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

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 (GHQ12). 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. (C) 2017 Elsevier B.V. All rights reserved.