%0 Journal Article
%T Self-harm subscale of the Schedule for Nonadaptive and Adaptive Personality (SNAP): Predicting suicide attempts over 8 years of follow-up
%J Journal of clinical psychiatry
%D 2011
%A Yen, Shirley
%A Shea, M. Tracie
%A Walsh, Zach
%A Edelen, Maria O.
%A Hopwood, Christopher J.
%A Markowitz, John C.
%A Ansell, Emily B.
%A Morey, Leslie C.
%A Grilo, Carlos M.
%A Sanislow, Charles A.
%A Skodol, Andrew E.
%A Gunderson, John G.
%A Zanarini, Mary C.
%A McGlashan, Thomas H.
%V 72
%N 11
%P 1522-1528
%X OBJECTIVE: We examined the predictive power of the self-harm subscale of the Schedule for Nonadaptive and Adaptive Personality (SNAP) to identify suicide attempters in the Collaborative Longitudinal Study of Personality Disorders (CLPS). METHOD: The SNAP, a self-report personality inventory, was administered to 733 CLPS participants at baseline, of whom 701 (96%) had at least 6 months of follow-up data. Cox proportional hazards regression analyses were performed to examine the SNAP-self-harm subscale (SNAP-SH) in predicting the 129 suicide attempters over 8 years of follow-up. Possible moderators of prediction were examined, including borderline personality disorder, major depressive disorder (MDD), and substance use disorder. We also compared baseline administration of the SNAP-SH to subsequent administrations more proximal to the suicide attempt, and to a higher-order SNAP-negative temperament (SNAP-NT) subscale. Receiver operating characteristic analyses were conducted using suicide attempts (n = 58) over the first year of follow-up to provide reference points for sensitivity and specificity. RESULTS: The SNAP-SH demonstrated good predictive power for suicide attempts (hazard ratio = 1.28, P < .001) and appeared relatively consistent across borderline personality disorder, MDD, and substance use disorder diagnoses. Using more proximal scores did not increase predictive power. The SNAP-SH compared favorably to the predictive power of the higher-order SNAP-NT. Receiver operating characteristic analyses indicate several cutoff scores on the SNAP-SH that yield moderate to high sensitivity and specificity for predicting suicide attempts over the first year of follow-up. CONCLUSIONS: The SNAP-SH may be a useful screening instrument for risk of suicide attempts in nonpsychotic psychiatric patients.<p /> <p>Language: en</p>
%G en
%I Physicians Postgraduate Press
%@ 0160-6689
%U http://dx.doi.org/10.4088/JCP.09m05583blu