Assessment of acquired capability for suicide in clinical practice
Assessment of acquired capability for suicide in clinical practice
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DOI：
10.1080/13548506.2015.1115108
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发表时间：
2016-01-01
影响因子：
3.8
通讯作者：
De Leo, Diego
中科院分区：
文献类型：
--
作者：
Rimkeviciene, Jurgita;Hawgood, Jacinta;De Leo, Diego
自杀的人际心理理论提出，受挫的归属感、感知的负担感和获得的自杀能力（ACS）之间的相互作用可以预测自杀死亡的近端风险。可以使用评估所有三种结构的工具。然而，对其中一项自杀能力量表（ACSS）有效性的研究有限，特别是在其临床相关性方面。本研究旨在探讨不同版本的 ACSS 在临床评估中的实用性。研究了该量表的三个版本：包含 20 项的完整版本、包含 7 项的版本以及代表自我感知自杀能力的单项版本。在专门治疗自杀的诊所和社区样本中招募的患者样本中，所有版本的 ACSS 都显示出合理的可靠性水平，并且与自杀意念、自残和自杀未遂的报告如预期相关。评估自我感知的获得性自杀能力的项目显示出与所有自杀行为水平的最高相关性。然而，没有任何版本的 ACSS 本身能够显示合并样本中的自杀企图。结论是，各版本的量表具有结构效度，但其临床实用性有限。在临床环境中，使用单个项目对自我感知的 ACS 进行评估优于完整版和缩短版的 ACSS，对于有兴趣评估此特征的临床医生可以谨慎推荐。
The Interpersonal Psychological Theory of suicide proposes that the interaction between Thwarted Belongingness, Perceived Burdensomeness, and Acquired Capability for Suicide (ACS) predicts proximal risk of death by suicide. Instruments to assess all three constructs are available. However, research on the validity of one of them, the acquired capability for suicide scale (ACSS), has been limited, especially in terms of its clinical relevance. This study aimed to explore the utility of the different versions of the ACSS in clinical assessment. Three versions of the scale were investigated, the full 20-item version, a 7-item version and a single item version representing self-perceived capability for suicide. In a sample of patients recruited from a clinic specialising in the treatment of suicidality and in a community sample, all versions of the ACSS were found to show reasonable levels of reliability and to correlate as expected with reports of suicidal ideation, self-harm, and attempted suicide. The item assessing self-perceived acquired capacity for suicide showed highest correlations with all levels of suicidal behaviour. However, no version of the ACSS on its own showed a capacity to indicate suicide attempts in the combined sample. It is concluded that the versions of the scale have construct validity, but their clinical utility is limited. An assessment using a single item on self-perceived ACS outperforms the full and shortened versions of ACSS in clinical settings and can be recommended with caution for clinicians interested in assessing this characteristic.