UNDERSTANDING SUICIDALITY IN RURAL ADOLESCENT POPULATIONS: A CONFIRMATORY FACTOR ANALYSIS OF THE COLLABORITVE ASSESSMENT AND MANAGEMENT OF SUICIDALITY(CAMS) SUICIDE STATUS FORM

Identifying and predicting suicide risk is increasingly challenging as suicide rates continue to rise, making suicide the ninth leading cause of death for those aged 10–64 in the United States. The Collaborative Assessment and Management of Suicidality (CAMS), an empirically derived suicide risk assessment, directly assesses risk of suicidality using the Suicide Status Form (SSF-4). This structured tool assesses elements of suicide risk, including Psychological Pain, Stress, Agitation, Hopelessness, Self-Hate, and Overall Risk of Suicide. Previous studies have identified a two-factor structure distinguishing acute and chronic suicidal states. However, inconsistent replication across age groups suggests that suicide risk factors may vary between adult and adolescent populations. This study aimed to assess whether this two-factor structure would replicate in a rural adolescent sample or if a unidimensional structure would more accurately capture their experiences. Confirmatory Factor Analysis (CFA) findings supported a unidimensional structure of suicidality, suggesting that rural adolescents in outpatient, school-based settings may experience suicide risk as a generalized form of emotional distress rather than distinct acute and chronic dimensions. Furthermore, these findings challenge the applicability of the previously identified two-factor models in this population, suggesting that adding complexity to the CAMS suicide risk assessment may not improve clinical utility, could increase the risk of misclassification, and impede effective intervention planning.<p></p>