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Factor analyses of the Suicidal Intent Scale (SIS) and the Risk-Rescue Rating Scale (RRRS): toward the identification of homogeneous subgroups of suicidal behaviors.

Abstract

BACKGROUND

Suicidal behavior is a heterogeneous entity, determined by multiple factors. This heterogeneity has major implications for clinical management of patients and identification of risk factors. Our study aims at identifying homogeneous subgroups of patients with suicidal behavior.

METHODS

We used two validated questionnaires to assess the intent (Suicidal Intent Scale, SIS) and lethality (Risk-Rescue Rating Scale, RRRS) of the most severe suicide attempt in a sample of 608 patients recruited consecutively. We first explored the factorial structure of the two scales, using a principal component analysis, and then tested the relationship between sub-scores identified and subtypes of suicide attempts (violent, serious overdose) using a backward logistic regression.

RESULTS

A four-factor structure was retained for the SIS (conception, preparation, precautions and communication). The RRRS, for which a factorial structure has not been previously published, had a three-factor structure (medical damage, implementation and rescue conditions). This structure was valid, stable and clinically relevant. Serious suicide attempts were characterized by less communication and more precautions against discovery, whereas violent attempts were associated with higher risk acts. Neither violent nor serious attempts were characterized by more planning.

LIMITATIONS

The SIS and RRRS were assessed retrospectively, and so could have been influenced by recall bias. Finally, censoring bias may have affected our results.

CONCLUSIONS

The characterization of suicidal behaviors using SIS and RRRS sub-scores constitutes a first step toward the identification of homogeneous subgroups of suicide attempters. Prospective studies are needed to test the predictive value of these sub-scores for subsequent suicidal acts.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    INSERM, Unit 955, IMRB, Psychiatry Genetics Team, Créteil, France. helene.misson@inserm.fr

    , , , , , , , , , ,

    Source

    Journal of affective disorders 121:1-2 2010 Feb pg 80-7

    MeSH

    Adult
    Comorbidity
    Drug Overdose
    Female
    France
    Humans
    Intention
    Male
    Mental Disorders
    Middle Aged
    Personality Assessment
    Psychometrics
    Reproducibility of Results
    Risk Assessment
    Sex Factors
    Suicide
    Suicide, Attempted
    Violence

    Pub Type(s)

    Comparative Study
    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19524302

    Citation

    TY - JOUR T1 - Factor analyses of the Suicidal Intent Scale (SIS) and the Risk-Rescue Rating Scale (RRRS): toward the identification of homogeneous subgroups of suicidal behaviors. AU - Misson,Hélène, AU - Mathieu,Flavie, AU - Jollant,Fabrice, AU - Yon,Liova, AU - Guillaume,Sébastien, AU - Parmentier,Claire, AU - Raust,Aurélie, AU - Jaussent,Isabelle, AU - Slama,Frédéric, AU - Leboyer,Marion, AU - Bellivier,Frank, AU - Courtet,Philippe, Y1 - 2009/06/12/ PY - 2009/02/03/received PY - 2009/05/17/revised PY - 2009/05/18/accepted PY - 2009/6/16/entrez PY - 2009/6/16/pubmed PY - 2010/4/15/medline SP - 80 EP - 7 JF - Journal of affective disorders JO - J Affect Disord VL - 121 IS - 1-2 N2 - BACKGROUND: Suicidal behavior is a heterogeneous entity, determined by multiple factors. This heterogeneity has major implications for clinical management of patients and identification of risk factors. Our study aims at identifying homogeneous subgroups of patients with suicidal behavior. METHODS: We used two validated questionnaires to assess the intent (Suicidal Intent Scale, SIS) and lethality (Risk-Rescue Rating Scale, RRRS) of the most severe suicide attempt in a sample of 608 patients recruited consecutively. We first explored the factorial structure of the two scales, using a principal component analysis, and then tested the relationship between sub-scores identified and subtypes of suicide attempts (violent, serious overdose) using a backward logistic regression. RESULTS: A four-factor structure was retained for the SIS (conception, preparation, precautions and communication). The RRRS, for which a factorial structure has not been previously published, had a three-factor structure (medical damage, implementation and rescue conditions). This structure was valid, stable and clinically relevant. Serious suicide attempts were characterized by less communication and more precautions against discovery, whereas violent attempts were associated with higher risk acts. Neither violent nor serious attempts were characterized by more planning. LIMITATIONS: The SIS and RRRS were assessed retrospectively, and so could have been influenced by recall bias. Finally, censoring bias may have affected our results. CONCLUSIONS: The characterization of suicidal behaviors using SIS and RRRS sub-scores constitutes a first step toward the identification of homogeneous subgroups of suicide attempters. Prospective studies are needed to test the predictive value of these sub-scores for subsequent suicidal acts. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/19524302/Factor_analyses_of_the_Suicidal_Intent_Scale__SIS__and_the_Risk_Rescue_Rating_Scale__RRRS_:_toward_the_identification_of_homogeneous_subgroups_of_suicidal_behaviors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(09)00221-3 ER -