Purpose: In this study we examine merit of a short version (Brief Interview Screener (SIS-MAP-scn )of a previously developed and validated 108 item scale, known as ‘ Scale for Impact of Suicidality-Management, Assessment and Planning of Care ( SIS MAP), for rapid assessment in challenging clinical settings e.g. primary care and emergency room. Background: Generally suicide risk is assessed clinically and structured assessments optimize the direction for decision-making across various settings e.g. inpatient care, emergency rooms and crisis centers. We believe that measures with accurate and valid information should be based upon multifactorial risk-constituent domains, e.g. biological, social, psychological, environmental and demographic factors. The above scale has been constructed based upon multidimensional constructs and a stress-diathesis model as its theoretical context. . Methods: Relevant risk factors from literature were regrouped in the domains mentioned above and a 108-item scale was constructed and validated. In order to create a brief screener, the items of each subscale of the full SIS-MAP were entered into stepwise regressions predicting total SIS-MAP risk index scores. Overall, 24 items were selected from this method. We assessed 79 (37 male & 42 female) of 95 randomly selected from both outpatient and inpatient facilities. Data was analyzed by SAS system. Results: The mean SISMAPscn score was 10.4, male 10.1(3.0), female 11.8 (3.3), Mean age 38.26 years (SD 14.78, range 19 - 80). The SIS-MAP risk index was 8.85 ( male 7.9 (3.5) and female 9.8 (3.8), females having significantly higher SISMAP risk index and total scores (11.8 vs. 10.1, p<0.020). There was no evidence of an association between age and suicide risk index (r=-0.061, p<0.595). Severity of suicide risk (SISMAP risk index) was positively correlated with low level of resilience, which was measured by Connor Davidson resilience scale (CD-RISC, n=44, r=-0.265, p=0.082). As well, the SISMAP risk index positively correlated with duration of illness (r=.334, p<.50), severity of depressive symptoms (r=.62, p <.001) and severity of psychotic symptoms (r=.413 p<.014). Risk of suicide was found to be high for individuals who were not married, (F=3.071, p=.042suicide attempt or crisis as reason for hospitalization, (F= 4.238. p .008), ). presence of history of physical assault (F=5.079, p .031) and presence of problem with friends or neighbor or relatives. (F=7.931, p.008).
Females had several other risk factors e. helplessness and hurting themselves. Based on the SIS-MAP-scn mean scores in the groups of outpatients and inpatients, preliminary clinical cut-off scores were determined indicating a score of 6 and below for outpatient and 8 and above for inpatients care Conclusions: The study supports that the SIS-MAP-brief screener scale is a valid adjunct for risk assessment. Patients with severe psychopathology and those admitted with an attempt carry high risk for suicide.
- Risk Assessment,
- New scale,
- SISMAP-brief screener,
Available at: http://works.bepress.com/amreshsrivastava/112/