Concise Health Risk Tracking Scale Accurately Assesses Suicidal Severity in Adolescents

doctor writing on medical chart
doctor writing on medical chart
Suicide is the second leading cause of death among Americans between the ages of 15 and 24 years.

Results from a retrospective chart review validate the use of the 14-item Concise Health Risk Tracking-Self-Report (CHRT-SR) to assess suicidality in adolescents, according to findings published in an article in the Journal of Affective Disorders.

Researchers evaluated data from teens treated in an intensive outpatient program for severe suicidality between January 1, 2014, and December 31, 2015. A total of 271 teens completed the CHRT-SR on entry into the program and 231 completed the questionnaire at discharge.

Suicide is the second leading cause of death among Americans between the ages of 15 and 24 years. 

Mood disorders, prior suicide attempts, and nonsuicidal self-injury are the most notable risk factors. Most self-report rating scales are based on assessment of suicidal ideation and past behaviors and do not examine other factors associated with suicide such as mental illness, hopelessness/helplessness, and lack of social support. The 14-item CHRT-SR has been validated in adults but not in younger patients.

Taryn L. Mayes, MS, of the Department of Psychiatry at UT Southwestern Medical Center in Dallas, Texas, and colleagues identified 3 factors with excellent model fit: propensity, impulsivity, and suicidal thoughts. The authors noted that internal consistency reliability coefficients were good to excellent for the total score and for the 3 factors at both study entry and discharge (a=0.774-0.915 and a=0.849-0.941). Furthermore, these variables also correlated significantly with overall severity of depression and suicidal ideation as rated by the adolescents and their parents (P =.704-.756; P <.001).

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Interestingly, the authors noted that the CHRT-SR differentiated these adolescent patients based on nonsuicidal self-injury and ambivalence/regret about the suicide attempt. The CHRT-SR results also changed from baseline, indicating the effect of the intervention. However, although the total score, propensity (comprised of the domains of pessimism, helplessness, limited social support, and despair), and suicidal thoughts were modified by the intervention, impulsivity was less likely to change than the other factors, suggesting that this may be more of a trait.

The study is limited by its retrospective nature, lack of a control group, and the enrollment of only adolescents at high risk for suicide.


Mayes TL, Kennard BD, Killian M, et al. Psychometric properties of the concise health risk tracking (CHRT) in adolescents with suicidality. J Affect Disord. 2018;(235):45-51.