Prediction of suicidal behavior in high risk psychiatric patients using an assessment of acute suicidal state: The suicide crisis inventory

Abstract

The SCI was predictive of future SB in high-risk psychiatric inpatients during the crucial weeks following their hospital discharge. Further validation in diverse patient populations is needed.

Suicide Crisis Syndrome: A review of supporting evidence for a new suicide‐specific diagnosis

“…A recent meta‐analysis also revealed that the experience of emotional pain was predictive of current suicidal ideation and attempts (Ducasse et al, ), suggesting its role in imminent suicide. Our studies with the STS found that emotional pain was a significant predictor of suicidal behavior within a month (Galynker et al, ). It must be noted that emotional pain may be strongly linked to entrapment (Bloch‐Elkouby et al, unpublished data), as suggested by the concept of “frantic hopelessness,” and future research may uncover emotional pain to be part of Criterion A.…”

“…In part to pay homage to these distinguished suicide researchers, the SCS name was derived from this term, as it was used to describe the intense affective state preceding an imminent suicide attempt. Further, because the development of the SCS stability and structure was confirmed by several factor analyses (Galynker et al, ; Yaseen et al, ; Yaseen et al, ; Yaseen et al, ), we felt justified in using the term syndrome in its widely accepted definition of several symptoms that occur together (American Psychiatric Association, ). A prodromal suicidal state was also considered, but its use can be problematic, as prodromes can last years (as in Bipolar Disorder), while the SCS is a true state phenomenon akin to state anxiety (Galynker, ).…”

“…Although at present entrapment remains the preferred term for Criterion A because of its acceptability and familiarity, there is some evidence that it is not entirely accurate. First, recent studies have identified emotional pain to be most highly correlated with entrapment (Galynker et al, ; Li et al, ). Second, a network analysis of the SCS (Bloch‐Elkouby et al, unpublished data) has established that entrapment is closely linked to emotional pain.…”

“…When entered together in a model, only anhedonia and entrapment had independent predictive validity for suicidal ideation over the six months following the assessment. Finally, social withdrawal was found to be an independent predictor of suicidal thoughts and behaviors in the four weeks following the index assessment (Galynker et al, ; Yaseen, Hawes, Barzilay, & Galynker, ).…”

Anhedonia and suicidal thoughts and behaviors in psychiatric outpatients: The role of acuity

“…These proposed syndromes posit severe affective disturbance combined with physiological arousal and varying degrees of cognitive disturbance as syndromal states driving a transition to suicidal action. However, measures of anhedonia have not yet been incorporated into the measures aimed at assessing these syndromes (Galynker et al., ; Hawes, Yaseen, Briggs, & Galynker, ; Rogers et al., ; Stanley, Rufino, Rogers, Ellis, & Joiner, ; Tucker, Michaels, Rogers, Wingate, & Joiner, ; Yaseen et al., ; Yaseen et al., ; Yaseen, Gilmer, Modi, Cohen, & Galynker, ). Our findings suggest that measures targeting acute anhedonia, such as the SLIPS (Winer et al., ), could be an important addition to the assessment of these syndromes.…”