 Facultad de Psicología, Universidad de Talca, Chile
  • 46 Departamento de Psicología y Filosofía, Facultad de Ciencias Sociales, Universidad de Tarapacá, Arica, Arica y Parinacota, Chile
  • 47 Florida State University, Panama; Sistema Nacional de Investigación (SNI), SENACYT, Panama
  • 48 Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Perú
  • 49 Leuven School for Mass Communication, KU Leuven, Leuven, Belgium
  • 50 Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, Brazil; Experimental Pathophisiology Post Graduation Program, Faculdade de Medicina, Universidade de São Paulo, Brazil
  • 51 Universidad Privada de Santa Cruz de la Sierra, Bolivia
  • 52 Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, 110029, India
  • 53 Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  • 54 Department of Psychology, Shardha University, India; Department of Health Kashmir, India
  • 55 Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Institute of Legal Psychiatry, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
  • 56 Auckland University of Technology, New Zealand
  • 57 Faculty of Philosophy, Ss. Cyril and Methodius University in Skopje, Macedonia; Faculty of Philosophy, University of Ss. Cyril and Methodius in Trnava, Slovakia
  • 58 SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa
  • 59 Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  • 60 Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
  • 61 Public Health Institute, Faculty of Health, Liverpool John Moores University, UK
  • 62 Département de Psychologie, Université de Montréal, Montréal, Canada; Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
Public Health, 2024 Apr;229:13-23.
PMID: 38382177 DOI: 10.1016/j.puhe.2023.12.031

Abstract

OBJECTIVES: This study aimed to examine the psychometric properties of the P4 suicide screener in a multinational sample. The primary goal was to evaluate the reliability and validity of the scale and investigate its convergent validity by analyzing its correlation with depression, anxiety, and substance use.

STUDY DESIGN: The study design is a cross-sectional self-report study conducted across 42 countries.

METHODS: A cross-sectional, self-report study was conducted in 42 countries, with a total of 82,243 participants included in the final data set.

RESULTS: The study provides an overview of suicide ideation rates across 42 countries and confirms the structural validity of the P4 screener. The findings indicated that sexual and gender minority individuals exhibited higher rates of suicidal ideation. The P4 screener showed adequate reliability, convergence, and discriminant validity, and a cutoff score of 1 is recommended to identify individuals at risk of suicidal behavior.

CONCLUSIONS: The study supports the reliability and validity of the P4 suicide screener across 42 diverse countries, highlighting the importance of using a cross-cultural suicide risk assessment to standardize the identification of high-risk individuals and tailoring culturally sensitive suicide prevention strategies.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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