The Development and Adaptation of a Spanish Suicide Assessment Measure

Introduction: As the Latino/a population continues to grow, so too does the urgency to develop culturally competent preventive and intervention services for this community. Suicidality among Latinos/as is one of the many areas that requires increased attention. Despite generally lower rates of suicides, suicidal ideation and behavior among Latinos/as is a source of concern (AAS, 2009; Zayas et al., 2005). In fact, Latino/a youth have higher levels of suicidality than non-Latino/a Black and White youth (CDC, 2006). To enhance suicide prevention efforts and preventive intervention research among the Latino/a community, the present state of suicide assessment measures must be strengthened. Currently, the field of translation research recommends a detailed, iterative process conducted by a committee representing diverse backgrounds and bases of knowledge (Chavez et al., 2007; Cortés et al., 2007). Our study applied such methods to translate and adapt the English version of the Suicide Status Form-II-R (SSF) into Spanish, as well as to conduct preliminary evaluations of the instrument’s cultural equivalence.

Methods: The SSF was translated into Spanish and then examined by a bilingual committee via three approaches: 1) independent back-translations, 2) item-level ratings of content and semantic equivalence on a 3-point scale, with 1 being the strongest and 3 being the weakest, and 3) measure-level reviews of technical equivalence issues related to formatting and response category barriers.

Results: The content equivalence of the Spanish SSF-II-R was solid (mean= 1.01). One noted issue pertained to the phrase sufrimiento mental (mental suffering). Stigma surrounding mental illness may bias clients’ ratings if the word mental is used; thus it was changed to emocional (emotional), a word that has been ascribed with less negative valence. Relatively more weaknesses were found with semantic equivalence (mean= 1.39). For instance, the word enojado (angry) is used in many Spanish-speaking countries, though enfadado(angry) is more common in others. Thus, to be inclusive of individuals from more Spanish-speaking countries, alternative words were placed in parentheses. Initial assessment of technical equivalence was also very strong. After multiple group discussions regarding the findings, modifications were made to the Spanish version. Procedures in the coming months will involve an expert review of the measure in addition to focus groups, extensive field-testing, and advanced psychometric analysis.

Conclusions: Adherence to best practices in translation/adaptation methodology is facilitating the development and evaluation of a Spanish suicide assessment tool in order to strengthen research on Latino/a suicidality and related preventive efforts. The poster will highlight key recommendations for prevention research colleagues interested in rigorously examining cultural, linguistic, and psychometric equivalences in measurement.