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BMC Psychiatry
Published in: BMC Psychiatry 1/2010

Open Access 01-12-2010 | Research article

Construct development: The Suicide Trigger Scale (STS-2), a measure of a hypothesized suicide trigger state

Authors: Zimri Yaseen, Curren Katz, Matthew S Johnson, Daniel Eisenberg, Lisa J Cohen, Igor I Galynker

Published in: BMC Psychiatry | Issue 1/2010

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Abstract

Background

This study aims to develop the construct of a 'suicide trigger state' by exploring data gathered with a novel psychometric self-report instrument, the STS-2.

Methods

The STS-2, was administered to 141 adult psychiatric patients with suicidal ideation. Multiple statistical methods were used to explore construct validity and structure.

Results

Cronbach's alpha (0.949) demonstrated excellent internal consistency. Factor analyses yielded two-component solutions with good agreement. The first component described near-psychotic somatization and ruminative flooding, while the second described frantic hopelessness. ROC analysis determined an optimal cut score for a history of suicide attempt, with significance of p < 0.03. Logistic regression analysis found items sensitive to history of suicide attempt described ruminative flooding, doom, hopelessness, entrapment and dread.

Conclusions

The STS-2 appears to measure a distinct and novel clinical entity, which we speculatively term the 'suicide trigger state.' High scores on the STS-2 associate with reported history of past suicide attempt.
Appendix
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Literature
1.
Brown GK, Ten HT, Henriques GR, Xie SX, Hollander JE, Beck AT: Cognitive therapy for the prevention of suicide attempts: a randomized controlled trial. JAMA. 2005, 294: 563-70. 10.1001/jama.294.5.563.CrossRefPubMed
2.
Mann JJ, Waternaux C, Haas GL, Malone KM: Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry. 1999, 156: 181-189.PubMed
3.
Motto JA, Bostrom A: Empirical indicators of near-term suicide risk. Crisis. 1990, 11 (1): 52-9.PubMed
4.
Hall RCW, Platt DE, Hall RCW: Suicide risk assessment: A review of risk for suicide in 100 patients who made severe suicide attempts. Evaluation of suicide risk in a time of managed care. Psychosomatics. 1999, 40: 18-27.CrossRefPubMed
5.
Pfaff JJ, Acres JG, McKelvey RS: Training general practitioners to recognize and respond to psychological distress and suicidal ideation in young people. Med J Aust. 2001, 174 (5): 222-6.PubMed
6.
Pfaff JJ, Almeida OP: Detecting suicidal ideation in older patients: identifying risk factors within the general practice setting. Br J Gen Pract. 2005, 55 (513): 269-73.PubMedPubMedCentral
7.
Oquendo MA, Currier D, Mann JJ: Prospective studies of suicidal behavior in major depressive and bipolar disorders: what is the evidence for predictive risk factors?. Acta Psychiatr Scan. 2006, 114 (3): 151-8. 10.1111/j.1600-0447.2006.00829.x.CrossRef
8.
Niméus A, Hjalmarsson Ståhlfors F, Sunnqvist C, Stanley B, Träskman-Bendz L: Evaluation of a modified interview version and of a self-rating version of the Suicide Assessment Scale. Eur Psychiatry. 2006, 21 (7): 471-7. Epub 2006 Mar 20CrossRefPubMed
9.
Niméus A, Alsén M, Träskman-Bendz L: The suicide assessment scale: an instrument assessing suicide risk of suicide attempters. Eur Psychiatry. 2000, 15 (7): 416-23.CrossRefPubMed
10.
Holmstrand C, Nimeus A, Traskman-Bendz L: Risk factors of future suicide in suicide attempters - a comparison between suicides and matched survivors. Nord J Psychiatry. 2006, 60 (2): 162-167. 10.1080/08039480600583597.CrossRefPubMed
11.
Beck AT, Kovacs M, Weissman A: Assessment of suicidal intention: the Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology. 1979, 47: 343-352. 10.1037/0022-006X.47.2.343.CrossRefPubMed
12.
Harriss L, Hawton K: Suicidal intent in deliberate self-harm and the risk of suicide: the predictive power of the Suicide Intent Scale. J Affect Disord. 2005, 86 (2): 225-233. 10.1016/j.jad.2005.02.009.CrossRefPubMed
13.
Motto JA, Bostrom A: Empirical indicators of near-term suicide risk. Crisis. 1990, 1: 52-9.
14.
Horesh N, Zalsman G, Apter A: Suicidal behavior and self-disclosure in adolescent psychiatric inpatients. J Nerv Ment Dis. 2004, 192 (12): 837-42. 10.1097/01.nmd.0000146738.78222.e5.CrossRefPubMed
15.
Busch KA, Fawcett J, Jacobs DG: Clinical correlates of inpatient suicide. J Clin Psychiatry. 2003, 64 (1): 14-9. 10.4088/JCP.v64n0105.CrossRefPubMed
16.
Deisenhammer EA, Ing CM, Strauss R, Kemmler G, Hinterhuber H, Weiss EM: The duration of the suicidal process: how much time is left for intervention between consideration and accomplishment of a suicide attempt?. J Clin Psychiatry. 2009, 70 (1): 19-24. 10.4088/JCP.07m03904. Epub 2008 Oct 21CrossRefPubMed
17.
Esposito C, Sirito A, Boergers J, Donaldson D: Affective, behavioral, and cognitive functioning in adolescents with multiple suicide attempts. Suicide Life Threat Behav. 2003, 33: 389-399. 10.1521/suli.33.4.389.25231.CrossRefPubMed
18.
Nock MK, Kazdin AE: Examination of affective, cognitive, and behavioral factors and suicide-related outcomes in children and young adolescents. Journal of clinical child and adolescent psychology. 2002, 31: 48-58.CrossRefPubMed
19.
Morrison R, O'Connor RC: A systematic review of the relationship between rumination and suicidality. Suicide Life Threat Behav. 2008, 38 (5): 523-38. 10.1521/suli.2008.38.5.523.CrossRefPubMed
20.
Rudd MD, Joiner T, Rajab MH: Treating suicidal behavior: an effective time-limited approach. 2001, New York; Guilford Press
21.
Randomsky ED, Haas GL, Mann JJ, Sweeny JA: Suicidal behavior in patients with schizophrenia and other psychotic disorders. American journal of psychiatry. 1999, 156: 1590-1595.CrossRef
22.
Goodwin RD, Hamilton SP: Panic as a marker of core pathological processes. Pyschopathology. 2001, 34: 278-288. 10.1159/000049326.CrossRef
23.
Katz CE, Mojtabai R, Camacho K, Samuel J, Galynker I: Panic attack and suicide risk: A multivariate logistic regression analysis of the National Epidemiological Survey of Alcoholism and Related Conditions. 2009, Poster session presented at the 162nd annual meeting of the American Psychiatric Association, San Francisco, CA
24.
Weissman MM, Klerman GL, Markowitz JS, Ouellette R: Suicidal ideation and suicide attempts in panic disorder and attack. N Engl J Med. 1989, 231: 1209-1214. 10.1056/NEJM198911023211801.CrossRef
25.
Schnyder U, Valach L, Bichsel K, Michel K: Attempted suicide: Do we understand patients reasons?. General hospital psychiatry. 1999, 21: 62-69. 10.1016/S0163-8343(98)00064-4.CrossRefPubMed
26.
Hendin H, Maltsberger JT, Haas AP, Szanto K, Rabinowicz H: Desperation and other affective states in suicidal patients. Suicide Life Threat Behav. 2004, 34 (4): 386-94. 10.1521/suli.34.4.386.53734.CrossRefPubMed
27.
Galynker I, Ieronimo C, Perez-Aquino A, Lee Y, Winston A: Panic attacks with psychotic features. Journal of Clinical Psychiatry. 1996, 57: 402-406.PubMed
28.
Fava M, Rush AJ, Trivedi MH, et al: Background and rationale for the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Psychiatr Clin North Am. 2003, 26: 457-494. 10.1016/S0193-953X(02)00107-7.CrossRefPubMed
29.
Rush AJ, Fava M, Wisniewski SR, et al: Sequenced treatment alternatives to relieve depression (STAR*D): rationale and design. Control Clin Trials. 2004, 25: 119-142. 10.1016/S0197-2456(03)00112-0.CrossRefPubMed
30.
31.
Galynker I, Mojtabai R, Cohen L: Panic attacks with psychotic features: are they "non-affective acute remitting psychosis?". 2006, Symposium S75 presentaed at the 159th Annual Meeting of the American Psychiatric Association, Toronto, Canada
32.
Goldman RS, Robinson D, Grube BS, Hanks RA, Putnam K, Walder DJ, Kane JM: General Psychiatric Symptoms Measures. Handbook of Psychiatric Measures. Edited by: The Taskforce for the Handbook of Psychiatric Measures. 2000, Washington DC: American Psychiatric Association Press, 81-84. 1
33.
Hyvarinen A, Karhunen J, Oja E: Independent component analysis. 2001, New York: WileyCrossRef
34.
Fawcett T: An introduction to ROC analysis. Pattern Recognition Letters. 2006, 27 (8): 861-874. 10.1016/j.patrec.2005.10.010.CrossRef
35.
Menard SW: Applied logistic regression analysis. 2002, Thousand Oaks, CA: Sage Publications, SecondCrossRef
36.
Rothman KJ: No Adjustments Are Needed for Multiple Comparisons. Epidemiology. 1990, 1 (1): 43-46. 10.1097/00001648-199001000-00010.CrossRefPubMed
37.
Beck AT, Weishaar ME: Suicide risk assessment and prediction. Crisis. 1990, 2: 22-30.
38.
Beck AT, Steer RA, Kovacs M, Garrison B: Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicidal ideation. Am J Psychiatry. 1985, 142 (5): 559-63.CrossRefPubMed
39.
Brown GK, Beck AT, Steer RA, Grisham JR: Risk factors for suicide in psychiatric outpatients: a 20-year prospective study. Journal of Consulting and Clinical Psychology. 2000, 68: 371-377. 10.1037/0022-006X.68.3.371.CrossRefPubMed
40.
Hawton K, Sutton L, Haw C, Sinclair J, Harriss L: Suicide and attempted suicide in bipolar disorder: a systematic review of risk factors. J Clin Psychiatry. 2005, 66 (6): 693-704. 10.4088/JCP.v66n0604.CrossRefPubMed
41.
Diefenbach GJ, Woolley SB, Goethe JW: The association between self-reported anxiety symptoms and suicidality. J Nerv Ment Dis. 2009, 197 (2): 92-7. 10.1097/NMD.0b013e318196127c.CrossRefPubMed
42.
Cougle JR, Keough ME, Riccardi CJ, Sachs-Ericsson N: Anxiety disorders and suicidality in the National Comorbidity Survey-Replication. J Psychiatr Res. 2009, 43 (9): 825-9. 10.1016/j.jpsychires.2008.12.004.CrossRefPubMed
43.
Morrison R, O'Connor RC: The role of rumination, attentional biases and stress in psychological distress. Br J Psychol. 2008, 99 (2): 191-209. 10.1348/000712607X216080. [Epub 2007 Jun 6]CrossRefPubMed
44.
Rudd MD, Dahm PF, Rajab MH: Diagnostic comorbidity in persons with suicidal ideation and behavior. Am J Psychiatry. 1993, 150 (6): 928-34.CrossRefPubMed
45.
Nordentoft M: Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Dan Med Bull. 2007, 54 (4): 306-69.PubMed
46.
Starcevic V, Bogojevic G, Marinkovic J, Kelin K: Axis I and axis II comorbidity in panic/agoraphobic patients with and without suicidal ideation. Psychiatry Res. 1999, 88 (2): 153-61. 10.1016/S0165-1781(99)00078-5.CrossRefPubMed
47.
Isometsä ET, Henriksson MM, Heikkinen ME, Aro HM, Marttunen MJ, Kuoppasalmi KI, Lönnqvist JK: Suicide among subjects with personality disorders. Am J Psychiatry. 1996, 153 (5): 667-73.CrossRefPubMed
48.
Escobar JI, Gureje O: Influence of cultural and social factors on the epidemiology of idiopathic somatic complaints and syndromes. Psychosom Med. 2007, 69 (9): 841-5. 10.1097/PSY.0b013e31815b007e.CrossRefPubMed
49.
Ebert D, Martus P: Somatization as a core symptom of melancholic type depression. Evidence from a cross-cultural study. J Affect Disord. 1994, 32 (4): 253-6. 10.1016/0165-0327(94)90089-2.CrossRefPubMed
Metadata
Title
Construct development: The Suicide Trigger Scale (STS-2), a measure of a hypothesized suicide trigger state
Authors
Zimri Yaseen
Curren Katz
Matthew S Johnson
Daniel Eisenberg
Lisa J Cohen
Igor I Galynker
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2010
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-10-110

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