Identification of Suicidality by Five-Item Suicide Crisis Scale (SCS-5) in an Online General Population Survey in Taiwan

Chia-Yi Wu ； Jia-In Lee ； Ming-Been Lee ； Megan L. Rogers ； Chia-Ta Chan ； Chun-Ying Chen ； Jenelle Richards ； Igor Galynker

《Journal of Suicidology》 Vol.17 No.4 (2022/12) Pp. 342-351

https://doi.org/10.30126/JoS.202212_17(4).0003

摘要

Background: Suicide crisis syndrome (SCS) was defined as a pre-suicidal mental condition comprising five components of affective disturbances, loss of cognitive control, hyperarousal, social withdrawal and entrapment. A revised Suicide Crisis Inventory (SCI-2) for assessing SCS has been validated to identify recent week suicidal ideation (SI) in Taiwan. The study aimed to develop and validate a shorter form of SCI-2 named five-item suicide crisis scale (SCS-5) to detect SCS and suicidality.Method: An anonymous online questionnaire survey was conducted on psychopathology and associated suicide risks among community residents. The participants were enrolled online and completed the survey questions including demographics, SCI-2, 5-item Brief Symptom Rating Scale (BSRS-5) and Suicide Narrative Inventory (SNI) to measure psychological distress as well as suicidality (i.e., SI and attempts). The SCS-5 contained five items derived from the SCI-2; each item had the highest correlation with the corresponding subscale of SCI-2. The factor structure and validity of the SCS-5 were examined using confirmatory factor analyses (CFA) and correlations with the SCI-2, BSRS-5, SNI and suicidality. Stepwise multiple regression and receiver operating characteristic (ROC) curve were performed to predict suicidal ideation.Results: A total of 4846 participants were eligible for analysis. Results of the one-factor CFA for SCS-5 indicated a good model fit. The SCS-5 demonstrated excellent internal consistency (Cronbach alpha: .92) and good correlations with all items of the BSRS-5, SNI and suicidality measures. Regression analysis revealed that all SCS-5 items significantly explained 28.0% of the variance of one-week SI. ROC curve indicated that the optimal cut-off (4/5) of the SCS-5 could significantly differentiate the one-week SI. Conclusion: The study revealed that the SCS-5 performed satisfactory psychometric properties to identify recent SI among the general adult population in Taiwan. Its predictive validity for future suicide behaviors in different clinical settings needs further investigation.

關鍵字

suicide crisis syndrome ； Five-item Suicide Crisis Scale (SCS-5) ； revised Suicide Crisis Inventory (SCI-2) ； Suicide Narrative Inventory (SNI) ； near-term suicide risk ； psychological distress ； BSRS-5