Assessing the Interpersonal Dynamics Associated with Serious Suicide Attempts: The Concept of Problem Irresolvability

Suicide represents a significant threat to a large number of individuals each year. This study sought to create an adult version of an adolescent suicide prediction instrument created by Orbach and colleagues (Subject Experience of Problem Irresolvability, 1999). An additional objective was to examine the relationship between the suicide attempters' experience of certain previously-researched interpersonal dynamics and lethality of suicide attempts. Eighty-three participants from a large, publicly-funded teaching hospital emergency department in Dallas completed a battery of questionnaires including a newly developed adult version of the SEPIA . Of the 83 participants, 42 individuals presented for psychiatric evaluation after a suicide attempt, and 41 patients presented for treatment of unintentional traumatic injury. An independent samples t-test suggested that the SEPIA-A accurately discriminates between individuals who have attempted suicide and those who have not (t =5.41, p = 0.00). In addition, analysis of the internal reliability of the SEPIA-A yielded a Cronbach's alpha of 0.97. Further analyses were conducted to refine and examine the items included on the newly constructed SEPIA. Finally, a significant positive correlation was noted between scores on the SEPIA-A and the BHS (r = 0.64). Overall, the results of the current study support further development of the SEPIA-A and provide encouraging results regarding its ability to distinguish between suicidal and non-suicidal individuals. The final step in the present study was the compilation of a revised version of the SEPIA, based on item-to-scale analyses, to be used in future studies examining the instrument's utility as a risk assessment measure.