Assessing suicide risk among callers to crisis hotlines: a confirmatory factor analysis.

Our goal was to investigate the factor structure of a risk assessment tool utilized by suicide hotlines and to determine the predictive validity of the obtained factors in predicting subsequent suicidal behavior. We conducted an Exploratory Factor Analysis (EFA), an EFA in a Confirmatory Factor Analysis (EFA/CFA) framework, and a CFA on independent subsamples derived from a total sample of 1,085. Similar to previous studies, we found consistent evidence for a two-factor solution, with one factor representing a more pernicious form of suicide risk (i.e., Resolved Plans and Preparations; RPP) and one factor representing milder suicidal ideation (i.e., Suicidal Desire and Ideation; SDI). The RPP factor trended toward being more predictive of suicidal ideation at follow-up than the SDI factor.

[1]  Kelly C. Cukrowicz,et al.  The interpersonal theory of suicide. , 2010, Psychological review.

[2]  Tracy K. Witte,et al.  The Interpersonal Theory of Suicide: Guidance for Working with Suicidal Clients , 2009 .

[3]  Phil Wood.  Confirmatory Factor Analysis for Applied Research , 2008 .

[4]  Charissa S. L. Cheah,et al.  Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization. , 2008, Journal of consulting and clinical psychology.

[5]  John Kalafat,et al.  An evaluation of crisis hotline outcomes. Part 2: Suicidal callers. , 2007, Suicide & life-threatening behavior.

[6]  John Kalafat,et al.  An evaluation of crisis hotline outcomes. Part 1: Nonsuicidal crisis callers. , 2007, Suicide & life-threatening behavior.

[7]  S. Gilbody,et al.  Can we predict suicide and non-fatal self-harm with the Beck Hopelessness Scale? A meta-analysis , 2007, Psychological Medicine.

[8]  T. Zonda.  One-hundred cases of suicide in Budapest: a case-controlled psychological autopsy study. , 2006, Crisis.

[9]  R. Kessler,et al.  A risk index for 12-month suicide attempts in the National Comorbidity Survey Replication (NCS-R) , 2006, Psychological Medicine.

[10]  Tracy K. Witte,et al.  Factors of suicide ideation and their relation to clinical and other indicators in older adults. , 2006, Journal of affective disorders.

[11]  Tracy K. Witte,et al.  Naturalistic evaluation of suicidal ideation: variability and relation to attempt status. , 2006, Behaviour research and therapy.

[12]  J. Reddon,et al.  An evaluation of the Psychache Scale on an offender population. , 2005, Suicide & life-threatening behavior.

[13]  C. Stefansson,et al.  Predictors of suicide in a community-based cohort of individuals with severe mental disorder , 2005, Social Psychiatry and Psychiatric Epidemiology.

[14]  R. Holden,et al.  Factor Analysis of the Beck Scale for Suicide Ideation With Female Suicide Attempters , 2005, Assessment.

[15]  Tracy K. Witte,et al.  Four studies on how past and current suicidality relate even when "everything but the kitchen sink" is covaried. , 2005, Journal of abnormal psychology.

[16]  A. Putnin̦š.  Correlates and Predictors of Self-Reported Suicide Attempts Among Incarcerated Youths , 2005, International journal of offender therapy and comparative criminology.

[17]  D. Flora,et al.  An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. , 2004, Psychological methods.

[18]  L. Hankoff.  Reducing Suicide: A National Imperative , 2003 .

[19]  J. Pearson,et al.  Contact with mental health and primary care providers before suicide: a review of the evidence. , 2002, The American journal of psychiatry.

[20]  H. Akiskal,et al.  Can temperament identify affectively ill patients who engage in lethal or near-lethal suicidal behavior? A 14-year prospective study. , 2002, Suicide & life-threatening behavior.

[21]  L. Appleby,et al.  Effects of legislation restricting pack sizes of paracetamol and salicylate on self poisoning in the United Kingdom: before and after study , 2001, BMJ : British Medical Journal.

[22]  Michael Miller.  The Practical Art of Suicide Assessment: A Guide for Mental Health Professionals and Substance Abuse Counselors , 2000 .

[23]  R A Steer,et al.  Risk factors for suicide in psychiatric outpatients: a 20-year prospective study. , 2000, Journal of consulting and clinical psychology.

[24]  E. Shneidman.  The psychological pain assessment scale. , 1999, Suicide & life-threatening behavior.

[25]  R. Kessler,et al.  Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. , 1999, Archives of general psychiatry.

[26]  A. Beck,et al.  Psychometric characteristics of the Scale for Suicide Ideation with psychiatric outpatients. , 1997, Behaviour research and therapy.

[27]  T. Joiner,et al.  The Modified Scale for Suicidal Ideation: factors of suicidality and their relation to clinical and diagnostic variables. , 1997, Journal of abnormal psychology.

[28]  R A Steer,et al.  Hopelessness, depression, suicidal ideation, and clinical diagnosis of depression. , 1993, Suicide & life-threatening behavior.

[29]  P. Bentler.  Comparative Fit Indices in Structural Models , 1990 .

[30]  J. H. Steiger.  Structural Model Evaluation and Modification: An Interval Estimation Approach. , 1990, Multivariate behavioral research.

[31]  P. Bentler,et al.  Comparative fit indexes in structural models. , 1990, Psychological bulletin.

[32]  David Brent,et al.  A quantitative literature review of the effectiveness of suicide prevention centers. , 1987, Journal of consulting and clinical psychology.

[33]  R. Holden,et al.  Relation of response set to observed suicide intent. , 1985 .

[34]  N. Kreitman,et al.  Suicide, unemployment, and domestic gas detoxification in Britain. , 1984, Journal of epidemiology and community health.

[35]  A. Beck,et al.  Assessment of suicidal intention: the Scale for Suicide Ideation. , 1979, Journal of consulting and clinical psychology.

[36]  L. Tucker,et al.  A reliability coefficient for maximum likelihood factor analysis , 1973 .

[37]  K. Jöreskog.  A general approach to confirmatory maximum likelihood factor analysis , 1969 .

[38]  Tracy K. Witte,et al.  Suicide risk in personality disorders: An argument for a public health perspective. , 2009 .

[39]  Bengt Muthén,et al.  Mplus Short Courses Topic 1 Exploratory Factor Analysis, Confirmatory Factor Analysis, And Structural Equation Modeling For Continuous Outcomes , 2009 .

[40]  L. Hankoff.  Why People Die by Suicide , 2006 .

[41]  T. Joiner,et al.  Scientizing and Routinizing the Assessment of Suicidality in Outpatient Practice , 2004 .

[42]  L. Angeles.  Evaluating Cutoff Criteria of Model Fit Indices for Latent Variable Models with Binary and Continuous Outcomes , 2002 .

[43]  P. Bentler,et al.  Cutoff criteria for fit indexes in covariance structure analysis : Conventional criteria versus new alternatives , 1999 .

[44]  I. Miller,et al.  The Modified Scale for Suicidal Ideation: reliability and validity. , 1986, Journal of consulting and clinical psychology.