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Psychometric evaluation of the Interview for Suicide in Schizophrenia-Third Revision
Dissertation

Psychometric evaluation of the Interview for Suicide in Schizophrenia-Third Revision

Kathryn Eva Korslund
Doctor of Philosophy (Ph.D.), Medical College of Pennsylvania and Hahnemann University
May 2001
DOI:
https://doi.org/10.17918/00002436
pdf
Korslund_Kathryn_20014.57 MB
PDF Access upon request, Email title, URL, or DOI to archives@drexel.edu

Abstract

Persons diagnosed with schizophrenia and schizoaffective disorder are at increased risk for suicide and self-harmful behavior. Identification of psychotic persons at elevated risk for suicide is an extraordinarily difficult task. This is in part due to the dynamic and emergent nature of a very rare behavior. Several suicide assessment instruments have been developed to provide standardized risk assessment. However, the existing tools are intended for a general psychiatric population and do not attend to the additional challenges and domains of vulnerability encountered among persons with psychotic illnesses. Furthermore, the majority of such instruments are static and rigid, providing quantification of suicide risk as a linear summation of vulnerability factors. To attend to the need of identifying schizophrenic and schizoaffective patients at high risk for suicide, the Interview for Suicide in Schizophrenia was developed. Unique among suicide assessment instruments, the semi-structured interview provides a synthesis between clinical judgement and scientific quantification of risk factors thereby allowing a more complete evaluation and judgement of risk. Since its original presentation, the instrument has been expanded to include assessment of additional cognitive, behavioral, and affective risk factors identified in the empirical literature as relevant to suicide risk. The present study describes the psychometric properties of the Interview for Suicide in Schizophrenia-Third Revision (ISIS-3). Results of this study conducted with 270 hospitalized psychotically ill patients reveal the ISIS-3 to be a reliable and valid instrument for the assessment of suicide vulnerability among persons with schizophrenia and schizoaffective disorder. Specifically, the ISIS-3 demonstrates excellent interrater reliability, temporal stability, high internal consistency, and strong construct validity. Additionally, the sensitivity and specificity of the ISIS-3 show it to be a more accurate means of identifying patients at elevated risk for suicide than independent clinicians or behavioral data. These results indicate great potential for the ISIS-3 as both a clinical and research suicide assessment tool. It may be used as a measure of suicide risk as well as to quantify and track change resulting from treatment interventions. Further research with this instrument may lead to the development of effective treatments and improved understanding of the emergent process of suicide.

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