8条目自杀意图量表的修订及测评农村老年人的效度和信度
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摘要
目的:修订8条目自杀意图量表(SIS-8),并探讨其在农村老年人中的适用性。方法:以242位农村老年自杀死亡者的配偶、子女或没有血缘关系但熟悉自杀者的村民为信息人。对数据进行条目分析、探索性因子分析;采用Beck绝望量表简版(BHS-4)、老年抑郁量表(GDS)和ULS-6孤独感量表(ULS-6)评价聚合效度;比较不同人口学资料、自杀行为特征及有无精神障碍老年人的量表得分来评价实证效度。结果:经条目分析后,删除SIS-8的条目4(寻求帮助)、7(自杀遗书)、8(死前沟通),形成5个条目的量表SIS-5。探索性因子分析提取出防范和计划2个公因子,累计解释方差的68.38%;SIS-5得分与BHS-4、GDS、ULS-6得分均呈正相关(r=0.23、0.21、0.15,均P<0.001);有精神障碍的自杀死亡者SIS-5得分高于无精神障碍自杀死亡者(P<0.05)。总量表的Cronbach α系数为0.68,防范和计划2个因子的α系数为0.67、0.69。结论:8个条目的自杀意图量表(SIS-8)经修订后形成SIS-5。SIS-5具有良好的信效度,适合用于农村老年人自杀意图的评估。
Objective:To revise the Suicide Intent Scale with 8 items(SIS-8) and explore its applicability among the elderly in rural areas.Methods:The spouses,children of 242 rural elderly suicide victims or villagers who were not related but familiar with suicides were informants.The frequency distribution,extreme group test,total item correlation and Crowns Bach coefficient method were used for item analysis.Exploratory factor analysis was used to evaluate the structural validity.The convergent validity of the scale was evaluated with the shorter version of Beck Hopelessness Scale(BHS-4),Geriatric Depression Scale(GDS) and the short-form of the UCLA Loneliness Scale(ULS-6);the scores of suicide intention among different demographic data,suicide characteristics and mental disorders were compared.Results:After item analysis,item-4(getting help),7(suicide note),8(communication) of SIS-8 were deleted and SIS-5 was finally formed.Exploratory factor analysis extracted 2 common factors of prevention and planning,accounting for 68.38% of the cumulative explanatory variance.SIS-5 scores were positively correlated with scores of BHS-4,GDS,and ULS-6(r=0.23,0.21,0.15,Ps<0.001).SIS-5 scores were higher in suicide victims with mental disorders than in those without mental disorders(P<0.05).The Cronbach' s αcoefficients were 0.68 for the total scale and 0.67 and 0.69 for the two factors(i.e.prevention and planning).Conclusion:The Suicide Intent Scale for 8 Items(SIS-8) is revised to form SIS-5.SIS-5 has good reliability and validity,which is suitable for the evaluating suicide intention in rural elderly.
Objective:To revise the Suicide Intent Scale with 8 items(SIS-8) and explore its applicability among the elderly in rural areas.Methods:The spouses,children of 242 rural elderly suicide victims or villagers who were not related but familiar with suicides were informants.The frequency distribution,extreme group test,total item correlation and Crowns Bach coefficient method were used for item analysis.Exploratory factor analysis was used to evaluate the structural validity.The convergent validity of the scale was evaluated with the shorter version of Beck Hopelessness Scale(BHS-4),Geriatric Depression Scale(GDS) and the short-form of the UCLA Loneliness Scale(ULS-6);the scores of suicide intention among different demographic data,suicide characteristics and mental disorders were compared.Results:After item analysis,item-4(getting help),7(suicide note),8(communication) of SIS-8 were deleted and SIS-5 was finally formed.Exploratory factor analysis extracted 2 common factors of prevention and planning,accounting for 68.38% of the cumulative explanatory variance.SIS-5 scores were positively correlated with scores of BHS-4,GDS,and ULS-6(r=0.23,0.21,0.15,Ps<0.001).SIS-5 scores were higher in suicide victims with mental disorders than in those without mental disorders(P<0.05).The Cronbach' s αcoefficients were 0.68 for the total scale and 0.67 and 0.69 for the two factors(i.e.prevention and planning).Conclusion:The Suicide Intent Scale for 8 Items(SIS-8) is revised to form SIS-5.SIS-5 has good reliability and validity,which is suitable for the evaluating suicide intention in rural elderly.
引文
[1] Zhong BL,Chiu HF,Conwell Y.Rates and characteristics of elderly suicide in China,2013-14[J].J Affect Disord,2016,206:273-279.doi:10.1016/j.jad.2016.09.003.
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[3] Scocco P,Marietta P,Tonietto M,et al.The role of psychopathology and suicidal intention in predicting suicide risk:a longitudinal study[J].Psychopathology,2000,33(3):143-150.
[4] Haw C,Hawton K,Houston K,et al.Correlates of relative lethality and suicidal intent among deliberate self-harm patients[J].Suicide Life Threat Behav,2003,33(4):353-364.
[5] Harriss L,Hawton K,Zahl D.Value of measuring suicidal intent in the assessment of people attending hospital following self-poisoning or self-injury[J].Br J Psychiatry,2005,186(1):60-66.
[6] Beck AT,Steer RA.Clinical predictors of eventual suicide:a 5- to 10-year prospective study of suicide attempters[J].J Affect Disord,1989,17(3):203-209.
[7] Misson H,Mathieu F,Jollant F,et al.Factor analyses of the Suicidal Intent Scale (SIS) and the Risk-Rescue Rating Scale (RRRS):toward the identification of homogeneous subgroups of suicidal behaviors[J].J Affect Disord,2010,121(1):80-87.
[8] Conner K,Phillips MS.Predictors of low-intent and high-intent suicide attempts in rural China[J].Am J Public Health,2007,97(10):1842-1846.
[9] Diaz FJ,Bacagarcia E,Diazsastre C,et al.Dimensions of suicidal behavior according to patient reports[J].Eur Arch Psychiatry Clin Neurosci,2003,253(4):197-202.
[10]Harriss L,Hawton K.Suicidal intent in deliberate self-harm and the risk of suicide:the predictive power of the Suicide Intent Scale[J].J Affect Disord,2005,86(2):225-233.
[11]Beck AT,Lester D.Components of suicidal intent in completed and attempted suicides[J].J Psychol,1976,92(1st Half):35-38.
[12]Zhang J,Jia C.Suicidal intent among young suicides in rural China[J].Arch Suicide Res,2011,15(2):127-139.
[13]Michael F,Miriam G,Robert LS.User' s Guide for the Structured Clinical Interview for DSM-IV Axis I disorders[M].New York:Biometrics Research,2001.
[14]许俊亭,姜潮,高岩,等.DSM-IV临床定式访谈(SCID)在心理解剖诊断中的应用[J].国际精神病学杂志,2011,38(4):201-204.
[15] Zhang J,Jia CX.Validating a short version of the Suicide Intent Scale in China[J].Omega,2007,55(4):255-265.
[16]Yip PS,Cheung YB.Quick assessment of hopelessness:a cross-sectional study[J].Health Qual Life Outcomes,2006,4(1):13.
[17]Hanna D,White R,Lyons K,et al.The structure of the Beck Hopelessness Scale:a confirmatory factor analysis in UK students[J].Pers Individ Differ,2011,51(1):17-22.
[18]Ac C.Clinical validation of the Geriatric Depression Scale (GDS):Chinese version.[J].J Aging Health,1996,8(2):238-253.
[19]Niu L,Jia C,Ma Z,et al.Validating the Geriatric Depression Scale with proxy-based data:a case-control psychological autopsy study in rural China[J].J Affect Disord,2018,241:533-538.doi:10.1016/j.jad.2018.08.066.
[20]周亮,黎芝,胡宓,等.ULS-8孤独感量表信效度检验及其应用[J].中南大学学报(医学版),2012,37(11):1124-1128.
[21]Niu L,Jia C,Ma Z,et al.The validity of proxy-based data on loneliness in suicide research:a case-control psychological autopsy study in rural China[J].BMC Psychiatry,2018,18(1):116..doi:10.1186/s12888-018-1687-x.
[22]Zhou L,Wang G,Jia C,et al.Being left-behind,mental disorder,and elderly suicide in rural China:a case-control psychological autopsy study[J].Psychol Med,2018,49(3):1-7.
[23]Conner KR,Phillips MR,Meldrum S,et al.Low-planned suicides in China[J].PsycholMed,2005,35(8):1197.
[24]童永胜,吴承京,肖春玲,等.自杀意图客观强度量表的效度和信度[J].中国心理卫生杂志,2015,29(8):611-617.
[25]肖春玲,李献云,张艳萍,等.服农药与其他方式自杀未遂者的特征[J].中国心理卫生杂志,2011,25(2):128-133.
[26]Zhang J,Li ZY.Suicide means used by Chinese rural youths:a comparison between those with and without mental disorders[J].J Nerv Ment Dis,2011,199(6):410-415.
[27]刘慧.农村不同自杀意图水平自杀未遂危险因素研究[D].济南:山东大学,2012.
[2] Beck AT,Weissman A,Lester D,et al.Classification of suicidal behaviors.II.Dimensions of suicidal intent[J].Arch Gen Psychiatry,1976,33(7):835-837.
[3] Scocco P,Marietta P,Tonietto M,et al.The role of psychopathology and suicidal intention in predicting suicide risk:a longitudinal study[J].Psychopathology,2000,33(3):143-150.
[4] Haw C,Hawton K,Houston K,et al.Correlates of relative lethality and suicidal intent among deliberate self-harm patients[J].Suicide Life Threat Behav,2003,33(4):353-364.
[5] Harriss L,Hawton K,Zahl D.Value of measuring suicidal intent in the assessment of people attending hospital following self-poisoning or self-injury[J].Br J Psychiatry,2005,186(1):60-66.
[6] Beck AT,Steer RA.Clinical predictors of eventual suicide:a 5- to 10-year prospective study of suicide attempters[J].J Affect Disord,1989,17(3):203-209.
[7] Misson H,Mathieu F,Jollant F,et al.Factor analyses of the Suicidal Intent Scale (SIS) and the Risk-Rescue Rating Scale (RRRS):toward the identification of homogeneous subgroups of suicidal behaviors[J].J Affect Disord,2010,121(1):80-87.
[8] Conner K,Phillips MS.Predictors of low-intent and high-intent suicide attempts in rural China[J].Am J Public Health,2007,97(10):1842-1846.
[9] Diaz FJ,Bacagarcia E,Diazsastre C,et al.Dimensions of suicidal behavior according to patient reports[J].Eur Arch Psychiatry Clin Neurosci,2003,253(4):197-202.
[10]Harriss L,Hawton K.Suicidal intent in deliberate self-harm and the risk of suicide:the predictive power of the Suicide Intent Scale[J].J Affect Disord,2005,86(2):225-233.
[11]Beck AT,Lester D.Components of suicidal intent in completed and attempted suicides[J].J Psychol,1976,92(1st Half):35-38.
[12]Zhang J,Jia C.Suicidal intent among young suicides in rural China[J].Arch Suicide Res,2011,15(2):127-139.
[13]Michael F,Miriam G,Robert LS.User' s Guide for the Structured Clinical Interview for DSM-IV Axis I disorders[M].New York:Biometrics Research,2001.
[14]许俊亭,姜潮,高岩,等.DSM-IV临床定式访谈(SCID)在心理解剖诊断中的应用[J].国际精神病学杂志,2011,38(4):201-204.
[15] Zhang J,Jia CX.Validating a short version of the Suicide Intent Scale in China[J].Omega,2007,55(4):255-265.
[16]Yip PS,Cheung YB.Quick assessment of hopelessness:a cross-sectional study[J].Health Qual Life Outcomes,2006,4(1):13.
[17]Hanna D,White R,Lyons K,et al.The structure of the Beck Hopelessness Scale:a confirmatory factor analysis in UK students[J].Pers Individ Differ,2011,51(1):17-22.
[18]Ac C.Clinical validation of the Geriatric Depression Scale (GDS):Chinese version.[J].J Aging Health,1996,8(2):238-253.
[19]Niu L,Jia C,Ma Z,et al.Validating the Geriatric Depression Scale with proxy-based data:a case-control psychological autopsy study in rural China[J].J Affect Disord,2018,241:533-538.doi:10.1016/j.jad.2018.08.066.
[20]周亮,黎芝,胡宓,等.ULS-8孤独感量表信效度检验及其应用[J].中南大学学报(医学版),2012,37(11):1124-1128.
[21]Niu L,Jia C,Ma Z,et al.The validity of proxy-based data on loneliness in suicide research:a case-control psychological autopsy study in rural China[J].BMC Psychiatry,2018,18(1):116..doi:10.1186/s12888-018-1687-x.
[22]Zhou L,Wang G,Jia C,et al.Being left-behind,mental disorder,and elderly suicide in rural China:a case-control psychological autopsy study[J].Psychol Med,2018,49(3):1-7.
[23]Conner KR,Phillips MR,Meldrum S,et al.Low-planned suicides in China[J].PsycholMed,2005,35(8):1197.
[24]童永胜,吴承京,肖春玲,等.自杀意图客观强度量表的效度和信度[J].中国心理卫生杂志,2015,29(8):611-617.
[25]肖春玲,李献云,张艳萍,等.服农药与其他方式自杀未遂者的特征[J].中国心理卫生杂志,2011,25(2):128-133.
[26]Zhang J,Li ZY.Suicide means used by Chinese rural youths:a comparison between those with and without mental disorders[J].J Nerv Ment Dis,2011,199(6):410-415.
[27]刘慧.农村不同自杀意图水平自杀未遂危险因素研究[D].济南:山东大学,2012.