Predictive validity of the Chinese version of the Adult Suicidal Ideation Questionnaire: Psychometric properties and its short version.

The success of screening for individuals at suicidal risk among the general population relies heavily on the availability of a reliable and validated instrument. However, there remains a lack of a well-validated screening tool for suicidal risk in Chinese, despite the fact that about a quarter of the world's suicides takes place in China. In view of the severity of the suicide problem among the Chinese population, there is a crucial need to develop robust screening tools locally. This study investigates the psychometric properties related to the Chinese version of the Adult Suicidal Ideation Questionnaire (ASIQ) with a 2-wave, population-based panel study in the Hong Kong Special Administrative Region, People's Republic of China. Two-thousand sixteen Chinese people were interviewed for their suicidality, psychological well-being, and ASIQ scores. The Chinese ASIQ was shown to have strong internal reliability, convergent validity, and factorial validity. This study also demonstrated its predictive validity by examining sensitivity and specificity in identifying subsequent suicidality. A 4-item short version of ASIQ was also developed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of suicide risk in a psychiatric hospital.

Assessment of suicide risk is a serious responsibility of psychologists. Best practice instructs use of a standardized instrument and clinical interview to evaluate suicide risk. Six instruments used to assess suicide behavior and symptoms of anxiety and depression were examined. The sample was adults receiving acute psychiatric treatment in a public hospital. The study consisted of 2 groups: 25 patients admitted for suicidal behavior and 42 patients admitted for other reasons. Analyses were conducted to discriminate between the 2 groups on study instruments. No single instrument predicted suicide risk without significant error. Standardized assessments must be used as part of a structured clinical interview. Suicide risk should be assessed with all people admitted to the hospital regardless of admissions criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social competence and self-image disparity in psychiatric and nonpsychiatric patients.

The relationship between social competence and self-image disparity in 20 psychiatric and 20 nonpsychiatric patients was investigated. Education, intelligence, occupation, employment history, and marital status were used as indices of social competence. Real-ideal-self and real-social-self disparity were each measured with 2 separate paper-and-pencil instruments. The predictions from a developmental framework were confirmed: (a) high competence Ss would manifest higher real-ideal disparity scores than low Ss on both instruments, (b) this difference would be greater on the instrument permitting more response differentiation, (c) the highs would have larger real-social disparity scores than the lows on the instrument allowing the greater response differentiation. This difference between groups would be less than that found for the real-ideal disparity scores. (21 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring psychotherapy process with the Adolescent Psychotherapy Q-set (APQ): Development and applications for training.

This study presents the initial findings from the development of an adolescent version of the Child Psychotherapy Q-set (CPQ, Schneider, 2003). The CPQ is a psychotherapy process measure that utilizes Q-methodology to define psychotherapy process in an empirical form suitable for quantitative analysis. This new instrument, the Adolescent Psychotherapy Process Q-set (APQ), was developed to be pantheoretical in assessing the process of psychotherapy with adolescents. Panels of "expert" psychodynamic (PD) and cognitive-behavioral (CB) theoreticians and practitioners (N = 22) rated the 100 APQ items, and these ratings were factor analyzed to develop general prototypes of ideally conducted therapy for each respective orientation. Agreement between and amongst the experts was examined; in order to determine the reliability of, and shared variance between, each prototype. Coefficient alpha reliabilities were high for both PD (.93) and CB (.94) orientations. A significant correlation between the factor scores of each prototype (r = .31; p ≤ .01) was found. In a second study, a case example is provided to demonstrate the applications of the APQ and the prototypes in psychotherapy training and supervision. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk taking and hedonic mood stimulation in suicide attempters.

Compared risk-taking levels of 15 hospitalized male suicide attempters with those of 15 hospitalized suicide threateners and other psychiatric and medical patient controls (n = 45). Ss were randomly assigned to view depressive, neutral, or elational mood-stimulation films, and pre- and postviewing scores on the Psychiatric Outpatient Mood Scale were compared. Risk-taking was operationalized by 2 paper-and-pencil tests, Kogan and Wallach's Choice Dilemmas instrument and Chance Bets instrument. The principal finding was that suicide attempters displayed an idiosyncratic "risky shift" in high value decision-making situations when confronted with depressive stimulation. They displayed significantly greater Choice Dilemmas risk-taking than suicide threateners and psychiatric or medical controls when all were exposed to depressive stimulation. (26 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Equating the MOS SF36 and the LSU HSI Physical Functioning Scales

This study equates the physical functioning subscales of the Medical Outcomes Study Short Form 36 (SF36) and the Louisiana State University Health Status Instruments (LSU HSI). Data from the SF36's 10-item physical functioning scale, the PF10, and the LSU HSI's 29-item Physical Functioning Scale (PFS), were fit to separate and mixed Rasch rating scale models. Data were provided by a convenience sample of 285 patients waiting for appointments in a public hospital general medicine clinic. Difficulty estimates for a subset of similar items from the two instruments were highly correlated (.95), indicating that the items from the two scales are working together to measure the same variable. The measures from the two equated instruments correlate .80 (.86 when disattenuated for error). Of the two instruments, the PFS's error is lower, model fit is better, and reliability coefficients are higher. Both instruments measure physical functioning, and can do so in a common unit of measurement. Conversion tables are provided for transforming raw scores from either instrument into the common metric.     

Reasons for staying alive when you are thinking of killing yourself: The Reasons for Living Inventory.

65 adults generated 72 distinct reasons for not committing suicide; these were reduced to 48 by factor analyses performed on 2 additional samples, and the items were arranged into the Reasons for Living Inventory (RFL), which requires a rating of how important each reason would be for living if suicide were contemplated. In addition, factor analyses indicated 6 primary reasons for living: Survival and Coping Beliefs, Responsibility to Family, Child-Related Concerns, Fear of Suicide, Fear of Social Disapproval, and Moral Objections. The RFL was then given to 2 additional samples, 197 Seattle shoppers (mean age 36 yrs) and 175 psychiatric inpatients (mean age 31 yrs). Both samples were divided into several suicidal (ideators and parasuicides) and nonsuicidal groups. Separate multivariate ANOVAs indicated that the RFL differentiated suicidal from nonsuicidal Ss in both samples. In the shopping-center sample, the Fear of Suicide scale further differentiated between previous ideators and previous parasuicides. In the clinical sample, the Child-Related Concerns scales differentiated between current suicide ideators and current parasuicides. In both samples, the Survival and Coping, the Responsibility to Family, and the Child-Related Concerns scales were most useful in differentiating the groups. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prognostic expectations and treatment outcome.

Studied the relationship between recovery (symptom reduction) from serious psychiatric disorder and patient-held and therapist-held expectations for recovery. Objective measures of prognostic expectations were taken from 150 patients (mean age, 32.6 yrs) upon hospital admission and from 14 staff therapists shortly thereafter. Expectations stated by both groups were factor analyzed, and 2 sets of 6 weighted factor scores were calculated for each patient. Multiple regression analyses were employed to test for association between sets of factor scores and symptom reduction through hospitalization. Changes in MMPI and Brief Psychiatric Rating Scale scores (admission to discharge) were used as measures of symptom reduction. It was found that therapists', but not patients', expectations were reliably associated with symptom reduction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sequentiality and structure in a cognitive model of college student development.

The challenge of explaining cognitive and attitudinal changes in college students has been approached developmentally in a sequential model detailing changes in students' views of knowledge and authority. In the present study, the scalability and structural unity of comprehension of ideas from 8 positions in the sequence were examined. 28 students were asked to reformulate short statements representing these positions as applied to 5 different topics. Correct reformulation of the ideas presented in 4 of the 5 items at each level was used as an index of comprehension of that level. Scalogram analysis yielded significant coefficients of reproducibility (.97) and scalability (.71). Intercorrelations between scale scores on the 5 topics were performed; factor analysis revealed a 1st factor, degree of relevance to school, and a 2nd factor affected by the degree of abstractness of the topic. The model has implications for the planning of educational experiences for college age students (and perhaps younger groups, also), as well as for understanding the processes by which formal operational abilities are brought to bear on nonscientific problems. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The MMPI as a suicide predictor

MMPIs of 36 patient suicides (20 males and 16 females) were compared with 2 matching control groups (36 highly suicidal patients and 36 nonsuicidal patients; each group was matched with the suicide group by age and sex). Female suicides had higher Mf, Si, and Hy scores and lower K scores than the high-suicidal female controls, suggesting nondefensiveness, a more masculine interest pattern, social withdrawal, and denial and repression of inner needs and feelings. Male suicides were significantly differentiated from nonsuicidal males but not from the high-suicidal male controls. Nonsuicidal males had higher K and OH scores and lower Mf and D scores than the other 2 male groups, suggesting a more active, assertive, and self-protective stance. These differentiating patterns emerged from a population of voluntary psychiatric patients and are not necessarily generalizable to other populations. Results emphasize the necessity for knowing the population and the subgroups within; once these measures are taken, MMPI patterns appear to have usefulness in predicting suicide potential. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of the Patient Health Questionnaire and the Older Adult Health and Mood Questionnaire for self-reported depressive symptoms after spinal cord injury.

Objective: To directly compare estimates of potential depressive disorders and clinically significant depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9) and Older Adult Health and Mood Questionnaire (OAHMQ) among participants with spinal cord injury (SCI). Research Design: 727 participants from a hospital in the Southeastern United States were administered the PHQ-9 and OAHMQ during a follow-up survey. We compared the rates of depressive disorders using cutoff scores and diagnostic criteria for each instrument. No independent psychiatric diagnostic interviews were conducted. Results: The PHQ-9 and OAHMQ were significantly correlated (r = .78), and both were correlated with satisfaction with life (r = ?.48, ?.54). Using recommended diagnostic scoring procedures, 10.7% of participants met the diagnostic criteria for major depressive disorder with the PHQ-9; 9.3% met the criteria for major depression based on PHQ-9 ≥ 10; and 19.7% based on PHQ-9 ≥ 15. Using the OAHMQ, 19.7% reported probable major depression and 44.5% clinically significant symptomatology. Conclusions: The measures were highly correlated overall. However, the estimated prevalence of depressive disorders varied substantially between the 2 instruments. These estimates were comparable to those previously reported for each instrument (i.e., higher rates with the OAHMQ). Therefore, differing estimates of depressive disorders reported in the literature using these instruments were largely attributable to the instruments themselves. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Applicability paradigm: Students' evaluations of teaching effectiveness in different countries.

The author (1981) reviews 4 studies concerning his paradigm for studying the applicability of 2 North American instruments designed to measure students' evaluations of university-teaching effectiveness in different countries. Across the 4 studies (1) all items were judged to be appropriate by a large majority of the students; (2) all items were selected by some students as being most important; (3) there was a surprising consistency in the items judged to be less appropriate and most important; (4) all but the Workload/Difficulty items clearly differentiated between good and poor instructors; (5) factor analyses generally replicated the factors that each instrument was designed to measure; and (6) multitrait–multimethod analyses demonstrated strong support for both the convergent and divergent validity of responses to the 2 instruments. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parental bonding as a predictive factor for the development of adult psychiatric disorders

OBJECTIVE: To asses the capacity of the Parental Bonding Instrument (PBI) to discriminate between normal subjects and clinical samples and between with different psychiatric diagnosis. DESIGN: The present paper analyzes the studies published between 1979 and 1995, which have used the PBI in normal subjects and clinical samples and have reported the respective means and standard deviations obtained on the two PBI dimensions: affection and control. Multiple comparisons were carried out between the mean scores of affection and control of: 1) samples with the same psychiatric diagnosis (intragroup comparison); 2) samples with different psychiatric diagnoses (intergroup comparison); 3) normal subjects and clinical samples. RESULTS: Of the 46 studies with normal and clinical subjects, 23 studies were selected for the analysis, reporting means and standard deviations and specifying the diagnostic criteria. Samples with the same psychiatric diagnosis had similar affection and control scores. With the exception of bipolar affective disorders and avoidant personality disorders, the prevalent parental style was for all diagnostic groups the affectionless control style. Within the affectionless control style, the PBI discriminated between panic attacks, borderline personality and drug addiction but not between schizophrenia, unipolar depression and anxiety disorder. The PBI discriminated also between normal subjects samples and samples with anxiety disorder, schizophrenia, bipolar affective disorder, personality disorder and drug addiction respectively. CONCLUSION: The results confirm previous suggestions from single studies that the perceived parental style as measured by the PBI can be considered a good predictor for the presence of psychiatric disorders excluding panic attacks, avoidant personality disorders and unipolar affective disorders. Although the different diagnostic groups do not differ in their perceived parental style (affectionless control), significant differences between some diagnostic groups within this category suggest that the PBI might have some specificity as well.     

Cognitive and personality factors in suicidal behavior.

Studied the role of aggression in suicidal behavior. The personality functioning of 20 suicide attempters, 20 nonsuicidal psychiatric controls, and 20 suicide completers was assessed using the Rorschach. There were 11 female and 9 male 21–63 yr old Ss in each group. M. Feffer's role-taking task (see record 1960-04380-001) provided a test of the cognitive functioning of the 1st 2 groups. All 3 groups experienced the breakthrough of more aggressive than libidinal drive derivatives, but no significant differences between the groups were found. Only the suicide attempters' aggressive responses were more primitive than their libidinal responses. On the role-taking task, the suicidal group's cognitive functioning in the neutral situation was superior to their functioning in the aggressive one. The control group yielded no such difference. The suicidal group's performance in the aggressive situation was also significantly inferior to the control group. Results are interpreted as underscoring the role of cognition in symptom choice. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expression and functional analysis of glycosyl-phosphatidyl inositol-linked CD46 in transgenic mice

OBJECTIVE: To determine whether a high level of hopelessness after treatment of a depressive episode is an indicator of a history of lifetime suicide attempts in older people. DESIGN: Groups of suicide attempters, suicidal ideators, and nonsuicidal patients were compared via analysis of variance with respect to levels of hopelessness, depression, anxiety, and global functioning before and after treatment of depression. SETTING: An outpatient research clinic providing two treatment protocols of late-life mood disorders. PARTICIPANTS: A total of 107 consecutive outpatients (mean age 67) with major depression who responded to treatment. MEASUREMENTS: Levels of hopelessness, severity of depression, anxiety, and global functioning were compared across the three groups at the beginning of treatment and at remission. RESULTS: After remission there were no differences between the three groups in depression severity, anxiety, and global functioning. Hopelessness remained significantly higher in the attempter group than among ideators or nonsuicidal patients. CONCLUSIONS: Suicide attempts, the most important risk factor for subsequent suicide, are associated with persistent, high levels of hopelessness following remission of depression in late-life patients. These findings suggest that treatments designed specifically to lower hopelessness (such as cognitive, behavioral or interpersonal therapy) may be effective in reducing suicide risk.     

Sleep disturbance preceding completed suicide in adolescents.

We examined sleep difficulties preceding death in a sample of adolescent suicide completers as compared with a matched sample of community control adolescents. Sleep disturbances were assessed in 140 adolescent suicide victims with a psychological autopsy protocol and in 131 controls with a similar semistructured psychiatric interview. Rates of sleep disturbances were compared between groups. Findings indicate suicide completers had higher rates of overall sleep disturbance, insomnia, and hypersomnia as compared with controls within both the last week and the current affective episode. Group differences in overall sleep disturbance (both within the last week and present episode), insomnia (last week), and hypersomnia (last week) remained significant after controlling for the differential rate of affective disorder between groups. Similarly, overall sleep disturbance (last week and present episode) and insomnia (last week) distinguished completers in analyses accounting for severity of depressive symptoms. Only a small percentage of the sample exhibited changes in sleep symptom severity in the week preceding completed suicide, but of these, a higher proportion were completers. These findings support a significant and temporal relationship between sleep problems and completed suicide in adolescents. Sleep difficulties should therefore be carefully considered in prevention and intervention efforts for adolescents at risk for suicide. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric diagnoses as contemporaneous risk factors for suicide attempts among adolescents and young adults: Developmental changes.

The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12–19 years of age at hospitalization, repeatedly assessed for up to 13 years (n = 1,825 assessments). Semistructured psychiatric diagnostic instruments were administered at repeated assessments to assess psychiatric disorders and suicide attempts. After controlling for demographic variables and prehospitalization suicide attempts, most contemporaneous psychiatric disorders (major depressive disorder [MDD], dysthymic disorder, generalized anxiety disorder [GAD], panic disorder, attention-deficit/hyperactivity disorder [AD/HD], conduct disorder, and substance use disorder [SUD]) were related to increased risk of attempts. The relationship between suicide attempts and MDD, GAD, AD/HD, and SUD strengthened as participants got older. MDD, dysthymic disorder, GAD, and panic disorder were more commonly associated with repeat than 1st-time suicide attempts. In sum, most major psychiatric disorders are associated with increased risk for suicide attempts, but the strength of the relationships between these disorders and attempts changes over the course of development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use of the MMPI in the selection of hospital aides.

MMPIs were administered to 2700 applicants for the position of psychiatric aide in an institution for the mentally retarded. MMPI subscale scores of all persons hired and subsequently discharged were compared with groups of like sex who: (a) were hired in the same year but resigned for reasons not associated with the job, (b) stayed in the employment of the institution, or (c) were not hired. No single subscale differentiated between the groups. The few differences which were found between the groups when a variety of configurational analyses were used did not reappear in a cross-validation sample. Conclusion: the hypothesis that personality test scores are related to the competency of psychiatric aides was not supported. From Psyc Abstracts 36:05:5LD34B. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward a clinical model of suicidal behavior in psychiatric patients

OBJECTIVE: Risk factors for suicide attempts have rarely been studied comprehensively in more than one psychiatric disorder, preventing estimation of the relative importance and the generalizability of different putative risk factors across psychiatric diagnoses. The authors conducted a study of suicide attempts in patients with mood disorders, psychoses, and other diagnoses. Their goal was to determine the generalizability and relative importance of risk factors for suicidal acts across diagnostic boundaries and to develop a hypothetical, explanatory, and predictive model of suicidal behavior that can subsequently be tested in a prospective study. METHOD: Following admission to a university psychiatric hospital, 347 consecutive patients who were 14-72 years old (51% were male and 68% were Caucasian) were recruited for study. Structured clinical interviews generated axis I and axis II diagnoses. Lifetime suicidal acts, traits of aggression and impulsivity, objective and subjective severity of acute psychopathology, developmental and family history, and past substance abuse or alcoholism were assessed. RESULTS: Objective severity of current depression or psychosis did not distinguish the 184 patients who had attempted suicide from those who had never attempted suicide. However, higher scores on subjective depression, higher scores on suicidal ideation, and fewer reasons for living were reported by suicide attempters. Rates of lifetime aggression and impulsivity were also greater in attempters. Comorbid borderline personality disorder, smoking, past substance use disorder or alcoholism, family history of suicidal acts, head injury, and childhood abuse history were more frequent in suicide attempters. CONCLUSIONS: The authors propose a stress-diathesis model in which the risk for suicidal acts is determined not merely by a psychiatric illness (the stressor) but also by a diathesis. This diathesis may be reflected in tendencies to experience more suicidal ideation and to be more impulsive and, therefore, more likely to act on suicidal feelings. Prospective studies are proposed to test this model.