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Protocol - Suicidal Intent of Suicide Attempts

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Description:

The Suicide Intent Scale (SIS) includes 15 interviewer-administered items that measure behavior before and during the most recent suicide attempt. Items 1-8 cover objective circumstances surrounding the attempt (e.g., preparation and execution of the attempt). Items 9-15 capture perceptions of potential lethality, expectations of rescue, purpose of the attempt, impulsivity, and reaction to the attempt. Each of the 15 items is scored from 0 to 2 and added together to give a total score from 0 to 30.

A self-report version of the Suicide Intent Scale is also available.

Protocol:

SUICIDE INTENT SCALE

(For Attempters)

Instructions: Interview the patient about his/her most recent suicide attempt to enable a reliable coding of the objective circumstances of the attempt, and the patient’s perceptions of the attempt. The total score is computed by summing items 1-15. If an item is "Not applicable" code it "-8." Do not include"-8’s" when calculating the total score.

I. Objective Circumstances Related to Suicide Attempt

1. Isolation

[ ] 0 Somebody present

[ ] 1 Somebody nearby, or in visual or vocal contact

[ ] 2 No one nearby or in visual or vocal contact

2. Timing

[ ] 0 Intervention is probable

[ ] 1 Intervention is not likely

[ ] 2 Intervention in highly unlikely

3. Precautions against Discovery/Intervention

[ ] 0 No precautions

[ ] 1 Passive precautions (avoiding others but doing nothing to prevent intervention; alone in room with unlocked door)

[ ] 2 Active precautions (locked door)

4. Acting to Get Help During/After Attempt

[ ] 0 Notified potential helper regarding attempt

[ ] 1 Contacted but did not specifically notify potential helper regarding attempt

[ ] 2 Did not contact or notify potential helper

5. Final Acts in Anticipation of Death (e.g., will, gifts, insurance)

[ ] 0 None

[ ] 1 Thought about or made some arrangements

[ ] 2 Made definite plans or completed arrangements

6. Active Preparation for Attempt

[ ] 0 None

[ ] 1 Minimal to moderate

[ ] 2 Extensive

7. Suicide Note

[ ] 0 Absence of note

[ ] 1 Note written, but torn up; note thought about

[ ] 2 Presence of note

8. Overt Communication of Intent Before the Attempt

[ ] 0 None

[ ] 1 Equivocal communication

[ ] 2 Unequivocal communication

II. Self-Report

9. Alleged Purpose of Attempt

[ ] 0 To manipulate environment, get attention, revenge

[ ] 1 Components of "0" and "2"

[ ] 2 To escape, surcease, solve problems

10. Expectations of Fatality

[ ] 0 Thought that death was unlikely

[ ] 1 Thought that death was possible but not probable

[ ] 2 Thought that death was probable or certain

11. Conception of Method’s Lethality

[ ] 0 Did less to self than he thought would be lethal

[ ] 1 Wasn’t sure if what he did would be lethal

[ ] 2 Equaled or exceeded what he thought would be lethal

12. Seriousness of Attempt

[ ] 0 Did not seriously attempt to end life

[ ] 1 Uncertain about seriousness to end life

[ ] 2 Seriously attempted to end life

13. Attitude Toward Living/Dying

[ ] 0 Did not want to die

[ ] 1 Components of "0" and "2"

[ ] 2 Wanted to die

14. Conception of Medical Rescuability

[ ] 0 Thought that death would be unlikely if he received medical attention

[ ] 1 Was uncertain whether death could be averted by medical attention

[ ] 2 Was certain of death even if he received medical attention

15. Degree of Premeditation

[ ] 0 None; Impulsive

[ ] 1 Suicide contemplated for three hours or less prior to attempt

[ ] 2 Suicide contemplated for more than three hours prior to attempt

III. Other Aspects (Not Included in Total Score)

16. Reaction to Attempt

[ ] 0 Sorry about attempt; feels foolish, ashamed (circle which one)

[ ] 1 Accepts both attempt and its failure

[ ] 2 Regrets failure of attempt

17. Visualization of Death

[ ] 0 Life-after-death, reunion with decedents

[ ] 1 Never ending sleep, darkness, end-of-things

[ ] 2 No conceptions of, or thoughts about death

18. Number of Previous Attempts

[ ] 0 None

[ ] 1 One or two

[ ] 2 Three or more

19. Relationship between Alcohol Intake and Attempt

[ ] 0 Some alcohol intake prior to but not related to attempt, reportedly not enough to impair judgment, reality testing

[ ] 1 Enough alcohol intake to impair judgment, reality testing and diminish responsibility/impulse control

[ ] 2 Intentional intake of alcohol in order to facilitate implementation of suicide attempt

20. Relationship between Drug Intake and Attempt (narcotics, hallucinogens, etc. drug is not the method used to suicide)

[ ] 0 Some drug intake prior to but not related to attempt, reportedly not enough to impair judgment, reality testing

[ ] 1 Enough drug intake to impair judgment, identity testing and diminish responsibility/impulse control

[ ] 2 Intentional drug intake in order to facilitate implementation of suicide attempt

Scoring:

Each of the 15 items is scored from 0 to 2 and added together to give a total score from 0 to 30.

Protocol Name from Source:

This section will be completed when reviewed by an Expert Review Panel.

Availability:

Publicly available

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.

Equipment Needs

The PhenX Working Group acknowledges these questions can be administered by the interviewer in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Interviewer-administered questionnaire

Life Stage:

Adult

Participants:

Adults, ages 18 and older

Specific Instructions:

This protocol includes questions that can potentially identify respondents who are at risk of suicide. Investigators implementing this protocol should consider developing a risk management plan specific to their study to ensure the safety of participants. The following links provide additional information and guidelines for suicide-related research:

ora.research.ucla.edu/OHRPP/Documents/Policy/8/Risk_of_Suicide.pdf

www.nimh.nih.gov/health/topics/suicide-prevention/issues-to-consider-in-intervention-research-with-persons-at-high-risk-for-suicidality.shtml

Selection Rationale

The Suicide Intent Scale (SIS) is a nonproprietary, widely used, low-burden questionnaire with high internal consistency, moderate-to-high interrater reliability, and evidence of convergent validity and predictive validity.

Language

English

Standards
StandardNameIDSource
Common Data Elements (CDE) Suicide Intent Scale (SIS) Score 4588800 CDE Browser
Derived Variables

None

Process and Review

This section will be completed when reviewed by an Expert Review Panel.

Source

Beck, A. T., Schuyler, D., & Herman, I. (1974). Development of suicidal intent scales. In A. T. Beck, H. L. P. Resnik, & D. J. Lettieri (Eds.). The prediction of suicide (pp. 45-56). Bowie, MD: Charles Press.

General References

Beck, A. T., & Lester, D. (1976). Components of suicidal intent in completed and

attempted suicides. The Journal of Psychology, 92, 35-38.

Beck, A. T., Resnik, H. L., & Lettieri, D. J. (1974). The prediction of suicide. Philadelphia, PA: Charles Press.

Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1976). Classification of suicidal behaviors. II. Dimensions of suicidal intent. Archives of General Psychiatry, 33, 835-837.

Beck, R. W., Morris, J. B., & Beck, A. T. (1974). Cross-validation of the Suicidal Intent Scale. Psychological Reports, 34, 445-446.

Mieczkowski, T. A., Sweeney, J. A., Haas, G. L., Junker, B. W., Brown, R. P., & Mann, J. J. (1993). Factor composition of the Suicide Intent Scale. Suicide and Life-Threatening Behavior, 23(1), 37-45.

Ojehagen, A., Regnell, G., & Traskman-Bendz, L. (1991). Deliberate self-poisoning: Repeaters and nonrepeaters admitted to an intensive care unit. Acta Psychiatrica Scandinavica, 84, 266-271.

Protocol ID:

640301

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX640301_Suicide_Attempt_Alcohol_Relationship PX640301190000 Other Aspects Relationship between Alcohol Intake and Attempt 4 N/A
PX640301_Suicide_Attempt_Attitude_Toward_LivingDying PX640301130000 Self-Report Attitude Toward Living/Dying 4 N/A
PX640301_Suicide_Attempt_Circumstances_ActivePreparation PX640301060000 Objective Circumstances Related to Suicide Attempt Active Preparation for Attempt 4 N/A
PX640301_Suicide_Attempt_Circumstances_Communication PX640301080000 Objective Circumstances Related to Suicide Attempt Overt Communication of Intent Before the Attempt 4 N/A
PX640301_Suicide_Attempt_Circumstances_FinalActs PX640301050000 Objective Circumstances Related to Suicide Attempt Final Acts in Anticipation of Death (e.g., will, gifts, insurance) 4 N/A
PX640301_Suicide_Attempt_Circumstances_GettingHelp PX640301040000 Objective Circumstances Related to Suicide Attempt Acting to Get Help During/After Attempt 4 N/A
PX640301_Suicide_Attempt_Circumstances_Isolation PX640301010000 Objective Circumstances Related to Suicide Attempt Isolation 4 N/A
PX640301_Suicide_Attempt_Circumstances_Note PX640301070000 Objective Circumstances Related to Suicide Attempt Suicide Note 4 N/A
PX640301_Suicide_Attempt_Circumstances_Precautions PX640301030000 Objective Circumstances Related to Suicide Attempt Precautions against Discovery/Intervention 4 N/A
PX640301_Suicide_Attempt_Circumstances_Timing PX640301020000 Objective Circumstances Related to Suicide Attempt Timing 4 N/A
PX640301_Suicide_Attempt_Conception_Method_Fatality PX640301110000 Self-Report Conception of Method's Lethality 4 N/A
PX640301_Suicide_Attempt_Conception_Rescuability PX640301140000 Self-Report Conception of Medical Rescuability 4 N/A
PX640301_Suicide_Attempt_Drugs_Relationship PX640301200000 Other Aspects Relationship between Drug Intake and Attempt (narcotics, hallucinogens, etc. drug is not the method used to suicide) 4 N/A
PX640301_Suicide_Attempt_Expectation_Fatality PX640301100000 Self-Report Expectations of Fatality 4 N/A
PX640301_Suicide_Attempt_Number PX640301180000 Other Aspects Number of Previous Attempts 4 N/A
PX640301_Suicide_Attempt_Premeditation PX640301150000 Self-Report Degree of Premeditation 4 N/A
PX640301_Suicide_Attempt_Purpose PX640301090000 Self-Report Alleged Purpose of Attempt 4 N/A
PX640301_Suicide_Attempt_Reaction PX640301160000 Other Aspects Reaction to Attempt 4 N/A
PX640301_Suicide_Attempt_Seriousness PX640301120000 Self-Report Seriousness of Attempt 4 N/A
PX640301_Suicide_Attempt_Visualization_Death PX640301170000 Other Aspects Visualization of Death 4 N/A
Research Domain Information
Measure Name:

Suicidal Intent of Suicide Attempts

Release Date:

November 21, 2014

Definition

A questionnaire to measure of the degree of intent to commit suicide during a suicide attempt.

Purpose

Suicidal intent reflects the intensity of a respondent’s wish to die, and higher levels of intent indicate higher levels of suicide risk.

Keywords

Suicide, Suicide intent, Suicide attempts, Suicide Intent Scale, SIS