scholarly journals The Brief Suicide Cognitions Scale: Development and Clinical Application

2021 ◽  
Vol 12 ◽  
Author(s):  
M. David Rudd ◽  
Craig J. Bryan

The study explored the development of the Brief Suicide Cognitions Scale (B-SCS), a simple and brief measure of suicide risk. The B-SCS provides a brief measure that captures critical aspects of suicide risk embedded in core beliefs about the self as unlovable, one's emotional experience as unbearable, and life problems as unsolvable (i.e., the suicidal belief system), resulting in chronic or enduring suicide risk and heightened vulnerability for acute episodes secondary to internal and external triggers. Data were analyzed from three diverse samples, including a student sample (N = 349), an inpatient psychiatric sample (N = 160), and a sample of emergency department (ED) patients presenting secondary to a suicidal crisis (N = 94). Those in the student and inpatient samples completed additional symptom measures (hopelessness, anxiety, depression) and the ED sample provided 6-month follow-up data for suicide attempts. Reliability (internal consistency, test-retest), concurrent validity, construct (divergent, convergent) validity, factorial, incremental, and predictive validity were evaluated, along with calculation of predictive value of negative and positive tests, sensitivity, and specificity estimates. The B-SCS demonstrated good reliability and validity, a unidimensional factor structure across samples, along with good predictive validity and value in real-world clinical settings. The B-SCS is a brief, reliable and valid measure of suicide risk, with good ability to identify those with enduring risk for subsequent suicide attempts. The B-SCS offers a unique contribution to understanding and assessing the nature of suicide risk over time targeting the suicidal belief system, with easy application across inpatient and outpatient clinical settings, and good predictive value.

Psichologija ◽  
2012 ◽  
Vol 45 ◽  
pp. 55-69
Author(s):  
Jurgita Rimkevičienė ◽  
Danutė Gailienė

Suicidologijoje stokojama duomenų apie psichoaktyvių medžiagų vartojimo vaidmenį savižudybės procese bei impulsyvių ir neimpulsyvių mėginimų nusižudyti skirtumus. Šiame tyrime atlikta 15 vartojančių alkoholį arba narkotikus asmenų, per paskutinius metus mėginusių nusižudyti, kokybinių interviu teminė analizė. Tyrimas leido išskirti ne du, kaip aprašoma literatūroje, o tris mėginimų nusižudyti tipus, būdingus vartojantiems psichoaktyvias medžiagas: planuoti, neplanuoti ir mėginimai nusižudyti „aptemus sąmonei“, ir aprašyti visiems jiems būdingus bruožus. Nepaisant kai kurių ribotumų, šis tyrimas gali pasiūlyti vertingų įžvalgų vertinant vartojančių psichoaktyvias medžiagas asmenų suicidinę riziką.Pagrindiniai žodžiai: mėginimas nusižudyti, savižudybės procesas, psichoaktyvios medžiagos, alkoholis, narkotikai.THE TYPES OF SUICIDE PROCESS AMONG PSYCHOACTIVE SUBSTANCE USERS Jurgita Rimkevičienė, Danutė Gailienė Summary Research regarding the role of psychoactive substance use in the process of suicide is lacking in current sui­cidology. In addition to this, evidence shows that im­pulsive suicide attempts are common among substance users. However there is no clear understanding of the impulsive suicide process. That makes it difficult to combine results of different studies and create clear guidelines for impulsive suicide risk evaluation. The purpose of this research is to depict the impulsive and non-impulsive process of suicide among psychoactive substance users. The participants of the study were 15 psycho­active substance (10 – alcohol, 5 – drug) users, who had attempted suicide during the last year. 8 of them attempted once, 4 – two or three times, other 3 – more than 5 times. All participants – 4 women and 11 men were patients from Vilnius Centre for Addictive Disorders and Vilnius Mental Health Centre. Quali­tative interviews based on Suicide Intent Scale were conducted about the suicide attempt or attempts. A thematic analysis of the interviews was used to depict the process of suicide. This study led to distinguishing 3 different types of attempted suicide – planned, unplanned and suicide attempts during a “blackout” – which are typical for psychoactive substance users. Both unplanned suicide attempts and suicide attempts during a “blackout” can be called impulsive, though the latter diverged by their hastiness, aggressiveness, inability to control one’s behaviour, intensive feeling of anger, serious danger caused to health and wellbeing, as well as a follo­wing amnesia of a major part of the suicide attempt. Intensive emotions, especially anger and stressors in interpersonal relationships, had a major impact for the respondents in the process of suicide. According to the participants of the survey, substance use had intensified their suicidal crisis having a clear effect on their emotional, relationship and other difficulties. In addition, alcohol and drug use was considered as one of the suicide methods. Despite several restrictions of the research, the study results provide some valuable insight in the suicide risk evaluation among psycho­active substance users. Key words: suicide attempt, suicide process, psychoactive substances, alcohol, drugs.


Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Jérôme Ottino

This paper deals with an inpatient unit that recently opened in Geneva, specializing in the treatment of patients aged 16-21 years who had attempted suicide or felt the desire to commit suicide. This particular center was established because of the significant weaknesses found in the provision of care to adolescents who had attempted suicide. Despite the growing interest of health workers in this area of study over recent years, the frequency of suicide among the young has not decreased and there are numerous recurrences of the suicide attempts. Further, all efforts to improve the adolescents' compliance with psychiatric treatment have failed to date. The number of drop-outs from treatment is still very high. Thus, the objectives of our inpatient unit are as follows: (1) to overcome initial resistance to treatment and to improve long-term compliance; (2) to decrease the number of recurrent attempts as a consequence of the above, thus increasing life expectancy; (3) to offer the adolescents who have tried (or have contemplated) committing suicide an improved quality of life, after first helping them overcome the suicidal crisis. To achieve these goals, the therapeutic team of the unit proposes short stays during which the work with the adolescents consists of a very intensive psychoanalytic-oriented crisis intervention. Numerous practical aspects of our therapeutic approach in the inpatient unit are related here in detail, always with reference to our theoretical hypothesis.


2020 ◽  
Author(s):  
Timothy Allen ◽  
Michael Hallquist ◽  
Aidan G.C. Wright ◽  
Alexandre Dombrovski

Importance: Clinicians treating borderline personality disorder (BPD) are often faced with the difficult challenge of assessing when, and for whom, risk for suicide is greatest. Addressing this dilemma requires longitudinal, prospective data from high-risk samples with an elevated base rate of suicide attempts.Objective: To test whether dispositional characteristics modulate the pathway from interpersonal dysfunction to suicide in BPD. Design: This longitudinal, observational study was conducted between 1990 and 2020. Data were analyzed between April and July 2020. Participants were assessed annually for up to 30 years (mean number of follow-ups = 7.82). Setting: Participants were recruited from inpatient, outpatient, and community referral sources.Participants: 458 individuals (Mean age = 28.59, 77% female) diagnosed with BPD.Main Outcomes and Measures: Presence or absence of a suicide attempt within one year of each follow-up assessment. Multilevel structural equation modeling was used to 1) examine longitudinal, within-person transitions from interpersonal dysfunction to suicidal ideation to suicide attempts (i.e., the [I]nterpersonal-[I]deation-[A]ttempt pathway); and 2) evaluate whether two maladaptive personality dimensions, negative affect and disinhibition, moderated these transitions.Results: At the within-person level, there was support for the I-I-A pathway: suicidal ideation accounted for the association between interpersonal dysfunction and suicide attempts. Personality further moderated each component of the I-I-A pathway: negative affect was associated with a stronger coupling between interpersonal dysfunction and ideation; and disinhibition was associated with a stronger coupling between ideation and attempts. Conclusions and Relevance: The escalation from interpersonal difficulties to a suicidal crisis in BPD involves two psychologically distinct process. An internalizing process links interpersonal dysfunction to suicidal ideation and is facilitated by trait negative. An additional externalizing process links suicidal ideation to suicide attempts, and is facilitated by trait disinhibition. Assessment of these intra- and interindividual risk factors may inform clinical decisions about when, and for whom, crisis intervention is necessary.


Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 489
Author(s):  
Giulio Emilio Brancati ◽  
Margherita Barbuti ◽  
Elisa Schiavi ◽  
Paola Colombini ◽  
Martina Moriconi ◽  
...  

Background and Objectives: Emotional dysregulation is central to the problem of the overlap between attention-deficit/hyperactivity disorder (ADHD) and cyclothymia. The aim of the study was to evaluate comorbidity rates between ADHD and cyclothymic disorder and to explore demographic and clinical differences among the groups, focusing on affective temperament and emotional dysregulation. Materials and Methods: One hundred sixty-five outpatients attending the Second Psychiatry Unit at the Santa Chiara University Hospital (Pisa) were consecutively recruited: 80 were diagnosed with ADHD, 60 with cyclothymic disorder, and 25 with both conditions. Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-M) and the 40-item version of Reactivity, Intensity, Polarity, and Stability questionnaire (RI-PoSt-40) were administered. Results: Cyclothymic patients were more frequently female and older with respect to the ADHD groups. Both comorbid and non-comorbid ADHD patients showed significantly lower educational attainment and more frequently had substance use disorders. Panic disorder was common in non-comorbid cyclothymic patients, who showed significantly higher rates of familial panic disorder, major depressive disorder and suicide attempts in comparison with patients only diagnosed with ADHD. Cyclothymic patients without ADHD were also characterized by fewer hyperthymic temperamental traits, higher depressive and anxious dispositions, and a greater negative emotionality. No significant differences among groups were observed for cyclothymic temperament and overall negative emotional dysregulation, but comorbid patients with both conditions scored the highest in these subscales. This group also showed significantly higher affective instability with respect to ADHD patients without cyclothymia and was less frequently diagnosed with bipolar disorder type II than patients from both the other groups. Conclusions: ADHD and cyclothymia often co-occur and show similar levels of emotional dysregulation. However, cyclothymic patients may be more prone to negative emotionality in clinical settings. Subjects with “sunny” cyclothymic features might escape the attention of clinicians unless ADHD is present.


2017 ◽  
Vol 41 (S1) ◽  
pp. S101-S101
Author(s):  
D. Cozman ◽  
R. Moldovan ◽  
B. Nemes

IntroductionA better understanding of the genomics of mental illnesses allowed genetic counselling to be provided to individuals with severe mental illness and their families.AimThe present study was aimed at assessing the efficacy of genetic counselling for severe mental illnesses with high suicide risk.MethodAssessment was performed before and after genetic counselling session. Measures used were evaluation of traumatic events in childhood, multidimensional scale for perception of social support (SMSSP), positive and negative affect schedule (PANAS-X), Brief Psychiatric Rating Scale (BPRS), Paykel questionnaire and Genetic Counselling Outcome Scale (GCOS). Paykel's questionnaire consists of five questions about suicidal thoughts and attempts, including: life-weariness, death wishes, suicidal ideation, suicidal plans and suicide attempts. Intervention and assessment lasted approximately one and a half hour. Data from 48 patients was analysed.ResultsMean age of participants was M = 38.4, SD = 9.7, and the group was batter represented by females (57%). The participants had various diagnoses, 22% had schizophrenia, 36% bipolar disorder and 42% recurrent depressive disorder. Forty percent of participants reported suicidal ideation and 22,5% had a past history of suicide attempt. Genetic counselling had a direct positive influence upon GCOS specific items and reduced the Paykel scores among participants presenting with suicidal ideation.ConclusionGenetic counselling offers information about the disorder, the role of genetics and the impact of environmental factors. Preliminary data suggest that providing genetic counselling decreases the suicidal ideation frequency.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2010 ◽  
Vol 106 (3) ◽  
pp. 785-790 ◽  
Author(s):  
Maurizio Pompili ◽  
David Lester ◽  
Marco Innamorati ◽  
Paolo Girardi ◽  
Roberto Tatarelli

To verify the hypothesis that suicide attempts are associated with lower serum cholesterol and triglyceride levels of patients with mood disorders, 26 patients with mood disorders (bipolar disorder and major depressive disorder) were admitted after a medically serious suicide attempt to the emergency department and then hospitalized in the psychiatric unit of the Sant'Andrea Hospital (Rome, Italy). Controls were 87 patients who had not made a recent suicide attempt. Attempters and nonattempters did not differ in the levels of serum cholesterol or triglycerides. Indeed, attempters had nonsignificantly higher serum levels of cholesterol and lower serum levels of triglycerides. The use of biologic indicators such as levels of serum cholesterol and triglycerides in the prediction of suicide risk in mood disorders was not fully supported from this small sample.


1991 ◽  
Vol 68 (3_suppl) ◽  
pp. 1317-1318 ◽  
Author(s):  
George A. Clum ◽  
Richard L. Luscomb ◽  
Anne T. Patsiokas

The question of whether high stress leads to attempting suicide (parasuicide) or suicide attempters are more likely to report high stress was examined in a one-year follow-up study of 98 persons, 47 of whom had attempted suicide. Cross-lagged panel correlations between stress and parasuicide provided both concurrent and predictive validity that stress as measured by life changes leads to parasuicide. A high relationship between stress at baseline and stress at follow-up provided support for the notion that some individuals experience chronic stress and that such individuals may be the ones at risk for future suicide attempts.


1998 ◽  
Vol 173 (6) ◽  
pp. 531-535 ◽  
Author(s):  
Erkki T. Isometsä ◽  
Jouko K. Lönnqvist

BackgroundThis study investigated three questions with major implications for suicide prevention: the sensitivity of the history of previous suicide attempt(s) as an indicator of suicide risk, the time interval from a preceding suicide attempt to the fatal one, and switching of suicide methods by those eventually completing suicide.MethodThe lifetime history of suicide attempts and the methods the victims (n=1397) used were examined in a nationwide psychological autopsy study comprising all suicides in Finland within a 12-month research period in 1987–1988.ResultsOverall, 56% of suicide victims were found to have died at their first suicide attempt, more males (62%) than females (38%). In 19% of males and 39% of females the victim had made a non-fatal attempt during the final year. Of the victims with previous attempts, 82% had used at least two different methods in their suicide attempts (the fatal included).ConclusionsMost male and a substantial proportion of female suicides die in their first suicide attempt, a fact that necessitates early recognition of suicide risk, particularly among males. Recognition of periods of high suicide risk on the grounds of recent non-fatal suicide attempts is likely to be important for suicide prevention among females. Subjects completing suicide commonly switch from one suicide method to another, a finding that weakens but does not negate the credibility of restrictions on the availability of lethal methods as a preventive measure.


2021 ◽  
Vol 9 ◽  
Author(s):  
Tzu-Yu Liu ◽  
Jui-Hsing Chang ◽  
Chun-Chih Peng ◽  
Chyong-Hsin Hsu ◽  
Wai-Tim Jim ◽  
...  

Purpose: To assess the predictive validity of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) cognitive scores at 6 months of corrected age (CA) for cognitive outcomes at 24 months of CA in very-low-birth-weight (VLBW) infants and investigate the predictors of change in cognitive outcomes.Methods: We retrospectively evaluated VLBW children enrolled in the Taiwan Premature Infant Follow-up Network between 2010 and 2015 and completed the Bayley-III at CA of 6 and 24 months. The predictive validity of the cognitive performance at 6-month CA for the cognitive outcomes at 24-month CA was analyzed. The positive and negative predictive factors were also evaluated using logistic regression. Cut-off scores of <70 and <85 were used to identify lower functioning groups based on the Bayley-III definition.Results: A total of 2,972 VLBW children, born with a mean weight of 1116.4 ± 257.5 g and mean gestational age of 29.0 ± 2.8 weeks, were evaluated. A cognitive score of <70 at 6-month CA had a positive predictive value (PPV) of 27.4% (95% confidence interval [CI]: 19.2–35.7%) for a cognitive score of <70 at 24-month CA, while the negative predictive value (NPV) was 97.3% (95% CI: 96.7–97.9%). A cut-off score of 85 had a PPV of 33.6% (95% CI: 28.1–39.0%) and an NPV of 87.7% (95% CI: 86.4–88.9%). Abnormal muscle tone at 6 months was a risk factor for cognitive function decline at 24 months for both Bayley-III cognitive cut-off scores: scores of 70 (adjusted odds ratio [AOR]: 2.8; 95% CI: 1.5–5.5) and 85 (AOR: 2.6; 95% CI: 1.6–4.1). Lower maternal socioeconomic status was associated with a worsening of the cognitive function in infants at 24 months who scored ≥85 at 6 months (AOR: 1.6; 95% CI: 1.2–2.0).Conclusion: Subnormal Bayley-III cognitive scores at 6-month CA were not predictive of subnormal cognitive function at 24-month CA. In children with normal cognition during early infancy, abnormal muscle tone and lower maternal socioeconomic status may influence the cognitive developing process; this highlighted the importance of early identification of high risk infants and complete preterm infant-associated public health policies to promote an improved neurodevelopmental outcome.


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