Emergency Room Validation of the Revised Suicide Trigger Scale (STS-3): A Measure of a Hypothesized Suicide Trigger State
Open Access
- 14 September 2012
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 7 (9), e45157
- https://doi.org/10.1371/journal.pone.0045157
Abstract
The Suicide Trigger Scale (STS) was designed to measure the construct of an affective ‘suicide trigger state.’ This study aims to extend the inpatient setting validation study of the original Suicide Trigger Scale version 2 to the revised Suicide Trigger Scale version 3 (STS-3) in an acute psychiatric emergency room setting. The 42-item STS-3 and a brief psychological test battery were administered to 183 adult psychiatric patients with suicidal ideation or attempt in the psychiatric emergency room, and re-administered to subjects at 1 year follow up. Factor analysis, linear and logistic regressions were used to examine construct structure, divergent and convergent validity, and construct validity, respectively. The STS-3 demonstrated strong internal consistency (Cronbach’s alpha 0.94). Factor analysis yielded a three-factor solution, which explained 43.4% of the variance. Principal axis factor analysis was used to identify three reliable subscales: Frantic Hopelessness, Ruminative Flooding, and Near-Psychotic Somatization (Cronbach’s alphas 0.90, 0.80, and 0.76, respectively). Significant positive associations were observed between Frantic Hopelessness and BSI depression and anxiety subscales, between Ruminative Flooding and BSI anxiety and paranoia subscales, and Near Psychotic Somatization and BSI somatization subscales. Suicidal subjects with suicide attempt history had mean scores 7 points higher than those without history of suicide attempts. Frantic hopelessness was a significant predictor of current suicide attempt when only attempts requiring at least some medical attention were considered. The STS-3 measures a distinct clinical entity, provisionally termed the ‘suicide trigger state.’ Scores on the STS-3 or select subscales appear to relate to degree of suicidality in terms of severity of ideation, history of attempt, and presence of substantive current attempts. Further study is required to confirm the factor structure and better understand the nature of these relations.This publication has 51 references indexed in Scilit:
- Love and Suicide: The Structure of the Affective Intensity Rating Scale (AIRS) and Its Relation to Suicidal BehaviorPLOS ONE, 2012
- Construct Validity of the Anxiety Sensitivity Index–3 in Clinical SamplesAssessment, 2011
- Construct development: The Suicide Trigger Scale (STS-2), a measure of a hypothesized suicide trigger stateBMC Psychiatry, 2010
- Psychiatric comorbidity in patients with chronic daily headache and migraine: a selective overview including personality traits and suicide riskThe Journal of Headache and Pain, 2009
- Pain and suicidal thoughts, plans and attempts in the United StatesGeneral Hospital Psychiatry, 2008
- Desperation and Other Affective States in Suicidal PatientsSuicide and Life-Threatening Behavior, 2004
- Suicide Risk in Patients with Somatization DisorderCrisis, 2004
- Risk factors for suicide in psychiatric outpatients: A 20-year prospective study.Journal of Consulting and Clinical Psychology, 2000
- Suicidal Ideation and Suicide Attempts in Panic Disorder and AttacksThe New England Journal of Medicine, 1989
- Assessment of suicidal intention: The Scale for Suicide Ideation.Journal of Consulting and Clinical Psychology, 1979