TY  - JOUR
PY  - 2011//
TI  - Self-harm subscale of the Schedule for Nonadaptive and Adaptive Personality (SNAP): Predicting suicide attempts over 8 years of follow-up
JO  - Journal of clinical psychiatry
A1  - Yen, Shirley
A1  - Shea, M. Tracie
A1  - Walsh, Zach
A1  - Edelen, Maria O.
A1  - Hopwood, Christopher J.
A1  - Markowitz, John C.
A1  - Ansell, Emily B.
A1  - Morey, Leslie C.
A1  - Grilo, Carlos M.
A1  - Sanislow, Charles A.
A1  - Skodol, Andrew E.
A1  - Gunderson, John G.
A1  - Zanarini, Mary C.
A1  - McGlashan, Thomas H.
SP  - 1522
EP  - 1528
VL  - 72
IS  - 11
N2  - 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>
LA  - en
SN  - 0160-6689
UR  - http://dx.doi.org/10.4088/JCP.09m05583blu
ID  - ref1
ER  -