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.

Artois University France

Auckland University of Technology New Zealand

Charles University 1st Faculty of Medicine Department of Addictology Prague Czech Republic; Charles University Faculty of Education Department of Psychology Prague Czech Republic

Charles University 1st Faculty of Medicine Department of Addictology Prague Czech Republic; General University Hospital Prague Department of Addictology Czech Republic

College of Healthcare Sciences James Cook University Australia

Departamento de Psicología y Filosofía Facultad de Ciencias Sociales Universidad de Tarapacá Arica Arica y Parinacota Chile

Département de Psychologie Université de Montréal Montréal Canada

Département de Psychologie Université de Montréal Montréal Canada; Département de Psychologie Université du Québec à Trois Rivières Trois Rivières Canada

Département de Psychologie Université du Québec à Trois Rivières Trois Rivières Canada

Department of Clinical Pharmaceutical and Biological Sciences University of Hertfordshire UK; Department of Psychology and Cognitive Science University of Trento Italy

Department of Educational Psychology and Psychology of Health Pavol Jozef Safarik University in Kosice Slovakia

Department of Neuropsychiatry Graduate School of Medicine Kyoto University Kyoto Japan

Department of Neuropsychiatry Graduate School of Medicine Kyoto University Kyoto Japan; Decentralized Big Data Team RIKEN Center for Advanced Intelligence Project Tokyo Japan

Department of Personality Assessment and Psychological Treatments University of Valencia Spain

Department of Psychiatry All India Institute of Medical Sciences New Delhi 110029 India

Department of Psychiatry Faculdade de Medicina Universidade de São Paulo Brazil; Experimental Pathophisiology Post Graduation Program Faculdade de Medicina Universidade de São Paulo Brazil

Department of Psychiatry Hallym University Chuncheon Sacred Heart Hospital South Korea; Chuncheon Addiction Management Center South Korea

Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand

Department of Psychology College of Humanity and Social Science Fuzhou University China

Department of Psychology Humanities and Social Sciences University of Zagreb Croatia

Department of Psychology Shardha University India; Department of Health Kashmir India

Department of Psychology University of Nevada Las Vegas Las Vegas NV USA

Department of Public Health and Informatics Jahangirnagar University Savar Dhaka 1342 Bangladesh; Centre for Advanced Research Excellence in Public Health Savar Dhaka 1342 Bangladesh

Department of Public Health College of Medicine National Cheng Kung University Tainan Taiwan

Departmento de Psicología Básica Clínica y Psicobiología University Jaume 1 of Castellón Spain

Doctoral School of Psychology ELTE Eötvös Loránd University Budapest Hungary; Institute of Psychology ELTE Eötvös Loránd University Budapest Hungary

Facultad de Ciencias de la Salud Universidad Privada del Norte Lima Perú

Facultad de Medicina Universidad Científica del Sur Lima Peru

Facultad de Psicología Universidad de Talca Chile

Faculty of Philosophy Ss Cyril and Methodius University in Skopje Macedonia; Faculty of Philosophy University of Ss Cyril and Methodius in Trnava Slovakia

Faculty of Psychology University of Cuenca Cuenca Ecuador

Florida State University Panama; Sistema Nacional de Investigación SENACYT Panama

Health Promotion Research Centre University of Galway Ireland UK

HELP University Malaysia

Institute for Behavioural Addictions Sigmund Freud University Vienna Austria

Institute of Allied Health Sciences College of Medicine National Cheng Kung University Tainan Taiwan; Biostatistics Consulting Center National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan

Institute of Forensic Psychiatry and Sex Research Center for Translational Neuro and Behavioral Sciences University of Duisburg Essen Essen Germany

Institute of Psychlogy Polish Academy of Sciences Poland; Institute for Neural Computations University of California San Diego USA

Institute of Psychology Cardinal Stefan Wyszynski University Warsaw Poland

Institute of Psychology ELTE Eötvös Loránd University Budapest Hungary; Centre of Excellence in Responsible Gaming University of Gibraltar Gibraltar Gibraltar

Institute of Psychology ELTE Eötvös Loránd University Budapest Hungary; Institute of Forensic Psychiatry and Sex Research University of Duisburg Essen Essen Germany

Institute of Psychology University of Lausanne Lausanne Switzerland; Center for Excessive Gambling Addiction Medicine Lausanne University Hospitals Lausanne Switzerland

Institute of Psychology University of Lausanne Lausanne Switzerland; Institute of Legal Psychiatry Lausanne University Hospitals Lausanne Switzerland

Laboratory of Behavioral Medicine Neuroscience Institute Lithuanian University of Health Sciences Lithuania

Leuven School for Mass Communication KU Leuven Leuven Belgium

Macedonian Academy of Sciences and Arts Macedonia

Nottingham Trent University UK

Pavol Jozef Safarik University in Kosice Department of Educational Psychology and Psychology of Health Slovakia

Public Health Institute Faculty of Health Liverpool John Moores University UK

SAMRC Unit on Risk and Resilience in Mental Disorders Dept of Psychiatry and Neuroscience Institute University of Cape Town South Africa

SAMRC Unit on Risk and Resilience in Mental Disorders Stellenbosch University South Africa

School of Psychology University of Southampton UK

School of Social Work Faculty of Social Welfare and Health Sciences University of Haifa Israel

Section of Sexual Psychopathology Department of Dynamic and Clinical Psychology and Health Studies Sapienza University of Rome Rome Italy

Universidad Pedagógca y Tecnológica de Colombia Colombia; Grupo de Investigación Biomédica y de Patología Colombia

Universidad Privada de Santa Cruz de la Sierra Bolivia

University of Baghdad College of Medicine Iraq

University of New Mexico Albuquerque USA; Center for Alcohol Substance Use And Addiction University of New Mexico Albuquerque USA

Virtual Teaching and Cyberpsychology Laboratory School of Psychology National Autonomous University of Mexico Mexico

William James Center for Research Departamento de Educação e Psicologia Universidade de Aveiro Aveiro Portugal

Yale University School of Medicine New Haven CT USA; Connecticut Council on Problem Gambling Wethersfield CT USA

References provided by Crossref.org