Imminent Suicide: The Illusion of Short‐Term Prediction

Simon, Robert I.

doi:10.1521/suli.2006.36.3.296

Cited by 47 publications

(29 citation statements)

References 13 publications

(7 reference statements)

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“…Understanding what is defined as an imminent suicide scenario, which some see as purely euphemistic, 13 would help establish a more detailed assessment of suicide risk. The expected result would be that active modification of those variables might decrease the risk of suicide.…”

Section: Introductionmentioning

confidence: 99%

Suicide detection in Chile: proposing a predictive model for suicide risk in a clinical sample of patients with mood disorders

Barros

Morales

Echávarri

et al. 2016

Rev. Bras. Psiquiatr.

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Objective: To analyze suicidal behavior and build a predictive model for suicide risk using data mining (DM) analysis. Methods: A study of 707 Chilean mental health patients (with and without suicide risk) was carried out across three healthcare centers in the Metropolitan Region of Santiago, Chile. Three hundred fortythree variables were studied using five questionnaires. DM and machine-learning tools were used via the support vector machine technique. Results: The model selected 22 variables that, depending on the circumstances in which they all occur, define whether a person belongs in a suicide risk zone (accuracy = 0.78, sensitivity = 0.77, and specificity = 0.79). Being in a suicide risk zone means patients are more vulnerable to suicide attempts or are thinking about suicide. The interrelationship between these variables is highly nonlinear, and it is interesting to note the particular ways in which they are configured for each case. The model shows that the variables of a suicide risk zone are related to individual unrest, personal satisfaction, and reasons for living, particularly those related to beliefs in one's own capacities and coping abilities. Conclusion: These variables can be used to create an assessment tool and enables us to identify individual risk and protective factors. This may also contribute to therapeutic intervention by strengthening feelings of personal well-being and reasons for staying alive. Our results prompted the design of a new clinical tool, which is fast and easy to use and aids in evaluating the trajectory of suicide risk at a given moment.

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Section: Introductionmentioning

confidence: 99%

Suicide detection in Chile: proposing a predictive model for suicide risk in a clinical sample of patients with mood disorders

Barros

Morales

Echávarri

et al. 2016

Rev. Bras. Psiquiatr.

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show abstract

“…Thus, despite considerable and wide-ranging efforts, risk-factor based approaches, while of significant value at an actuarial and public health level, have never fully achieved clinical significance [5], [6]. However, a small but growing body of evidence characterizes a suicide crisis as an acute state which can precipitate the transition from chronic SI to acute SA [7]–[9].…”

Section: Introductionmentioning

confidence: 99%

Predictive Validity of the Suicide Trigger Scale (STS-3) for Post-Discharge Suicide Attempt in High-Risk Psychiatric Inpatients

et al. 2014

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BackgroundThe greatly increased risk of suicide after psychiatric hospitalization is a critical problem, yet we are unable to identify individuals who would attempt suicide upon discharge. The Suicide Trigger Scale v.3 (STS-3), was designed to measure the construct of an affective ‘suicide trigger state’ hypothesized to precede a suicide attempt (SA). This study aims to test the predictive validity of the STS-3 for post-discharge SA on a high-risk psychiatric-inpatient sample.MethodsThe STS-3, and a psychological test battery measuring suicidality, mood, impulsivity, trauma history, and attachment style were administered to 161 adult psychiatric patients hospitalized following suicidal ideation (SI) or SA. Receiver Operator Characteristic and logistic regression analyses were used to assess prediction of SA in the 6-month period following discharge from hospitalization.ResultsSTS-3 scores for the patients who made post-discharge SA followed a bimodal distribution skewed to high and low scores, thus a distance from median transform was applied to the scores. The transformed score was a significant predictor of post-discharge SA (AUC 0.731), and a subset of six STS-3 scale items was identified that produced improved prediction of post-discharge SA (AUC 0.814). Scores on C-SSRS and BSS were not predictive. Patients with ultra-high (90th percentile) STS-3 scores differed significantly from ultra-low (10th percentile) scorers on measures of affective intensity, depression, impulsiveness, abuse history, and attachment security.ConclusionSTS-3 transformed scores at admission to the psychiatric hospital predict suicide attempts following discharge among the high-risk group of suicidal inpatients. Patients with high transformed scores appear to comprise two clinically distinct groups; an impulsive, affectively intense, fearfully attached group with high raw STS-3 scores and a low-impulsivity, low affect and low trauma-reporting group with low raw STS-3 scores. These groups may correspond to low-plan and planned suicide attempts, respectively, but this remains to be established by future research.

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“…However, while chronic risk factors for suicide are increasingly well understood, we remain unable to predict acute suicide risk [3].…”

Section: Introductionmentioning

confidence: 99%

Love and Suicide: The Structure of the Affective Intensity Rating Scale (AIRS) and Its Relation to Suicidal Behavior

et al. 2012

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BackgroundSuicide has been linked to intense negative affect. However, little is known about the range of affects experienced by suicidal persons, or the separate effects of affect valence and intensity. We examine a novel self-report scale, the 17-item Affective Intensity Rating Scale (AIRS), and its relation to suicidality in a high-risk sample.Methodology/Principal FindingsPatients presenting with suicidality were recruited from the Emergency Department in a large urban hospital, and completed a battery of assessments there. Structure of the AIRS was assessed using Maximum Likelihood Factor Analysis with Oblimin rotation. Convergent and divergent validity were assessed by regressing AIRS subscales against Brief Symptom Inventory subscales. Relation to suicidality was assessed by regression of suicide attempt status against scale and subscale scores, and individual items and two-way item interactions, along with significant clinical and demographic factors. 176 subjects were included in analyses. Three reliable subscales were identified within the AIRS measure: positive feelings towards self, negative feelings towards self, and negative feelings towards other. Only individual AIRS items associated significantly with suicide attempt status; strong ‘feelings of love’ associated positively with actual suicide attempt, while ‘feelings of calm’ and ‘positive feelings towards self’ associated negatively. Interaction analyses suggest ‘calm’ moderates the association of ‘love’ with suicide attempt.Conclusions/SignificanceFactor analysis of the AIRS is consistent with a circumplex model of affect. Affective dimensions did not predict suicidal behavior, but intense feelings of love, particularly in the absence of protective feelings of calm or positive self-view associated with current attempt.

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Imminent Suicide: The Illusion of Short‐Term Prediction

Cited by 47 publications

References 13 publications

Suicide detection in Chile: proposing a predictive model for suicide risk in a clinical sample of patients with mood disorders

Suicide detection in Chile: proposing a predictive model for suicide risk in a clinical sample of patients with mood disorders

Predictive Validity of the Suicide Trigger Scale (STS-3) for Post-Discharge Suicide Attempt in High-Risk Psychiatric Inpatients

Love and Suicide: The Structure of the Affective Intensity Rating Scale (AIRS) and Its Relation to Suicidal Behavior

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