Psychometric properties of the suicidal history self-rating screening scale

Measuring psychache as a suicide risk variable: A Mokken analysis of the Holden's Psychache Scale

BACKGROUND

The Psychache Scale (PAS) is a questionnaire measuring trait-level psychological pain with satisfactory internal consistency and a strong correlation with suicidal ideation severity. However, inconsistent results have been reported for the PAS dimensionality. In the present study we used a non-parametric item response theory model, called Mokken Scale Analysis (MSA), to refine an unidimensional version of the PAS.

METHODS

The sample was composed of 400 Italian adults (312 females and 88 males) nonrandomly recruited from the general population.

RESULTS

A final set of 10 items satisfied the unidimensionality, local independence, and monotonicity assumptions, although it did not satisfy the double monotonicity assumption. The internal consistency of the PAS-10 was satisfactory (ordinal alpha = 0.98, ω = 0.97, and AVE = 0.82), and ROC curves analysis indicated good discriminant validity when differentiating participants with higher suicide risk from those with lower suicide risk.

LIMITATIONS

Structural invariance between nonclinical and clinical samples was not investigated, and the presence of suicide ideation and behaviors was assessed with self-report measures with potential under-reporting of the phenomenon.

CONCLUSION

The PAS-10 resulted to be a potentially valid and unidimensional measure of psychological pain (i.e., psychache) that could be used to screen adults at higher risk for suicide. Future studies are needed to investigate psychometric properties of the PAS-10 in clinical samples and to replicate results in independent samples.

The Morbidity and Associated Factors of Depression in Caregivers of Patients with Depressive Disorder

Objective

Depressive disorder significantly impacts patients' daily living activities and quality of life. Caregivers of patients with depression may also suffer from psychological distress related to the chronic burden of caring for the patient's mood changes. The purpose of this study was to evaluate the morbidity and associated factors of depression in caregivers of patients with depressive disorder.

Methods

In this study, we used a cross-sectional design with consecutive sampling. Study subjects were recruited from the psychiatric outpatient clinic of a medical center from August 2021 to June 2022. Caregivers of depressive disorder patients were enrolled and assessed using the Mini International Neuropsychiatric Interview, Hospital Anxiety and Depression Scale (HADS), Suicide Assessment Scale (SAS), Stigma Scale of the Explanatory Model Interview Catalogue (EMIC), and Family APGAR Index.

Results

Of the 120 caregivers that completed the study, 59.2% (n=71) were females. The most common psychiatric diagnosis was depressive disorders (25.8%), followed by anxiety disorders (17.5%) and insomnia disorder (15.8%); 54.2% of the caregivers had a psychiatric diagnosis. Using logistic regression analysis, we found that anxiolytics/hypnotics use (OR=5.58; 95% CI, 1.84-16.96; p<0.01), higher suicide risk (SAS) (OR=1.10; 95% CI, 1.05-1.16; p<0.001), and lower family support (APGAR scores) (OR=0.82; 95% CI, 0.71-0.94; p<0.01) were three significant associated factors.

Conclusion

Depression was the most prevalent psychiatric diagnosis in caregivers of patients with depressive disorder. Early psychiatric diagnosis for caregivers of patients with depression is crucial to offering suitable support and treatment and may improve caregivers' quality of life.

Seeking and receiving help for mental health services among pregnant women in Ghana

OBJECTIVE

The heightened vulnerability of women to mental health issues during the period of pregnancy implies that seeking and receiving support for mental health services is a crucial factor in improving the emotional and mental well-being of pregnant women. The current study investigates the prevalence and correlates of seeking and receiving help for mental health services initiated by pregnant women and health professionals during pregnancy.

DESIGN

Using a cross-sectional design and self-report questionnaires, data were collected from 702 pregnant women in the first, second and third trimesters from four health facilities in the Greater Accra region of Ghana. Data were analyzed using descriptive and inferential statistics.

RESULTS

It was observed that 18.9% of pregnant women self-initiated help-seeking for mental health services whereas 64.8% reported that health professionals asked about their mental well-being, of which 67.7% were offered mental health support by health professionals. Diagnosis of medical conditions in pregnancy (i.e., hypertension and diabetes), partner abuse, low social support, sleep difficulty and suicidal ideation significantly predicted the initiation of help-seeking for mental health services by pregnant women. Fear of vaginal delivery and COVID-19 concerns predicted the provision of mental health support to pregnant women by health professionals.

CONCLUSION

The low prevalence of individual-initiated help-seeking implies that health professionals have a high responsibility of supporting pregnant women achieve their mental health needs.

Suicidal Ideation among University Students: A Moderated Mediation Model Considering Attachment, Personality, and Sex

The present study aimed to examine the link between attachment, personality traits, and suicidal ideation with consideration of the potential moderating role of age and sex. The Suicidal History Self-Rating Screening Scale, the Personality Inventory for DSM-5-Brief Form, and the Attachment Style Questionnaire were administered to 183 students. There was a significant indirect effect of need for approval on suicidal ideation via detachment. Moreover, the moderated mediation models of need for approval and preoccupation with relationships on suicidality via negative affectivity were significant in men, but not women, whereas the moderated mediation model of need for approval on suicidality via detachment was significant in women, but not men. Young men and women seem at risk for increased suicidal ideation based on specific attachment and personality characteristics, which should be considered for the development of prevention and therapeutic interventions.

Psychosis risk among pregnant women in Ghana

Introduction

Psychotic illness, although is rare, has been reported in the perinatal period. Individuals diagnosed with psychotic illness tend to first exhibit psychotic-like experiences (PLEs), defined as subclinical psychotic symptoms that occur outside the context of sleep or drug use. However, there is a paucity of empirical data on PLEs in pregnancy to advance scholarly discourse and support professional practice. The current study investigated the prevalence and correlates of PLEs among pregnant women in Ghana, a West African state.

Design

A cross-sectional survey design was used to collect data from 702 pregnant women who responded to measures of PLEs, COVID-19 concerns and behavioral maladies such as anxiety and depressive symptoms. Descriptive and inferential statistics, namely chi square, exploratory factor analysis, MANOVA and multinomial logistic regression were used to analyze the data.

Results

The results showed that 54.2%, 27.3% and 18.5% of participants were at no/low, moderate and high risk for psychosis, respectively. A total of 44.4% participants were not distressed by PLEs, whereas 32.2% and 23.4% were a bit/quite and very distressed, respectively. Psychosis risk was elevated among pregnant women who were more concerned about the COVID-19 effects, scored high in suicidal ideation, depressive symptoms and sleep difficulties.

Conclusion

The study showed that psychosis risk is present in pregnancy.

Implications

Screening for psychosis risk in pregnancy should be prioritized for pregnant women with behavioral maladies, including suicidal tendencies, depressive symptoms, sleep difficulties and heightened concerns about COVID-19.

Screening for suicide risk among older adults: assessing preliminary psychometric properties of the Brief Geriatric Suicide Ideation Scale (BGSIS) and the GSIS-Screen

OBJECTIVES

To initially assess psychometric properties of two abbreviated versions of the Geriatric Suicide Ideation Scale (GSIS): a 10-item Brief Geriatric Suicide Ideation Scale (BGSIS), and a 5-item Geriatric Suicide Ideation Scale-Screen (GSIS-Screen).

METHODS

A series of psychometric analyses was conducted, assessing the internal consistency, test-retest reliability, construct and predictive validity of the abbreviated GSIS scales. This was done by selecting-out GSIS items from a combined dataset of studies on suicide ideation in older adults: 1) The GSIS scale development study (n = 107); 2) A clinical trial of Interpersonal Psychotherapy (IPT) modified for suicidal older adults(n = 25); 3) A longitudinal study of risk and resiliency to suicide ideation in community-residing older adults (n = 173).

RESULTS

Overall findings demonstrated strong internal consistency, test-retest reliability, concurrent and predictive validity for the BGSIS and GSIS-Screen with older adults across community, clinical, and residential settings.

CONCLUSION

Study findings support the use of the abbreviated GSIS scales when conducting research on suicide risk identification among older adults. Future research is recommended testing these scales prospectively in public health, residential, and clinical settings, in research and healthcare delivery contexts.

Psychometric properties and diagnostic capacity of the scale of resilience to suicide attempts-18

OBJECTIVE

Early detection of suicide attempts remains a handicap for suicide prevention. Most studies have focused on risk factors, but few have assessed protective factors that promote resilient outcomes, especially in subpopulations vulnerable to suicide re-attempts. This study aims to create and adapt a new Scale of Resilience to Suicide Attempts (SRSA), and to analyse its predictive validity and diagnostic capacity for the detection of suicide re-attempts at six months in people who have made a previous attempt.Design and main outcome measures: The psychometric properties and diagnostic capacity of the resulting SRSA-18 scale were assessed in 229 persons (where 133-58.1% were women, aged 18- to 76-year old) who had made a previous suicide attempt.

RESULTS

Factor analyses (AFE and AFC) yielded a three-dimensional structure with excellent goodness-of-fit indices RMSEA, high levels of reliability and adequate convergent validity with the Suicide Resilience Inventory-25 (SRI-25) scale. Additionally, the SRSA-18 has significant diagnostic power on suicide re-attempts across months of follow-up.

CONCLUSION

Reliable and valid protective factor-based instruments for the detection of future suicide re-attempts may help in the prevention of suicide-associated mortality in specific clinical subpopulations.

Adolescents With Attention-Deficit/Hyperactivity Disorder: Adverse Behaviors and Comorbidity

PURPOSE AND OBJECTIVE

There is growing evidence that adolescents with ADHD develop long-term impairments and adverse outcomes, yet less is known about their adverse behaviors. To quantify rates of mental health comorbidities in adolescents with ADHD and compare the risks of adverse behaviors among adolescents with and without ADHD.

METHODS

We performed a cohort analysis of 6,483 youth from the National Comorbidity Survey Adolescent Supplement (NCS-A), a nationally representative in-person structured diagnostic interview of adolescents aged 14-18 years focusing on mental, emotional, and behavioral disorders.

MAIN OUTCOMES

(1) Percentages with comorbid anxiety, mood, disruptive behavior, and substance use disorders. (2) Strength of associations of ADHD with several adverse behaviors, including suicidal symptoms, aggression, behavior regulation, life events, education, and substance use. Odds ratios were adjusted for age, sex, and race.

RESULTS

Among the sample of 6,483 adolescents, overall, 9.5% met the criteria for ADHD. Most (69.5%) of adolescents with ADHD had at least one comorbid mental health condition. As compared to adolescents without ADHD, those with ADHD were significantly more likely to have had a suicide attempt (aOR 2.9, 95% CI = 1.3-6.6) and to have had perpetrated physical aggression (aOR 2.3, 95% CI = 1.7-3.2). Adolescents with ADHD were also more likely to have been expelled from school or fired from a job (aOR 3.3, 95% CI = 1.7-6.5) and to have had problems related to drinking alcohol (95% CI = 1.2-2.9).

CONCLUSIONS

ADHD in adolescents is a complicated disorder with elevated risks for a wide range of adverse behaviors.

State and Trait Anxiety Among University Students: A Moderated Mediation Model of Negative Affectivity, Alexithymia, and Housing Conditions

Objective

Starting university education is a crucial period for the mental health of students, who report higher levels of distress compared to the general population. This study sought to better understand the distress experienced by students by considering contextual facets (e.g., housing conditions) as well as stable clinical variables (e.g., negative affectivity, emotion regulation, and anxiety).

Methods

A total of 177 University students (71.2% females) aged 18-29 were administered the State-Trait Anxiety Inventory-Y, the Beck Depression Inventory-II, the Suicidal History Self-Rating Screening Scale, the Personality Inventory for DSM-5-Brief Form, and the Toronto Alexithymia Scale-20.

Results

University students showed concerning levels of distress, particularly concerning anxiety, and depression. We found that the relationship between negative affectivity and both state and trait anxiety was mediated by alexithymia but housing conditions did not act as a moderator for the indirect effect of negative affectivity on state or trait anxiety through alexithymia.

Conclusion

Undoubtedly, university lifestyle can be demanding, but experiencing distress is not inevitable nor inexplicable. The present study sought to gain insight into the anxiety experienced by Italian University students while taking into account the importance of personality and clinical characteristics that have previously been widely underestimated. We found that these characteristics can be of extreme importance for developing preventative and therapeutic interventions tailored to the clinical characteristics of students, as well taking into account their living environment.

Predictive Validity of the MINI Suicidality Subscale for Suicide Attempts in a Homeless Population With Mental Illness

OBJECTIVE

Suicide is a leading cause of death, yet the accurate prediction of suicidal behavior is an elusive target for clinicians and researchers. The current paper examines the predictive validity of the Mini Neuropsychiatric Interview (MINI) Suicidality subscale for suicide attempts (SAs) for a homeless population with mental illness.

METHODS

Two thousand two hundred and fifty-five homeless individuals with mental illness across five Canadian cities enrolled in the At Home/Chez Soi Housing First trial interviewed at baseline using the MINI Suicidality subscale with 2-year follow-up of self-reported SAs.

RESULTS

Two thousand two hundred and twenty-one participants were included in the analysis. High rates of mood and substance use disorders were present (56.5% and 67.4%, respectively). The mean MINI Suicidality subscale score was 7.71. Among 1,700 participants with follow-up data, 11.4% reported a SA over the 2-year study period. MINI Suicidality subscale scores were predictive of SAs (AUC ≥ 0.70) among those with and without a history of SAs, even among those with missing answers. A positive predictive value of 0.20 and a negative predictive value of 0.95 were demonstrated, with a relatively low number needed to assess of 4.5-5.

CONCLUSION

The MINI Suicidal subscale shows promise as an easy to use and accurate suicide risk prediction tool among homeless individuals with mental illness.

The Psychometric Properties in the Chinese Version of the Reasons for Living Inventory and the Relationship with Suicidal Behaviors Among Psychiatric Patients in Taiwan

This study examines the reliability, factor structure, convergent, and construct validities of the Mandarin Chinese version of the Reasons For Living Inventory (RFL) among Taiwanese psychiatric patients. Demographical characteristics of patients who hold these adaptive cognitions and differences on the level of endorsement between suicidal and non-suicidal individuals were also investigated. All adult patients that had visited the psychiatric ambulatory clinic or had been admitted to the psychiatric ward in a general hospital in Taiwan over a 3-month period were consecutively invited to complete an inventory that included background information, the Mandarin Chinese versions of the RFL, the Suicidal Behaviors Questionnaire-Revised (SBQ-R), and the Beck Hopeless Scale (BHS). Of the 254 respondents aged 19 to 65 years, 47.2% had suicidal ideations or attempts within the past year. The original six-factor structure of the American version was confirmed to be acceptable. The Cronbach α was 0.964.Total scores on RFL were inversely and significantly correlated with that from BHS. Multivariate analysis with demographic data and items from SBQ-R revealed that higher scores on the RFL have been associated with married, have children or religious beliefs, fewer past and current suicidal ideations and attempts, fewer histories of suicidal threats, and a less self-reported likelihood of future suicide in our sample. The Mandarin version of the RFL inventory showed acceptable psychometric properties and could distinguish suicidal patients from non-suicidal ones.

Childhood Maltreatment, Pathological Personality Dimensions, and Suicide Risk in Young Adults

Several studies have demonstrated that child maltreatment (psychological, physical, and sexual abuse, and neglect) may be a significant factor in the development of pathological personality traits that increase the risk for suicidal ideation and behavior from adolescence to adulthood. Currently, the challenge is to understand how different forms of early negative experiences render an individual prone to develop specific personality traits and, in turn, be more vulnerable to suicide risk. To understand the relationship between childhood maltreatment and personality dimensions in suicide risk, our study aims to explore the role of self-criticism and dependency, two different pathological personality traits, as potential mediators of the link between different types of childhood maltreatment and suicide risk in young adults. For this purpose, 306 students from three Italian public universities were recruited. We used the Italian version of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) to assess experiences of lack of care by parents (i.e., antipathy and neglect) as well as psychological and physical abuse before the age of 17 years. The Depressive Experiences Questionnaire (DEQ) was used to assess the personality dimensions of self-criticism and dependency, and the Suicide History Self-Rating Screening Scale was administered to assess suicide risk. Results revealed that lack of care and psychological abuse were significantly associated with suicide risk and this association was partially mediated by the maladaptive personality dimension of self-criticism. These findings suggest that the combined effect of specific forms of dysfunctional parental behavior during childhood and the development of rigid and dysfunctional negative personality traits may increase the risk for suicidal ideation and behavior during adulthood.

Association between serotonin 2A receptor genetic variations, stressful life events and suicide

AIM

Life events are series of events that disrupt a person's psychological equilibrium and may enhance the development of a disorder such as suicide. Several studies have assessed a relationship between 5-hydroxytryptamine (serotonin) 2A receptor (5-HTR2A) gene polymorphisms with an increased risk of suicide. However, there has been no study about the association between three 5-HTR2A gene polymorphisms, A1438G (rs6311), T102C (rs6313) and C1354T (rs6314), suicide, stressful life, and loss events in a same time.

METHODS

Relatives of 191 suicide victims were interviewed using a semi-structured questionnaire designed according to Iranian culture. Venous blood was taken from all subjects for DNA isolation. 5-HTR2A polymorphisms in a total of 191 suicide victims and 218 healthy controls were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Chi-squared and Fisher's exact tests were used to compare genotype and allele frequencies between suicide and control groups. Correction for multiple comparisons was calculated using Bonferroni correction.

RESULTS

There was a significant association between the 102 C/C genotype of 5-HTR2A gene and suicide (к² = 8.700, P = 0.012). Furthermore, we found that suicide victims with a 102 C/C genotype had a significantly higher number of stressful life and loss events (P < 0.05). Genotype and allele distributions of A1438G (rs6311) and C1354T (rs6314) polymorphisms of 5-HTR2A gene showed no differences between suicide victims and control participants and there was no association between genotype distribution and higher number of stressful life and loss events (P > 0.05).

CONCLUSION

Our results suggest that C102T (rs6313) polymorphism of 5-HTR2A gene may be involved in the susceptibility to suicide, higher number of stressful life and loss events, but A1438G (rs6311) and C1354T (rs6314) polymorphisms of 5-HTR2A gene were not associated with suicide, higher number of stressful life and loss events.

Detecting Suicide Risk Among College Students: A Test of the Predictive Validity of the Modified Emotional Stroop Task

Detecting suicide risk among nonclinical populations is challenging due to low base rates and the help-negation tendency of at-risk individuals. The current longitudinal study investigated the predictive validity of the modified emotional Stroop task (EST) by conducting a follow-up study of 197 students who participated in a study by Chung and Jeglic (2016). The EST latencies for suicide-related cues and past suicidal behaviors were the only significant predictors of suicide risk. The findings of this study provide preliminary support for the use of the EST as part of a suicide risk screening battery that could add to the detection of suicide risk.

Genetic association analysis of serotonin and signal transduction pathways in suicide attempters from an Italian sample of psychiatric patients

Genetic factors have been reported to contribute to the liability of suicide. We aimed to investigate functional polymorphisms in eight genes (serotonin transporter, SLC6A4; receptors, 5HTR1A, 1B, 5HTR2A; Tryptophan Hydroxylase, TPH1, TPH2; Monoamine Oxidase, MAOA and G Protein Subunit Beta 3, GNB3) to investigate their predictive value for suicide. The possible confounding effects of gender and phenotypic patients dissection were also valued. A sample of 111 consecutive psychiatric inpatients was recruited and assessed using specific psychometric instruments. Genomic DNA was isolated from peripheral white blood cell samples and polymorphisms were genotyped by pyrosequencing technology. Although no differences were observed between allele and genotype frequencies for all polymorphisms and suicide attempt (SA), a polygenic risk score was detected for three genes HTR2A (A-1438G), TPH1 and TPH2 increasing the prediction of SA risk (Thresh=0.43, p=0.038, R²=0.053). Moreover some nominal associations were obtained after gender and phenotypic dissection stratification (TEMPS-A, TEMPs-H, GSMD, SHSS, GAF, CGI) for SLC6A4 (5-HTTLPR), HTR1A (C-1019G), HTR2A (A-1438G), TPH1 (A799C) and GNB3 (C825T) genes, that were lost after Bonferroni correction. This is a first evidence that specific additive combinations of genes could increase the prediction of SA risk and that gender and phenotypic dissection could influence the association of the genes with SA. This could represent a further study also for future meta-analyses on larger samples.

Item Response Patterns on the Patient Health Questionnaire-8 in a Nationally Representative Sample of US Adults

Recent studies have shown that item responses on the Center for Epidemiologic Studies Depression Scale (CES-D) and Kessler Screening Scale for Psychological Distress (K6) exhibit the same characteristic item response patterns among the general population. However, the distributional patterns of responses on the Patient Health Questionnaire-8 (PHQ-8) among the general population have not been adequately studied. Thus, we conducted a pattern analysis of PHQ-8 item responses among US adults. Data (18,446 individuals) were obtained from the 2015 Behavioral Risk Factor Surveillance Survey (BRFSS). Item responses on the BRFSS version of the PHQ-8 were scored using the number of days response set and then converted to the original 4-point scale. The patterns of item responses were analyzed through graphical analysis. Lines of item responses scored using the number of days response set showed the same pattern among the eight items, characterized by crossing at a single point between "0 days" and "1 day," and parallel fluctuation from "1 day" to "14 days" on a semi-logarithmic scale. Lines of item responses converted to the 4-point scale also showed the same characteristic pattern among the eight items. The present results demonstrate that the item responses on the PHQ-8 show the same characteristic patterns among items, consistent with the CES-D and the K6.

History of childhood trauma as risk factors to suicide risk in major depression

The aim of this study was to compare childhood trauma scores domains between Major Depressive Disorder (MDD) patients with and without suicide risk. This is cross-sectional study including a clinical sample of adults (18-60 years) diagnosed with MDD through the Mini International Neuropsychiatric Interview Plus version (MINI Plus). The Childhood Trauma Questionnaire (CTQ) was also used to verify types of trauma scores: abuse (emotional, physical, and sexual) and neglect (emotional and physical). Adjusted analysis was performed by linear regression. The sample was composed to 473 patients, suicide risk was observed in 16.3% of them. Suicide risk was independently associated with emotional abuse and neglect and sexual abuse, but not with physical abuse and neglect. Different domains of childhood trauma are associated with suicide risk in MDD population and emotional trauma should be considered a risk factor for suicide risk in MDD patients.

Morningness—Eveningness, Current Depression, and Past Suicidality

Previous research has reported that people who feel at their peak in the evening are more prone to depression and affective disorders. In a sample of 194 undergraduate students (54 men, 140 women; M age = 21.6 yr., SD = 1.4), using a simple correlational design, describing oneself as an evening person and scores on Horne and Óstberg's Morningness–Eveningess Scale were correlated with higher scores on measures of depression, hopelessness, defeat, and entrapment, but not with a report of past suicidal ideation or attempts, thereby supporting previous research findings.

The associations among childhood maltreatment, "male depression" and suicide risk in psychiatric patients

In the current cross-sectional study, we aimed to investigate the presence and severity of "male" depressive symptoms and suicidal behaviors in psychiatric patients with and without a history of child abuse and neglect, as measured by the Childhood Trauma Questionnaire (CTQ), as well as to explore the associations among childhood maltreatment, "male depression" and suicide risk. The sample consisted of 163 consecutively admitted adult inpatients (80 men; 83 women). The patients were administered the CTQ, Gotland Male Depression Scale (GMDS), and Suicidal History Self-Rating Screening Scale (SHSS). Those with a moderate-severe childhood maltreatment history were more likely to be female (p<0.05) and reported more "male depression" (p<0.001) and suicidal behaviors (p<0.01) as compared to those not having or having a minimal history of child abuse and neglect. In the multivariate analysis, only the minimization/denial scale of the CTQ (odds ratio=0.31; p<0.001) and "male depression" (odds ratio=1.83; p<0.05) were independently associated with moderate/severe history of child maltreatment. The findings suggest that exposure to abuse and neglect as a child may increase the risk of subsequent symptoms of "male depression", which has been associated with higher suicidal risk.

Biased processing of neutral facial expressions is associated with depressive symptoms and suicide ideation in individuals at risk for major depression due to affective temperaments

BACKGROUND

To elucidate whether abnormal facial emotion processing represents a vulnerability factor for major depression, some studies have explored deficits in emotion processing in individuals at familial risk for depression. Nevertheless, these studies have provided mixed results. However, no studies on facial emotion processing have been conducted in at-risk samples with early or attenuated signs of depression, such as individuals with affective temperaments who are characterized by subclinical depressive moods, cognitions, and behaviors that resemble those that occur in patients with major depression.

METHODS

Presence and severity of depressive symptoms, affective temperaments, death wishes, suicidal ideation, and suicide planning were explored in 231 participants with a mean age 39.9 years (SD=14.57). Participants also completed an emotion recognition task with 80 emotional face stimuli expressing fear, angry, sad, happy, and neutral facial expressions.

RESULTS

Participants with higher scores on affective temperamental dimensions containing a depressive component, compared to those with lower scores, reported more depressive symptoms, death wishes, suicide ideation and planning, and an increased tendency to interpret neutral facial expressions as emotional facial expressions; in particular, neutral facial expressions were interpreted more negatively, mostly as sad facial expressions. However, there were no group differences in identification and discrimination of facial expressions of happiness, sadness, fear, and anger.

CONCLUSIONS

A negative bias in interpretation of neutral facial expressions, but not accuracy deficits in recognizing emotional facial expressions, may represent a vulnerability factor for major depression. However, further research is needed.

Construct validity and reliability of the adult rejection sensitivity questionnaire: a comparison of three factor models

Objectives and Methods. The aim of the study was to investigate the construct validity of the ARSQ. Methods. The ARSQ and self-report measures of depression, anxiety, and hopelessness were administered to 774 Italian adults, aged 18 to 64 years. Results. Structural equation modeling indicated that the factor structure of the ARSQ can be represented by a bifactor model: a general rejection sensitivity factor and two group factors, expectancy of rejection and rejection anxiety. Reliability of observed scores was not satisfactory: only 44% of variance in observed total scores was due to the common factors. The analyses also indicated different correlates for the general factor and the group factors. Limitations. We administered an Italian version of the ARSQ to a nonclinical sample of adults, so that studies which use clinical populations or the original version of the ARSQ could obtain different results from those presented here. Conclusion. Our results suggest that the construct validity of the ARSQ is disputable and that rejection anxiety and expectancy could bias individuals to readily perceive and strongly react to cues of rejection in different ways.

Depression and affective temperaments are associated with poor health-related quality of life in patients with HIV infection

INTRODUCTION

Human immunodeficiency virus (HIV) represents one of the most chronic and debilitating infections worldwide. Hopelessness and affective temperaments (mood that is characteristic of an individual's habitual functioning) may play important roles in the health-related quality of life (HRQoL) of patients with HIV. The purpose of this study was to examine affective temperaments in a sample of patients with HIV, the impact of hopelessness on HRQoL, and associations among HRQoL, hopelessness, and affective temperaments.

METHODS

The study involved 88 participants who were administered the short- form health survey (SF-36), the Beck hopelessness scale (BHS), the suicidal history self-rating screening scale (SHSS), the Gotland male depression scale (GMDS), and the temperament evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A).

RESULTS

Patients with a poorer HRQoL reported more severe depression and hopelessness than patients with a higher HRQoL. Patients with a poorer HRQoL also had higher scores on all dimensions of the TEMPS-A with a depressive component compared to patients with a higher HRQoL. The small sample size in this study limits the generalizability of the findings.

CONCLUSION

Patients with a poorer HRQoL were more depressed and also at an increased risk of suicide as indicated by the more severe hopelessness they reported compared to patients with higher HRQoL. These patients were also more likely to have depressive affective temperaments than those with a higher HRQoL.

Psychometric Properties of the Attitudes toward Self-Revised in Italian Young Adults

Objectives and Methods. Several researchers have provided support for the critical role of cognitive vulnerabilities in the development of depression. The Attitudes toward Self-Revised (ATS-R) was designed to assess three potential self-regulatory vulnerabilities to depression: High Standards (HS), Self-Criticism (SC), and Negative Generalization (NG). The aim of the study was to assess the psychometric properties of the ATS-R in the Italian young adult population. The ATS-R, the Beck Depression Inventory-II (BDI-II), the Beck Hopelessness Scale (BHS), and the Teate Depression Inventory (TDI) were administered to 857 (320 men and 537 women) young adults. Results. The best-fitting solution for the ATS-R was a 2-factor model, which obtained satisfactory homogeneity of content (HS/SC: Cronbach α = 0.81; mean interitem correlation = 0.46. NG: Cronbach α = 0.75; mean interitem correlation = 0.43) and significant correlation with the BDI-II (NG: Pearson r = 0.29, P < 0.01), the TDI (HS/SC: Pearson r = -0.26, P < 0.01), and the BHS (HS/SC: Pearson r = -0.29, P < 0.01; NG: Pearson r = 0.22, P < 0.01). Conclusions. The Italian version of the ATS-R seems to be a valid instrument for the study of the role of cognitive tendencies as potential vulnerability for depression.

Predictive validity of the MINI suicidal scale for self-harm in acute psychiatry: a prospective study of the first year after discharge

The aim of the study was to explore the predictive validity of the Suicidal Scale of the Mini-International Neuropsychiatric Interview as a screen for suicidal behavior and non-suicidal self-injury following discharge from an acute psychiatric ward. Using a prospective, naturalistic design, the patients were screened with the Suicidal Scale when discharged (n = 307). At 12 months post-discharge, the Suicidal Scale was a significant predictor of suicidal behavior (n = 48) and suicidal behavior+non-suicidal self-injury (n = 49) but not for non-suicidal self-injury (n = 15). For patients without any known previous suicide attempts (n = 180), the Suicidal Scale was a significant predictor of suicidal behavior (n = 21) and suicidal behavior+non-suicidal self-injury (n = 11). Further research is needed to determine the overall utility of the routine screening of self-harm.

Affective temperaments are associated with higher hopelessness and perceived disability in patients with open-angle glaucoma

AIM

The aims of the study were to study: (i) affective temperaments in open-angle glaucoma (OAG) patients with some degree of functional visual impairment; (ii) psychological well-being and perceived disability, and their associations with affective temperaments; and (iii) associations between visual impairment, affective temperaments and psychological well-being.

METHOD

Participants were 91 outpatients (39 women, and 52 men) with open-angle glaucoma (OAG) who were assessed for Visual Field Index, Mean Defect and Pattern Standard Deviation. Patients were also administered the Beck Hopelessness Scale, the TEMPS-A (Rome), the Gotland Male Depression Scale, the Emotional Well-being Scale, the Perceived Disability Questionnaire and the Suicidal History Self-Rating Screening Scale.

RESULTS

Open-angle glaucoma patients (compared with a non-clinical sample of university students) had higher scores on the TEMP-A dysthimic and hyperthimic traits and lower scores on cyclothimic, irritability and anxiety traits. Such temperament variability was not linked to differences in severity of glaucoma. We did not find strong evidence supporting the fact that measures of visual impairment were linked to emotional well-being and depression. However, logistic regression analysis revealed that patients may have different patterns related to their illness according to specific temperaments.

CONCLUSION

Patients with OAG may have different temperament profiles than non-clinical individuals. Such categorisation may be useful for predicting how they face the illness, for providing better care as well as for early recognition of mood disorders symptoms.