Suicide risk screening: Comparing the Beck Depression Inventory-II, Beck Hopelessness Scale, and Psychache Scale in undergraduates.

Abstract

The current research evaluates the effectiveness and relative merits of 3 screening measures (the Beck Depression Inventory-II, the Beck Hopelessness Scale, and the Psychache Scale) in evaluating preexisting suicide risk factors for a sample of 7,522 undergraduate students. All measures demonstrated significant diagnostic accuracy for indicating suicide ideation, previous single and multiple suicide attempts, and a recent suicide attempt, which are all serious risk factors for subsequent death by suicide in university students. However, the Psychache Scale displayed superior performance in accurately identifying suicide risk compared with both the Beck Depression Inventory-II and the Beck Hopelessness Scale. Identifying students most at risk for suicide requires diagnostically efficient measures, thus preliminary cut-scores for identifying at-risk students are provided.

Utility of a time frame in assessing psychological pain and suicide ideation

“…With average psychological pain scores in the low thirties, our sample experienced a higher level of psychological pain than was observed in a large sample of undergraduate students (20.35 [SD 8.25] Troister, D’Agata & Holden, 2015). As expected, our observed scores were higher than those found previously in healthy adults (13.70 [SD 0.50] Cáceda et al, 2014) and (20.60 [SD 4.95] Xie et al, 2014), and not quite as high as the level of psychological pain observed in outpatients with major depressive episodes (40.01 [SD 11.86] Li et al, 2014).…”

“…This implies 13% fewer false positives when screening for suicide ideation among general population adults with the PS-TF. In a comparable analysis of undergraduate students with suicide ideation, Troister, D’Agata & Holden (2015) reported a specificity of .79 and PPV of .27 when using the PS. These values are respectively 2% points and 21% points lower than obtained with the PS-TF.…”

“…In concert with Verrocchio et al (2016), we recommend that psychological pain be assessed as one component in a more comprehensive suicide assessment. As more than two thirds of people with suicidal behaviors do not express their suicidal intent to healthcare professionals (Turecki & Brent, 2016), the PS/PS-TF provides an initial indication that suicide ideation may be present, without actually referring to suicide in its items (Troister, D’Agata & Holden, 2015). We also recommend that the cutoff score for psychological pain identified in our findings be tested in future research with general population samples that reflect the general population more accurately.…”

“…The PS has been used in clinical as well as general population samples and was found to distinguish participants with respect to their level of suicide ideation and history of suicide attempts. In a direct comparison of the PS with the Beck Depression Inventory (BDI) and the Beck Hopelessness Scale (BHS), the PS significantly outperformed the BDI and BHS in terms of identifying individuals with a history of multiple suicide attempts including an attempt in the past year (Troister, D’Agata & Holden, 2015). Studies in undergraduate students, homeless men, and prison inmates found that psychological pain was significantly associated with a history of suicide attempts (Pereira et al, 2010; Troister & Holden, 2010; Patterson & Holden, 2012; You et al, 2014).…”

“…While these studies provide empirical support for the relationship between psychological pain and suicidal thoughts and behaviors, the PS score classified a high number of undergraduate students at elevated risk for suicide who were not at risk based on their current suicidal thoughts and suicide attempt history (Troister, D’Agata & Holden, 2015). In a related area of research, biological markers in adults with a history of depression were not associated with psychological pain assessed on the PS, whereas these markers were associated with an alternate measure of psychological pain, namely the Orbach & Mikulincer Mental Pain (OMMP) questionnaire (Meerwijk, Chesla & Weiss, 2014; Meerwijk, Ford & Weiss, 2015).…”