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Cited by 74Suicide and Self-Harm StudiesAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPersonality Disorders and Psychopathology

The revised suicide crisis inventory (SCI-2): Validation and assessment of prospective suicidal outcomes at one month follow-up

Bloch-Elkouby, Sarah, Barzilay, Shira, Gorman, Bernard S., Lawrence, Olivia C., Rogers, Megan L., Richards, Jenelle, Cohen, Lisa J., Johnson, Benjamin N. +1 more·2021·Journal of Affective Disorders
DOI 10.1016/j.jad.2021.08.048
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Abstract

Background and aim The Suicide Crisis Syndrome (SCS) is an evidence-based pre-suicidal cognitive and affective state predictive of short-term suicide risk. The most recent SCS formulation, proposed as a suicide-specific DSM diagnosis, features a feeling of Entrapment accompanied by four additional symptom clusters: Affective Disturbance; Loss of Cognitive Control; Hyperarousal; and Social Withdrawal. The aim of the present study was to revise the Suicide Crisis Inventory (SCI; Barzilay et al., 2020), a self-report measure assessing the presence of the SCS,in accordance with the current SCS formulation, as well as to assess the psychometric properties and clinical utility of its revised version, the Suicide Crisis Inventory-2 (SCI-2). Methods The SCI-2, a 61-item self-report questionnaire, was administered to 421 psychiatric inpatients and outpatients at baseline. Prospective suicidal outcomes including suicidal ideation, preparatory acts, and suicidal attempts were assessed after one month. Internal structure and consistency were assessed with confirmatory factor analysis, convergent, discriminant, and current criterion validity. Receiver-operating characteristic (ROC) curves with Area under the Curve (AUC) were used to examine the predictive validity of the SCI-2 to prospective outcomes. Exploratory analyses assessed the predictive validity of the five SCI-2 dimensions. Results The SCI-2 demonstrated excellent internal consistency (Cronbach's α = 0.971), good convergent, dis…

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  • Overall, four studies investigated the factor structure of the SCI, three studies investigated the factor structure of the SCI-2, and one study investigated the factor structure of the proxy-SCS.

    “Overall, four studies investigated the factor structure of the SCI (Barzilay et al., 2020;Bloch-Elkouby, Gorman, Lloveras, et al., 2020;Galynker et al., 2017;Otte et al., 2020), three studies investigated the factor structure of the SCI-2 (Bloch-Elkouby et al., 2021;Menon et al., 2022;Wu et al., 2022) and one study investigated the factor structure of the proxy-SCS (Bafna et al., 2022).”

    From Suicide Crisis Syndrome: A systematic review (2024) · cites this paper as Bloch-Elkouby et al., 2021

  • The revised Suicide Crisis Inventory-2 (SCI-2) is used to assess the proposed SCS criteria.

    “To assess the proposed criteria, the revised Suicide Crisis Inventory-2 (SCI-2) is used (Bloch-Elkouby et al., 2021).”

    From Suicide Crisis Syndrome: A systematic review (2024) · cites this paper as Bloch-Elkouby et al., 2021

  • For the SCI-2, internal consistency was excellent for the total score (alpha = 0.97-0.98) and for its five dimensions: Entrapment (alpha = 0.96), Affective Disturbance (alpha = 0.91-0.93), Loss of Cognitive Control (alpha = 0.82-0.87), Hyperarousal (alpha = 0.91-0.94), and Social Withdrawal (alpha = 0.90-0.93).

    “This applies also to the SCI-2: total score (α = 0.97-0.98),subscale scores for its five dimensions: (1) Entrapment (α = 0.96), (2) Affective Disturbance (α = 0.91-0.93),(3) Loss of Cognitive Control (α = 0.82-0.87),( 4) Hyperarousal (α = 0.91-0.94),and (5) Social Withdrawal (α = 0.90-0.93)(Bloch-Elkouby et al., 2021;Menon et al., 2022;Rogers, Bafna, & Galynker, 2022;Wu et al., 2022).”

    From Suicide Crisis Syndrome: A systematic review (2024) · cites this paper as Bloch-Elkouby et al., 2021

  • In three studies, the SCS was the only predictor of near-term suicide attempts when controlling for factors such as depression, anxiety, suicidal ideation, and suicide attempts.

    “In three studies the SCS was the only predictor of nearterm suicide attempts-controlling for factors such as depression, anxiety, suicidal ideation, and suicide attempts (Bloch-Elkouby et al., 2021;Galynker et al., 2017;Yaseen et al., 2019)”

    From Suicide Crisis Syndrome: A systematic review (2024) · cites this paper as Bloch-Elkouby et al., 2021

  • Out of the different components of the SCS, the strongest predictors were entrapment and loss of cognitive control, whereas social withdrawal was not a significant predictor.

    “and out of the different components of the SCS, the strongest predictors were entrapment (Galynker et al., 2017) and loss of cognitive control (Bloch-Elkouby et al., 2021), whereas social withdrawal was no significant predictor (Bloch-Elkouby et al., 2021).”

    From Suicide Crisis Syndrome: A systematic review (2024) · cites this paper as Bloch-Elkouby et al., 2021

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Authors
Bloch-Elkouby, S., Barzilay, S., Gorman, B. S., Lawrence, O. C., Rogers, M. L., Richards, J., Cohen, L. J., Johnson, B. N., & Galynker, I.
Affiliations
Icahn School of Medicine at Mount Sinai (US)
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2021-12
Volume
295
Pages
1280-1291
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2021.08.048
OpenAlex
W3198668784
Cited by
72
References
99
Citations by year
2026: 12 · 2025: 13 · 2024: 20 · 2023: 12 · 2022: 14 · 2021: 1
FWCI
8.01
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
Funders
American Foundation for Suicide Prevention (-1-015-14)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
suicide crisis syndrome, suicide risk assessment, suicidal ideation, suicide attempts, preparatory acts, entrapment, hyperarousal, social withdrawal, mood disorders, psychiatric inpatients and outpatients, predictive validity, psychometric validation
MeSH terms
Mental Disorders, Follow-Up Studies, Humans, Prospective Studies, Risk Factors, Suicide, Reproducibility of Results, Suicidal Ideation

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