The Development Of Suicidal Behavior Screening Questionnaire

Suicide is a serious public health problem and a social problem,causing numerous tragedies and great losses.As the first step of suicide prevention and intervention,suicide screening plays an important role in solving the problem of suicide.Therefore,how to develop effective measurement tools for suicide screening has become the focus of many fields and researchers.At present,although there are many tools used for suicide screening,they mainly focus on the measurement of suicide-related psychological risk factors.The scores of psychological factors are used to indirectly screen people who may be suicide,while there are few tools for direct measurement of previous suicidal behavior.At the same time,due to the lack of a unified definition and classification of suicidal behavior,screening tools based on previous suicidal behavior often have great differences in measurement content and structure,which not only affects the accuracy of measurement results,but also hinders the comparison and generalization of different research results,and fails to convert research conclusions into effective guidance.Therefore,the purpose of this study is to propose a standardized definition and classification of suicidal behavior,and develop a suicidal behavior screening questionnaire,which provides a reliable and effective measurement tool for suicide screening.This study is mainly divided into four parts: The first part combs the numerous definitions of suicide in the previous literature,and explains and defines the core concepts most commonly involved in the definition of suicide,so as to propose a new definition of suicide,suicide is a self-initiated behavior(not necessarily carried out by himself)with the intent to die(knowing or expecting to achieve actual or potentially fatal outcome in some way),no matter whether such behavior constitutes harm or not..The second part,on the basis of the definition,combined with the existing classification schemes of suicidal behavior,further describes and explores the different subtypes of suicidal behavior and their specific manifestations in the occurrence and development of suicide through semi-structured interviews and post-coding,and constructs the classification model of suicidal behavior.In the third part,under the guidance of the definition and classification of suicidal behavior proposed in this study,methods such as literature review and group discussion were used to compile the questionnaire.After the preliminary test,the contents and expressions of the items were deleted and adjusted,and the reliability and validity of the questionnaire was formally tested.The results are as follows:1.Suicidal behavior can be divided into four categories: suicidal ideation,presuicidal attempt,suicidal attempt and suicidal death.Suicidal ideation includes passive suicidal ideation and active suicidal ideation;pre-suicide attempt includes suicidal plan,suicidal preparation and suicidal rehearsal;suicide attempt includes aborted suicidal attempt,interrupted suicidal attempt and attempted suicide.2.There are 8 items in the suicidal behavior screening questionnaire.Confirmatory factor analysis showed that the three-factor model was well fitted(χ2/ DF =7.231,RMSEA=0.081,NFI=0.971,RFI =0.941,CFI=0.975,IFI=0.975,TLI=0.949).The correlation coefficients between the questionnaire and the measurement tools of criterion-related validity and convergent validity were between 0.36 ～ 0.44 and 0.68 ～0.71,respectively(P<0.01).The total questionnaire and dimensions have good internal reliability with Cronbach’ s α coefficients from 0.79 to 0.89,split-half reliability coefficients from 0.63 to 0.86,the split-half reliability ranged from 0.63 to 0.86,and the retest reliability Kappa value of each item ranged from 0.33 to 0.71.When the cutoff value was 22 points,the sensitivity(73.68%)and specificity(73.77%)of the questionnaire were the highest,and the area under the ROC curve(AUC)was 0.747(95%CI: 0.650-0.829).There were significant differences in risk factors such as hopelessness,depression,anxiety,and stress among people with suicidal ideation,presuicidal attempt,suicidal attempt.3.A sample of 9099 freshmen in the class of 2020 from a university was taken as the sample.Among individuals with a previous history of suicide,1493 were former suicidal ideators,accounting for 16.57% of the total number;728 were pre-suicidal attempters,accounting for 8.08% of the total;458 were suicidal attempters,accounting for 5.08% of the total.There were significant differences in demographic variables such as gender,single child,single parent,religious belief,educational background,family location and parents’ marital status.There were significant differences among suicidal ideators,pre-suicidal attempters and suicidal attempters in extroversion,neuroticism,psychoticism,depression,somatization,obsessive-compulsive,anxiety,interpersonal sensitivity,anxiety,hostility,photic anxiety,paranoid ideation,psychoticism and other psychological variables.The high-risk group and the low-risk group showed significant differences in other psychological variables except for extroversion.The results show that the suicidal behavior screening questionnaire has been tested and applied in the sample of Chinese college students,and is a reliable and effective measuring tool.