Older adults with depression resist accepting depression screening and seeking treatment due to stigmatization of mental disorders and little knowledge about depression. This study was undertaken to develop and determine the psychometrics of an instrument for assessing triggers of suicidal ideation among older outpatients.

Participants were recruited from older outpatients of two hospitals in northern Taiwan. An initial 32-item Triggers of Suicidal Ideation Inventory (TSII) was developed, and its items were validated by experts in two runs of Delphi technique survey. After this TSII was pre-tested in 200 elderly outpatients, 12 items were retained. The 12-item TSII was examined by criterion validity, construct validity, internal consistency reliability, and test-retest reliability.

TSII scores were significantly and positively correlated with the Beck Scale for Suicide Ideation (r = 0.45, P < 0.01), and UCLA Loneliness scores (r = 0.55, P < 0.01), indicating satisfied criterion validity. Participants with depressive tendency tended to have higher TSII scores than participants with no depressive tendency (t = 8.62, P < 0.01), indicating good construct validity. Cronbach's α and the intraclass correlation coefficient for the TSII were 0.70 and 0.99 respectively, indicating acceptable internal consistency reliability and excellent test-retest reliability. Receiver operating characteristic analysis revealed that the area under the curve was 0.83, indicating excellent ability to detect triggers of suicidal ideation. With a cutoff point of 2, the sensitivity and specify were 0.86 and 0.67, respectively.

The TSII can be completed in 5 minutes and is perceived as easy to complete. Moreover, the inventory yielded highly acceptable parameters of validity and reliability.

The authors have not supplied their declaration of competing interest.