ArticleSpine deformity2026
PROMIS Anxiety scale is responsive in assessing suicide risk in adolescents with spine concerns.
Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study aimed to evaluate the responsiveness of Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety Scale with the Ask Suicide-Screening Questions (ASQ) and associations of suicide risk in adolescents with spine concerns.
methodsAdolescents ages 10-18 referred to a pediatric orthopedic institution for spine concerns who simultaneously completed both the PROMIS Pediatric Anxiety Computer Adaptive Test and the ASQ were retrospectively reviewed. Positive ASQ scores (≥ 1 yes response) were compared to negative ASQ scores. Elevated PROMIS Anxiety was defined as scores ≥ 51, indicating minimum mild severity. Logistic regression followed by ROC analysis determined the PROMIS Anxiety threshold.
resultsOf 8089 adolescents with spine concerns, 4.2% (338) had positive ASQs. Elevated (≥ mild severity) PROMIS Anxiety indicated a sixfold risk of a positive ASQ than those with PROMIS Anxiety scores within normal limits (OR 6.35, 95% CI 5.07-7.99). Multivariate analysis revealed older age (OR 1.08, 95% CI 1.02-1.15), female sex (OR 1.61, 95% CI 1.23-2.15), English vs. Spanish language (OR 2.17, 95% CI 1.39-3.53), public vs. private insurance type (OR 1.37, 95% CI 1.05-1.77), and higher PROMIS Anxiety scores (OR 1.10, 95% CI 1.09-1.12) were associated with a positive ASQ. A PROMIS Anxiety threshold of 44.5 (AUC = 0.80) was associated with a positive ASQ.
conclusionIncreased anxiety is clearly associated with suicide risk in youth with spine concerns with an acceptable AUC. PROMIS Anxiety may be a readily available, useful clinical adjunct of suicide risk, prompting further evaluation in youth with spine concerns in settings that do not routinely screen for suicide risk.
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