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This study examined the factor structure, reliability, and validity of the Suicide Probability Scale (SPS) in a sample of 226 (80 male, 146 female) adolescent psychiatric inpatients. Confirmatory factor analyses provided only some support for the original subscales. Exploratory factor analyses revealed some overlap with the original scales, but the factors differed by gender. Internal consistency of the original factors was somewhat better than the factors derived from this sample. A negative change in SPS scores over the course of the inpatient admission was related to risk for readmission due to repeat suicidal behavior.

Differentiating between additive (quantitative) and interactive (qualitative) effects of comorbidity has important treatment implications. This study illustrates the heuristic superiority of a multifactorial approach over simple group comparisons in testing quantitative versus qualitative models of comorbidity. Analysis of variance was used to compare 266 adolescent inpatients identified as depressed, externalizing, both, or neither on self-report measures of personality, school problems, and substance abuse. The results support quantitative rather than qualitative models of comorbidity. Depressed status related most strongly to group differences in interpersonal and self-critical concerns. Externalizing status related most strongly to group differences in school problems and drug use. Main effects for the two statuses together explained especially elevated levels of reactance and alcohol abuse among the comorbid adolescents.