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Citation
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Lee JI, Wu CY, Lee MB, Chan CT, Chen CY, Liao CC, Galynker I. J. Suicidol. (Taipei) 2023; 18(4): 742-751. |
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Abstract
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BACKGROUND: A Narrative-Crisis Model (NCM) indicates that the suicidal crisis emerges from the dynamic interactions of three components: trait vulnerability, the suicidal narrative, and suicide crisis syndrome (SCS). The 38-item Suicide Narrative Inventory (SNI-38) has been validated to identify SCS and suicidality in an online survey among community residents in Taiwan. The study aimed to further validate the shorter form of SNI namely the Six-item Suicide Narrative Inventory (SNI-6) to screen the potential SCS and related suicidality in representative nationwide community residents.
METHODS: Participants comprised a representative sample of the general population aged ≥15 years in Taiwan. A computer-assisted telephone interview CATI) system was used to select the respondents using the stratified proportional randomization method. The SNI-6, Five-item Suicide Crisis Scale (SCS-5), Five-item Brief Symptom Rating Scale (BSRS-5), and suicidality assessment were used to examine the association between suicide narratives (SN), SCS, psychopathology, and suicidal risks. Pearson's correlation and regression models were used to estimate the association between SNI-6 and other constructs (i.e., SCS, BSRS-5, and suicidality). Cronbach's alpha and factor analysis were performed to test the reliability and validity of the SNI-6. The SNI-6 contained six items (i.e., perceived burdensomeness, thwarted belonging, social defeat, perception of no future, fear of humiliation, and goal reengagement); each item was selected from those with the highest correlation with the original corresponding subscale of SNI-38. Stepwise multiple regression was performed to test the predictive validity of the SNI-6 on SCS and one-week suicidal ideation (SI), respectively.
RESULTS: In total, 2,107 participants completed the survey questions. The SNI- 6 demonstrated a two-factor structure with a good model fit and had significantly positive correlations with BSRS-5, SCS-5, and suicidality variables. A stepwise regression analysis on the SCS-5 and SI-one week respectively indicated that social defeat, perception of no future, goal reengagement, and fear of humiliation were significant predictors for SCS; perceived burdensomeness together with the first three aforementioned items for one-week SI.
CONCLUSIONS: The study revealed that the SNI-6 had satisfactory psychometric properties in the identification of psychological distress, suicide crisis syndrome, and suicidality among the general adult population in Taiwan. The findings supported the NCM. However, the validity of SNI-6 to predict future suicide behaviors in the vulnerable population needs further study.
Language: en |