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This study evaluated the psychometric properties of the 9-item Concise Health Risk Tracking Self-Report (CHRT-SR 9), a measure of suicidality, in adolescent psychiatric outpatients. Altogether, 933 depressed or suicidal adolescents (12–20 years of age), receiving treatment at psychiatric outpatient clinics in Texas, completed the 16-item CHRT-SR at baseline and one month later. CHRT-SR 9 was extracted from CHRT-SR 16 using multigroup confirmatory factor analysis. Sex and age measurement invariance, classical test theory, item response theory (IRT), and concurrent validity analyses (against the suicidal ideation Item 9 of Patient Health Questionnaire-Adolescent (PHQ-A)) were conducted. The CHRT-SR 9 demonstrated excellent model fit with four factors (pessimism, helplessness, despair, and suicidal thoughts). Measurement invariance was upheld. Acceptable item-total correlations (0.56–0.80) and internal consistency (Spearman-Brown 0.78–0.89) were revealed. IRT analyses showed a unidimensional instrument with excellent item performance. Using the CHRT-SR 9 total score as a measure of overall suicidality and comparing it against levels of PHQ-A Item 9, the mean (standard deviation) of CHRT-SR 9 total score was 8.64 (SD = 5.97) for no-risk (0 on Item 9), 17.05 (SD = 5.00) for mild, 23.16 (SD = 5.05) for moderate, and 26.96 (SD = 5.24) for severe-risk (3 on Item 9). Significant differences (p-value<0.0001) indicated that CHRT-SR 9 total score distinguished between levels of suicidal risk. Furthermore, CHRT-SR 9 was sensitive to change over a one-month period. Whether CHRT-SR 9 predicts actual suicidal attempts in adolescents is not well defined. The CHRT-SR 9 is an easy-to-administer, user-friendly self-report with good psychometric qualities which makes it an excellent screening measure of suicidal risk in adolescent psychiatric outpatients. • CHRT-SR 9 is a measure of suicidal risk in adolescent psychiatric outpatients. • It is brief, easy to comprehend, and simple to score. • It has excellent psychometric qualities and stable subscales. • It has high reliability, validity and is sensitive to change in suicidality over time. • It can be useful as a screening tool for suicide or to assess treatment outcomes. [ABSTRACT FROM AUTHOR]

• CHRT-SR 9 and C-SSRS predicted suicidal events and attempts in adolescents at risk. • CHRT-SR 9 and C-SSRS had similar sensitivity at detecting these events in our sample. • CHRT and C-SSRS have good negative predictive value (low rate of false negatives). • CHRT-SR 9 and C-SSRS are effective and can help assess suicidal risk in adolescents. This report examines the predictive capabilities of two scales of suicidality in high-risk adolescents. Charts of adolescents with severe suicidality participating in an intensive outpatient program were reviewed. Self-report data from the 9-item Concise Health Risk Tracking Self-Report (CHRT-SR 9) and clinician-completed data from the Columbia Suicide Severity Risk Scale (C-SSRS) were obtained at entry. Scales' performances in predicting suicide attempts and suicidal events were evaluated using logistic regression models and ROC analyses. Of 539 adolescents, 53 had events of which 19 were attempts. The CHRT-SR 9 total score predicted events (OR =1.05) and attempts (OR =1.09), as did the C-SSRS Suicide Ideation (SI) Intensity Composite for events (OR =1.10) and attempts (OR =1.16). The CHRT-SR 9 AUC was 0.70 (84.2% sensitivity; 41.7% specificity; PPV=5.0%; NPV=98.6%) for attempts. The C-SSRS Intensity Composite AUC was 0.62 (89.5% sensitivity; 24.1% specificity; PPV=4.2%; NPV=98.4%) for attempts. Both the CHRT-SR 9 and C-SSRS capture important parameters related to suicidal events or attempts that can help assess suicidal risk in adolescents. [ABSTRACT FROM AUTHOR]

Study Design: Cross-sequential study design that used data from Texas Scottish Rite Hospital for Children (TSRHC).Objective: Examine anxiety symptoms and family experiences subsequent to school scoliosis screening (SSS) referrals.Summary Of Background Data: Use of SSS remains controversial. Prior research suggested that SSS programs may result in anxiety for both children and parents. Unfortunately, no study has examined the SSS referral processes and anxiety in families.Methods: Study consisted of 2 groups-patients/parents from TSRHC evaluated for Adolescent Idiopathic Scoliosis (AIS) (n = 27) and control participants/parents (n = 27) between ages 9 and 17. All participants completed the primary outcome measure (State-Trait Anxiety Inventory) before and after the scoliosis evaluation or controlled wait time. Parents also rated experience and satisfaction with SSS.Results: Compared with the control group, children/parents in patient group experienced significantly elevated levels of state-anxiety at preappointment. Children/parents in the patient group not diagnosed with AIS experienced a significant decline in state-anxiety. Children/parents in the patient group diagnosed with AIS continued to report elevated levels of anxiety. The control group remained consistent, reporting of low levels of anxiety pre to post. More than half (55.5%) of families indicated they received no information from the school about scoliosis. A third of the families who received information indicated it did not adequately address their concerns. Nonetheless, most families reported overall satisfaction with SSS.Conclusion: This study suggested that children and parents referred through the SSS program experienced significantly elevated levels of state-anxiety. This supports the subjective concerns of anxiety experiences in families voiced by researchers previously. However, families deemed the costs of the SSS referral process as worth the benefits. Though challengers of SSS programs were accurate in observing anxiety in families, it may not constitute significant burden to eliminate SSS programs altogether. Improvements to the current system may be warranted.Level Of Evidence: 3. [ABSTRACT FROM AUTHOR]