Reevaluating suicidal behaviors: comparing assessment methods to improve risk evaluations

This study examined suicide assessment validity by comparing methods of measuring current risk associated with past suicidal behaviors. Three independent samples (Ns\ua0=\ua0359, 1007, and 713; aged 18–76\ua0years) all included participants covering a broad spectrum of suicidality. Information theory, item response theory, general linear modeling, and linear regression modeling tested seven competing methods/models of assessing past suicidal behaviors in relation to current suicidality. In contrast to contemporary theories, ANOVA results showed suicide plans can indicate higher risk than suicide attempts when intent to die is higher. Contrary to popular practice, evidence demonstrated that defining risk by suicide ideation (yes/no), attempts or serious attempts (yes/no), are false dichotomies, were the least valid models tested, and failed to explain substantial explainable variance in suicidality/risk. A newly proposed model, differentiating behaviors with or without intent to die, was the most efficacious dichotomous method. However, as predicted, continuous variables were superior to dichotomous. The proposed suicidal barometer model (SBM) exhibited robust evidence as the best available model for evaluating suicidal behaviors in all samples (100 % probability), explaining 47–61\ua0% of suicidality variance and provided incremental improvement in risk evaluations. Findings were consistent by sample, sex, age-group, ethnicity, and psychiatric history. This study, and related evidence, demonstrate that there is a clear and present need for updating measures, clinical training and core competencies, for valid assessment and risk formulation

Eyes on Asia (2012)

Introduction to the section 'Eyes on Asia' (curator E.Pollacchi) and presentation of each of the selected films. The catalogue is a bilingual English/Norwegian publication which is widely used as a reference material within nordic european countries

Factor loadings and communalities of Suicidal ABC Scale items.

<p>S1 = Study 1 (n = 359), S2 = Study 2 (n = 1007), S3 = Study 3 (n = 713), S4 = Study 4 (n = 72). Ideation = suicidal ideation, WTD = wish to die, Prediction = prediction of future suicide attempts, WTLr = wish to live reverse-scored, Debate = internal suicidal debate, Behaviors = history of suicidal behaviors, Variance = percentage of total trait variance explained by the retained factor.</p><p>Factor loadings and communalities of Suicidal ABC Scale items.</p

Graded response model analyses of the Suicidal ABC Scale and the Suicidal Behaviors Questionnaire-Revised.

<p>N = 1,720; WTD = wish to die; WTLr = wish to live reverse-scored; Ideation = suicidal ideation; Prediction = prediction of suicide attempts; Debate = internal suicidal debate; Behaviors = history of suicidal behaviors (SABCS uses SBM scoring; SBQ-R uses Osman et al. scoring [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0127442#pone.0127442.ref034" target="_blank">34</a>]); Comm. = communication of suicidality; a = item discrimination level; b_L = lowest item difficulty threshold; b_U = upper item difficulty threshold; IF = information function; Pct. = percentage of total scale information.</p><p>Graded response model analyses of the Suicidal ABC Scale and the Suicidal Behaviors Questionnaire-Revised.</p

The suicidal barometer model with descriptions of suicidality levels based on item response theory analyses.

<p>WTL = wish to live, WTD = wish to die.</p

Psychometric properties of the Suicidal ABC Scale and the Suicidal Behaviors Questionnaire-Revised.

<p>Study 1, n = 359; Study 2, n = 1007; Study 3, n = 713; Study 4, clinical sample, n = 72; SABCS-4 = 4-item SABCS; T2 = Time 2, n = 54. α = Cronbach’s α; S-B = Spearman-Brown prophecy coefficient; SE_m = standard error of measurement.</p><p>^†Studies used different response ranges for some SABCS items.</p><p>Psychometric properties of the Suicidal ABC Scale and the Suicidal Behaviors Questionnaire-Revised.</p

Item information curves: A = Suicidal ABC Scale, B = Suicidal Behaviors Questionnaire-Revised.

<p>Item information curves: A = Suicidal ABC Scale, B = Suicidal Behaviors Questionnaire-Revised.</p

Pearson correlations of psychosocial factors with the Suicidal ABC Scale and the Suicidal Behaviors Questionnaire-Revised.

<p>S1 = Study 1 (n = 359), S2 = Study 2 (n = 1007), S3 = Study 3 (n = 713). CES-D = Center for Epidemiologic Studies-Depression scale; DASS = Depression Anxiety Stress Scales; BHS5 = 5-item Beck Hopelessness Scale; UCLA5 = 5-item UCLA Loneliness Scale; MSPSS = Multidimensional Scale of Perceived Social Support; IPIP = International Personality Item Pool. Correlations between SABCS and SBQ-R with other variables were statistically significant, ps < .05, excluding online shopping.</p><p>*p < .05</p><p>**p < .01</p><p>***p < .001</p><p>Pearson correlations of psychosocial factors with the Suicidal ABC Scale and the Suicidal Behaviors Questionnaire-Revised.</p