Psychometric Properties and Continuous National Norms of the Parent-Report Concise Health Risk Tracking Assessment: Charting Pediatric Suicide Risk Across Age and Sex
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Objective
The Concise Health Risk Tracking (CHRT) assessment has utility in suicide risk prediction in adults and adolescents. Because multi-informant assessment is the gold standard in pediatric populations, a parent report version of the CHRT may enhance evaluation of youth suicide risk. We adapted the self-report version of the 16-item CHRT as a parent report version (CHRT-PR 16 ) and evaluated the psychometric properties and continuous age- and sex-specific norms in a nationally representative sample of parents.
Method
Parents of youth aged 6-18 years (N=2,236; 2,235 in sex-stratified analyses) completed the CHRT-PR 16 , enabling evaluation of both the 16- and 14-item (CHRT-PR 14 ) version. Psychometric analyses included internal consistency, factor structure, Item Response Theory, measurement invariance, criterion validity, and continuous norming using Generalized Additive Models for Location, Scale and Shape (GAMLSS).
Results
Internal consistency was excellent for both CHRT-PR 16 and CHRT-PR 14 (both ω t =.98, α =.96), although general factor variance was higher for CHRT-PR 14 ( ω H =.83) than CHRT-PR 16 ( ω H =.68). Mokken scale analysis confirmed zero monotonicity violations for CHRT-PR 14 . CHRT-PR 16 showed a clinically trivial edge in criterion correlations with other measures of psychopathology. In GAMLSS modeling, a zero-inflated negative binomial distribution achieved optimal fit for both scales. Score trajectories diverged by age and sex around age 10, with males scoring slightly higher at upper percentiles.
Conclusions
CHRT-PR 16 and CHRT-PR 14 demonstrate strong psychometric support, essential unidimensionality, measurement invariance, and optimal GAMLSS fit. Age- and sex-specific percentile lookup tables provide population-level benchmarks to guide measurement-based care, symptom tracking, and suicide risk stratification in pediatric settings.
