The psychometric characteristics of the 4-item Suicidal Behaviors Questionnaire-Revised (SBQ-R) as a screening tool in a non-clinical sample of Nigerian university students

Abstract

Background: Suicide is a major contribution to mortality among university students in developed countries. There is no reliable and validated self-report suicide assessment scale with adequate sensitivity and specificity for the identification of Nigerian university students who are at risk of future suicidal behaviors.

Objective: The objective of this study was to examine the psychometric characteristics of the 4 item Suicidal Behaviors Questionnaire-Revised (SBQ-R) as a screening tool for suicide risk assessment among university undergraduate students in South-western Nigeria.

Method: This is a cross-sectional descriptive study involving 536 undergraduate Nigerian students. The students completed the SBQ-R, in addition to a sociodemographic and academic related questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the 12 item General Health Questionnaire (GHQ-12). Suicidal risk categories among the students were determined by interviewing them with the items of the suicidality module section of the Mini International Neuropsychiatric Interview (MINI).

Results: Cronbach's alpha for the SBQ-R items was 0.80. Construct validity was supported through significant positive correlations with the HADS-Anxiety and Depression subscales, and the GHQ-12. Receiver Operating Characteristics (ROC) curve evaluation suggests that the best cut-off total score with the optimal sensitivity (0.882), specificity (0.875) and highest accuracy (0.879) was 8 in terms of identifying the students at high risk of suicide (Area Under the Curve=0.928; 95% Confidence Interval=0.890-0.966; Standard Error=0.019).

Conclusions: The use of the SBQ-R may be an important and vital step in the prevention of suicidal attempts among Nigerian university students.

Keywords: Nigerian university students; Reliability; Sensitivity; Specificity; Suicide Behaviors Questionnaire-Revised; Validity.