Self-harm subscale of the Schedule for Nonadaptive and Adaptive Personality (SNAP): predicting suicide attempts over 8 years of follow-up.

نویسندگان

  • Shirley Yen
  • M Tracie Shea
  • Zach Walsh
  • Maria O Edelen
  • Christopher J Hopwood
  • John C Markowitz
  • Emily B Ansell
  • Leslie C Morey
  • Carlos M Grilo
  • Charles A Sanislow
  • Andrew E Skodol
  • John G Gunderson
  • Mary C Zanarini
  • Thomas H McGlashan
چکیده

OBJECTIVE We examined the predictive power of the self-harm subscale of the Schedule for Nonadaptive and Adaptive Personality (SNAP) to identify suicide attempters in the Collaborative Longitudinal Study of Personality Disorders (CLPS). METHOD The SNAP, a self-report personality inventory, was administered to 733 CLPS participants at baseline, of whom 701 (96%) had at least 6 months of follow-up data. Cox proportional hazards regression analyses were performed to examine the SNAP-self-harm subscale (SNAP-SH) in predicting the 129 suicide attempters over 8 years of follow-up. Possible moderators of prediction were examined, including borderline personality disorder, major depressive disorder (MDD), and substance use disorder. We also compared baseline administration of the SNAP-SH to subsequent administrations more proximal to the suicide attempt, and to a higher-order SNAP-negative temperament (SNAP-NT) subscale. Receiver operating characteristic analyses were conducted using suicide attempts (n = 58) over the first year of follow-up to provide reference points for sensitivity and specificity. RESULTS The SNAP-SH demonstrated good predictive power for suicide attempts (hazard ratio = 1.28, P < .001) and appeared relatively consistent across borderline personality disorder, MDD, and substance use disorder diagnoses. Using more proximal scores did not increase predictive power. The SNAP-SH compared favorably to the predictive power of the higher-order SNAP-NT. Receiver operating characteristic analyses indicate several cutoff scores on the SNAP-SH that yield moderate to high sensitivity and specificity for predicting suicide attempts over the first year of follow-up. CONCLUSIONS The SNAP-SH may be a useful screening instrument for risk of suicide attempts in nonpsychotic psychiatric patients.

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عنوان ژورنال:
  • The Journal of clinical psychiatry

دوره 72 11  شماره 

صفحات  -

تاریخ انتشار 2011