Abstract
BackgroundThis study aims to develop the construct of a 'suicide trigger state' by exploring data gathered with a novel psychometric self-report instrument, the STS-2.MethodsThe STS-2, was administered to 141 adult psychiatric patients with suicidal ideation. Multiple statistical methods were used to explore construct validity and structure.ResultsCronbach's alpha (0.949) demonstrated excellent internal consistency. Factor analyses yielded two-component solutions with good agreement. The first component described near-psychotic somatization and ruminative flooding, while the second described frantic hopelessness. ROC analysis determined an optimal cut score for a history of suicide attempt, with significance of p < 0.03. Logistic regression analysis found items sensitive to history of suicide attempt described ruminative flooding, doom, hopelessness, entrapment and dread.ConclusionsThe STS-2 appears to measure a distinct and novel clinical entity, which we speculatively term the 'suicide trigger state.' High scores on the STS-2 associate with reported history of past suicide attempt.
Highlights
This study aims to develop the construct of a ‘suicide trigger state’ by exploring data gathered with a novel psychometric self-report instrument, the Suicide Trigger Scale (STS)-2
Within the study limitations, our findings suggest that the Suicide Trigger Scale version 2 (STS-2) describes a novel and coherent syndrome of psychic experience, separate from suicidal ideation and DSM-IV axis I diagnosis, which demonstrates an association with report of past suicidal action
This state consists of ruminative flooding, near-psychotic somatization and frantic hopelessness
Summary
This study aims to develop the construct of a ‘suicide trigger state’ by exploring data gathered with a novel psychometric self-report instrument, the STS-2. Though many chronic factors placing an individual at increased risk for suicide are well established, the acute factors that lead a person to make a suicide attempt (SA) are not known. Chronic risk factors include suicidal ideation (SI), history of suicide attempts, severe psychopathology, history of psychiatric hospitalization, substance abuse, and poor social supports [1,2]. Current measures of suicidality, including the Suicide Assessment Scale,[8,9,10] Suicide Intent Scale, [11,12] and Motto and Bostrom’s proposed scale, [13] rely heavily on self-report of overt suicidal thoughts and plans. Acutely suicidal individuals often deny or hide their suicidal intent, [14,15] and the presence of a plan for suicide is a poor predictor of attempt, as many
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