Global cross-cultural validation of a brief measure for identifying potential suicide risk in 42 countries

Objectives This study aimed to examine the psychometric properties of the P4 suicide screener in a multinational sample. The primary goal was to evaluate the reliability and validity of the scale and investigate its convergent validity by analyzing its correlation with depression, anxiety, and substance use. Study design The study design is a cross-sectional self-report study conducted across 42 countries. Methods A cross-sectional, self-report study was conducted in 42 countries, with a total of 82,243 participants included in the final data set. Results The study provides an overview of suicide ideation rates across 42 countries and confirms the structural validity of the P4 screener. The findings indicated that sexual and gender minority individuals exhibited higher rates of suicidal ideation. The P4 screener showed adequate reliability, convergence, and discriminant validity, and a cutoff score of 1 is recommended to identify individuals at risk of suicidal behavior. Conclusions The study supports the reliability and validity of the P4 suicide screener across 42 diverse countries, highlighting the importance of using a cross-cultural suicide risk assessment to standardize the identification of high-risk individuals and tailoring culturally sensitive suicide prevention strategies

Questionnaire of Cognitive Schema Activation in Sexual Context: translation and psychometric properties of the Italian version

The Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC) is a validated and widespread used measure to assess the self-schemas elicited during sexual negative events in both men and women. The current study aimed to test the psychometric characteristics of the Italian version of the QCSASC in both heterosexual men and women. After linguistic translation, the psychometric properties (internal consistency, construct and discriminant validity) were evaluated in 1038 participants (435 men and 603 women, 767 healthy and 271 clinicals complaining of sexual problems). Confirmatory factor analyses showed a not satisfactory fit of the original factor structure of the QCSASC versions. Principal component analyses were performed highlighting two new factorial structures, further validated with CFAs (“Helpless” and “Unlovable”). Cronbach’s alpha, composite reliability and average variance extracted were used as internal consistency measures. Moreover, the QCSASC showed a strong association with emotional response and sexual functioning, being able to differentiate between sexually clinical and control group. Current findings support the validity and the internal consistency of the QCSASC Italian version and allows to assess dysfunctional cognitive schemas activated when facing sexual problematic situations for both clinical and research purposes

Cross-cultural validation and measurement invariance of anxiety and depression symptoms: A study of the Brief Symptom Inventory (BSI) in 42 countries.

Depression and anxiety are among the most prevalent mental health issues experienced worldwide. However, whereas cross-cultural studies utilize psychometrically valid and reliable scales, fewer can meaningfully compare these conditions across different groups. To address this gap, the current study aimed to psychometrically assess the Brief Symptomatology Index (BSI) in 42 countries. Using data from the International Sex Survey (N = 82,243; M <sub>age</sub>  = 32.39; SD <sub>age</sub>  = 12.52; women: n = 46,874; 57 %), we examined the reliability of depression and anxiety symptom scores of the BSI-18, as well as evaluated evidence of construct, invariance, and criterion-related validity in predicting clinically relevant variables across countries, languages, genders, and sexual orientations. Results corroborated an invariant, two-factor structure across all groups tested, exhibiting excellent reliability estimates for both subscales. The 'caseness' criterion effectively discriminated among those at low and high risk of depression and anxiety, yielding differential effects on the clinical criteria examined. The predictive validation was not made against a clinical diagnosis, and the full BSI-18 scale was not examined (excluding the somatization sub-dimension), limiting the validation scope of the BSI-18. Finally, the study was conducted online, mainly by advertisements through social media, ultimately skewing our sample towards women, younger, and highly educated populations. The results support that the BSI-12 is a valid and reliable assessment tool for assessing depression and anxiety symptoms across countries, languages, genders, and sexual orientations. Further, its caseness criterion can discriminate well between participants at high and low risk of depression and anxiety