Using the Suicide Index Score to Predict Treatment Outcomes among Psychiatric Inpatients

Abstract

For many suicidal people, the desire to die is moderated by a competing desire to live. This study aimed to demonstrate the ability of a wish-to-live versus wish-to-die index score to measure ambivalence and trichotomize suicidal inpatients into distinct stratified risk groups. Analyses revealed that index scores calculated for patients at treatment start significantly discriminated among the groups at index and uniquely predicted suicidal ideation, hopelessness, and depression scores across treatment. On average, patients with wish-to-live and wish-to-die orientations resolved suicidal ideation by discharge. Changes in suicidal ideation among ambivalently oriented patients were more variable. Clinical and research implications are discussed.

Suicide Attempt Characteristics Among Veterans and Active-Duty Service Members Receiving Mental Health Services: A Pooled Data Analysis

“…Assessment of suicidal ambivalence (i.e., both the wish to die and the wish to live) has successfully predicted future suicidal thoughts and behaviors, response to suicide treatment, and eventual suicide (O’Connor, Jobes, Yeargin, et al, 2012; Brown, Steer, Henriques, & Beck, 2005; O’Connor, Jobes, Comtois, et al, 2012; Lento, Ellis, Hinnant, & Jobes, 2013). We recommend that clinicians assess both reasons to live and reasons to die when calculating suicide risk and throughout treatment in order to monitor progress.…”

Relative Impact of Risk Factors, Thwarted Belongingness, and Perceived Burdensomeness on Suicidal Ideation in Veteran Service Members

“…The measure has also been used to demonstrate meaningful differences in trajectories of recovery for suicidal individuals involved in psychotherapy (Lento, Ellis, Hinnant, & Jobes, ; S. S. O'Connor et al., ). The total score for the BSS reflects the severity of suicidal ideation, with higher scores indicating greater severity; overall, the measure demonstrated excellent internal consistency reliability (α = .97).…”

Clinical assessment and treatment of suicidal risk: A critique of contemporary care and CAMS as a possible remedy.

“…Previous test construction research has shown that the six SSF variables are quasi-independent and describe unique variance with factor structure reflecting acute and chronic suicidal states. Beyond this dichotomy however there are valuable wish to live versus wish to die ratings that can reliability differentiate distinct suicidal states (Lento, Ellis, Hinnant, & Jobes, 2013). Qualitative SSF prompts may also revelatory information that can inform treatment planning (Jobes & Mann, 1999; Jobes et al, 2004).…”