Psychometrics of the Concise Health Risk Tracking Self-Report (CHRT-SR16) Assessment of Suicidality in a Sample of Adults with Moderate to Severe Methamphetamine Use Disorder: Findings from the ADAPT-2 Randomized Trial

Joseph M Trombello; Alexandra Kulikova; Taryn L Mayes; Karabi Nandy; Thomas Carmody; Gavin Bart; Edward V Nunes; Joy Schmitz; Mariah Kalmin; Steven Shoptaw; Madhukar H Trivedi

doi:10.2147/NDT.S406909

Psychometrics of the Concise Health Risk Tracking Self-Report (CHRT-SR₁₆) Assessment of Suicidality in a Sample of Adults with Moderate to Severe Methamphetamine Use Disorder: Findings from the ADAPT-2 Randomized Trial

Neuropsychiatr Dis Treat. 2023 Jun 22:19:1443-1454. doi: 10.2147/NDT.S406909. eCollection 2023.

Authors

Joseph M Trombello¹, Alexandra Kulikova², Taryn L Mayes¹, Karabi Nandy^{1

3}, Thomas Carmody^{1

3}, Gavin Bart⁴, Edward V Nunes⁵, Joy Schmitz⁶, Mariah Kalmin⁷, Steven Shoptaw⁷, Madhukar H Trivedi¹

Affiliations

¹ Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
² Department of Educational Psychology, University of North Texas, Denton, TX, USA.
³ Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
⁴ Department of Medicine, University of Minnesota, Hennepin County Medical Center, Minneapolis, MN, USA.
⁵ Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA.
⁶ Faillace Department of Psychiatry and Behavioral Sciences, University of Texas (UT Health) at Houston, Houston, TX, USA.
⁷ Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.

Abstract

Background: The co-occurrence of suicidality and substance use disorders has been well established, but rating scales to examine suicidal behavior and risk are sparse among participants with substance use disorders. We examined the psychometric properties of the 16-item Concise Health Risk Tracking Scale - Self Report (CHRT-SR₁₆) to measure suicidality among adults with moderate-to-severe methamphetamine use disorder.

Methods: Participants (n = 403) with moderate-to-severe methamphetamine use disorder completed the CHRT-SR₁₆ as part of a randomized, double-blind, placebo-controlled pharmacotherapy trial. The CHRT-SR₁₆ factor structure was assessed using confirmatory factor analysis (CFA). Internal consistency was estimated with coefficients alpha (α) and omega (ω), test-retest reliability with intraclass correlation coefficient (ICC) and standard error of measurement, and convergent validity using Spearman's ρ rank order correlation coefficient test between CHRT-SR₁₆ factors and the Patient Health Questionnaire (PHQ-9). The analyses utilized baseline and week 1 data (for test-retest reliability only).

Results: CFA revealed a seven-factor model of Pessimism, Helplessness, Social Support, Despair, Impulsivity, Irritability, and Suicidal Thoughts as the best-fitting model. The CHRT-SR₁₆ also exhibited strong internal consistency (α = 0.89; ω = 0.89), test-retest reliability (ICC = 0.78) and convergent validity with the PHQ-9 total score (ρ = 0.62).

Conclusion: The CHRT-SR₁₆ showed strong psychometric properties in a sample of participants with primary methamphetamine use disorder.

Clinicaltrialsgov identifier: NCT03078075.

Keywords: PHQ-9; confirmatory factor analysis; impulsivity; irritability; propensity; stimulant use disorder.

Associated data

ClinicalTrials.gov/NCT03078075

Grants and funding

This work was supported by the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (UG1DA020024, 2017), and the Department of Health and Human Services (HHSN271201500065C and HHSN271201400028C, 2016). Alkermes provided Vivitrol (naltrexone for extended-release injectable suspension) and matched placebo free of charge for use in this trial under a written agreement with NIDA. Licensing and distribution of the CHRT is managed by Mapi Research Trust on behalf of the copyright holder, University of Texas Southwestern Medical Center. At the time of publishing, the CHRT is available without charge to non-commercial users. Fees may apply to commercial users, IT companies, funded academic users or health-care organizations. Requests for information and licensing of the CHRT should be submitted through Mapi Research Trust’s ePROVIDE platform (https://eprovide.mapi-trust.org/).