Assessment of near-term risk for suicide attempts using the suicide crisis inventory

Barzilay, Shira; Assounga, Krystel; Veras, Jacqueline; Beaubian, Courtnie; Bloch-Elkouby, Sarah; Galynker, Igor

doi:10.1016/j.jad.2020.06.053

Cited by 31 publications

(41 citation statements)

References 37 publications

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“…Both patient‐rated and clinician‐rated components of the MARIS demonstrated incremental utility in predicting STBs 1 month later, above and beyond intake STB, suggesting that both patient and clinician dimensions have value in understanding and predicting who may be at risk for subsequent STBs. Namely, consistent with previous literature examining the SCI and the SCS more generally, 6,7,20 Module 1 (SCI‐SF) of the MARIS was uniquely positively related to future STB, even after controlling for intake STB. Likewise, this study extended previous findings that the Module 4 (TRQ‐SF) total score was positively related to STBs 6 by examining this association prospectively and using the subscales of the TRQ‐SF: Distress, Detachment, and Hopelessness; in this sample, only Distress was uniquely and significantly associated with future STBs.…”

Section: Discussionsupporting

confidence: 87%

“…Included in the SCS are empirically based components that relate to STBs: entrapment, 10,11 affective disturbances, 12,13 loss of cognitive control, 14,15 hyperarousal, 16,17 and social withdrawal, 18,19 though the original SCI incorporated only some of these dimensions (ie, entrapment, ruminative flooding, emotional pain, panic‐dissociation, and fear of dying). The full version of the SCI has been consistently associated with concurrent 20,21 and future 7,20,22 suicidal behavior within a four‐to‐eight week follow‐up period.…”

Section: Introductionmentioning

confidence: 98%

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Validity of the modular assessment of risk for imminent suicide in predicting short‐term suicidality

Rogers

Vespa

Bloch-Elkouby

et al. 2021

Acta Psychiatr Scand

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Objective The Modular Assessment of Risk for Imminent Suicide (MARIS) is a clinical assessment tool, consisting of four modules assessing (1) a pre‐suicidal cognitive‐affective state (Module 1); (2) patients’ attitudes toward suicide (Module 2); (3) clinicians’ assessment of suicide risk factors (Module 3); and (4) clinicians’ emotional responses to patients (Module 4) that assesses short‐term suicide risk. Initial evidence provided evidence for its reliability and concurrent validity. The present study extended these findings by examining the MARIS’s predictive validity in relation to suicidal thoughts and behaviors at one‐month follow‐up. Methods A sample of 1039 psychiatric patients (378 inpatients, 661 outpatients) and their clinicians (N = 144) completed a battery of measures at baseline; 670 patients completed the one‐month follow‐up assessment. Results MARIS total scores predicted suicidal thoughts and behaviors at one‐month follow‐up, even after controlling for baseline suicidal thoughts and behaviors. Moreover, both Module 1 and the Distress subscale of Module 4 were uniquely associated with suicidal thoughts and behaviors at one‐month follow‐up, controlling for baseline suicidal thoughts and behaviors. Modules 2 and 3, on the other hand, exhibited poor internal consistency. Conclusion Overall, both patient‐ and clinician‐rated indices are uniquely predictive of suicidal thoughts and behaviors at one‐month follow‐up, highlighting the need for integrating clinicians’ emotional responses into suicide risk assessment. Pending replication and extension of these findings in external samples, a briefer, two‐module version of MARIS (MARIS‐2) may be such an integrative, psychometrically sound, and clinically useful instrument that can be utilized to assess short‐term suicide risk.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 98%

Validity of the modular assessment of risk for imminent suicide in predicting short‐term suicidality

Rogers

Vespa

Bloch-Elkouby

et al. 2021

Acta Psychiatr Scand

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“…The SCS—including its factorial structure, convergent and discriminant validity, criterion validity, and predictive/incremental validity—have been tested and replicated across several studies. Specifically, evidence from existing samples provides evidence for the unidimensionality of SCS as a syndrome (Barzilay et al, 2020; Bloch‐Elkouby et al, 2020; Galynker et al, 2017; Otte et al, 2020), its convergent and discriminant validity (Barzilay et al, 2020; Calati et al, 2020; Galynker et al, 2017; Otte et al, 2020), its associations with concurrent and lifetime suicidality (Barzilay et al, 2020; Calati et al, 2020; Cohen et al, 2018, 2019; Yaseen et al, 2019), and its relations with future short‐term (i.e., 4–8 weeks) suicidal behavior above and beyond other relevant risk factors (Barzilay et al, 2020; Galynker et al, 2017; Pia et al, 2020; Yaseen et al, 2019; Ying et al, 2020). Notably, the severity of SCS was associated with an increased risk of suicide attempts among high‐risk inpatients within 2 months of hospital discharge (Galynker et al, 2017), and the occurrence of suicidal behavior one‐month following hospital discharge was seven times greater in patients with higher SCS scores than in those with lower SCS scores (Yaseen et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Comparative clinical utility of screening for Suicide Crisis Syndrome versus suicidal ideation in relation to suicidal ideation and attempts at one‐month follow‐up

Rogers

Bafna

Galynker

2022

Suicide & Life Threat Behav

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Introduction: Suicidal ideation (SI) has numerous limitations in predicting suicidal behavior. The Suicide Crisis Syndrome (SCS) is proposed as an alternative method of detecting risk. This study compares the relative utility of SI and SCS in statistically predicting SI and behaviors at one-month follow-up. Methods: 382 psychiatric patients (98 inpatients, 284 outpatients) completed baseline measures and provided information about suicide-related outcomes one month later. Participants were grouped based on responses to measures assessing SCS and SI.Results: Rates of follow-up suicidal behavior were significantly higher among those reporting both SCS and SI (22.2%) than those reporting SI alone (6.0%) or neither SCS nor SI (0.9%). SCS alone (8.3%) had descriptively, but not statistically, higher rates of suicidal behavior than those with neither SCS nor SI, and did not differ from SI alone and the combination of SCS and SI. Those reporting SI-with and without SCS-had higher levels of follow-up suicidal thoughts than those without SI. Conclusion:The SCS was equivalent to SI, and incrementally informative alongside SI, in detecting individuals at risk of future suicidal behavior, whereas SI was more strongly related to future SI than SCS. The combination of SCS and SI may be clinically useful in detecting individuals who are at risk for suicide.

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“…The concept of imminent risk, however, focuses on the question when is the risk?-that is, on identifying the acute psychological processes leading an individual to a suicidal act at a specific moment. In the last 5 years, two suicide-specific syndromes have been introduced to address this question, each with a growing research body and support among adult populations: Acute Suicidal Affective Disturbance [33,34] and Suicidal Crisis Syndrome (SCS) [35][36][37]. A recent conceptual analysis [38 & ] compared their clinical utility with the traditional risk factors and concluded that the two proposals offer transdiagnostic classification of acute suicidal states and new validated tools to objectively measure them.…”

Section: Ideation-to-action and Imminent Risk Frameworkmentioning

confidence: 99%

Recent research advances in identification and prevention of youth suicide risk

Barzilay

Apter

2022

Current Opinion in Psychiatry

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Purpose of the reviewThe rate of youth suicidal behaviors has gradually increased over the last 15 years and continues to grow during the COVID-19 pandemic. This trend burdens mental health services and demands significant developments in risk detection and delivery of interventions to reduce the risk. In this article we outline significant advances and recent findings in youth suicide research that may facilitate strategies for identifying and preventing suicide risk among youth at risk in general and in specific risk groups.Recent findingsThe rise in suicide and suicidal behaviors is most likely to affect young people of racial, ethnic, sexual, and gender identity minorities and those living in poverty or experiencing maltreatment. The suicide rate in children is rising and demands special attention. Proximal risk factors for suicidal behavior compared with suicidal ideation have been suggested to identify near-term suicidal risk. Effective and scalable prevention strategies were identified, and the role of new technologies in suicide prevention among youth is to be determined.SummaryTo reach broader suicide prevention in youth and reduce the pressure on mental healthcare, public health approaches and improved service access for minority youth and those living in underserved areas of the world are needed.

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Assessment of near-term risk for suicide attempts using the suicide crisis inventory

Cited by 31 publications

References 37 publications

Validity of the modular assessment of risk for imminent suicide in predicting short‐term suicidality

Validity of the modular assessment of risk for imminent suicide in predicting short‐term suicidality

Comparative clinical utility of screening for Suicide Crisis Syndrome versus suicidal ideation in relation to suicidal ideation and attempts at one‐month follow‐up

Recent research advances in identification and prevention of youth suicide risk

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