TY - JOUR
T1 - Assessment of near-term risk for suicide attempts using the suicide crisis inventory
AU - Barzilay, Shira
AU - Assounga, Krystel
AU - Veras, Jacqueline
AU - Beaubian, Courtnie
AU - Bloch-Elkouby, Sarah
AU - Galynker, Igor
N1 - Publisher Copyright:
© 2020
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Background: The Suicide Crisis Syndrome (SCS) describes a pre-suicidal mental state marked by entrapment accompanied by affective disturbances, loss of cognitive control, hyperarousal and social withdrawal. This study tested the consistency and validity of the Suicide Crisis Inventory (SCI), a proposed measure of SCS severity, amongst a large, heterogeneous patient sample. Methods: The SCI was used to assess 867 adult psychiatric inpatients and outpatients. Confirmatory factor analysis, logistic regressions and area under the curve analyses (AUC) were used to examine internal structure, construct validity and predictive validity for suicide ideation, plan and attempt one-month post-assessment. Results: The five-factor model of the SCS demonstrated good fit and excellent internal consistency. SCI scores indicated significant associations but non-redundancy with depression, anxiety, and independence from other dimensions of psychiatric distress. SCI scores specifically predicted suicide attempts with an AUC of 0.733 and odds ratio=8.62 (p<0.001) at optimal cut-off point. SCI incremental predictive validity over and beyond suicidal ideation and attempts history reported at baseline was supported for predicting suicide attempts (β= 0.012, S.E = 0.006; p=0.046). Limitations: The SCI is subject to self-report bias and does not include the SCS social withdrawal component. Follow-up assessment retention was partial (68%, n=591). Conclusion: The SCI is validated as a tool for the assessment of the SCS intensity and of imminent suicidal behavior. The SCI is suggested as a tool that could aid both researchers and clinicians in comprehensive assessment of a pre-suicidal mental state within moderate to high-risk populations, regardless of self-report on suicidal intent.
AB - Background: The Suicide Crisis Syndrome (SCS) describes a pre-suicidal mental state marked by entrapment accompanied by affective disturbances, loss of cognitive control, hyperarousal and social withdrawal. This study tested the consistency and validity of the Suicide Crisis Inventory (SCI), a proposed measure of SCS severity, amongst a large, heterogeneous patient sample. Methods: The SCI was used to assess 867 adult psychiatric inpatients and outpatients. Confirmatory factor analysis, logistic regressions and area under the curve analyses (AUC) were used to examine internal structure, construct validity and predictive validity for suicide ideation, plan and attempt one-month post-assessment. Results: The five-factor model of the SCS demonstrated good fit and excellent internal consistency. SCI scores indicated significant associations but non-redundancy with depression, anxiety, and independence from other dimensions of psychiatric distress. SCI scores specifically predicted suicide attempts with an AUC of 0.733 and odds ratio=8.62 (p<0.001) at optimal cut-off point. SCI incremental predictive validity over and beyond suicidal ideation and attempts history reported at baseline was supported for predicting suicide attempts (β= 0.012, S.E = 0.006; p=0.046). Limitations: The SCI is subject to self-report bias and does not include the SCS social withdrawal component. Follow-up assessment retention was partial (68%, n=591). Conclusion: The SCI is validated as a tool for the assessment of the SCS intensity and of imminent suicidal behavior. The SCI is suggested as a tool that could aid both researchers and clinicians in comprehensive assessment of a pre-suicidal mental state within moderate to high-risk populations, regardless of self-report on suicidal intent.
KW - Risk assessment
KW - Suicidal behavior
KW - Suicidal ideation
KW - Suicide
KW - Suicide attempts
UR - http://www.scopus.com/inward/record.url?scp=85088134083&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2020.06.053
DO - 10.1016/j.jad.2020.06.053
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C2 - 32697697
AN - SCOPUS:85088134083
SN - 0165-0327
VL - 276
SP - 183
EP - 190
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -