Instruments such as the Beck Hopelessness Scale or the Coping Response Inventory were not designed to be administered to a suicide decedent's collateral contacts. However, in some psychological autopsy research this is how they are sometimes used. I think that this "off label" use may raise methodological issues that may affect the validity of data so gathered. I would appreciate feedback, one way or the other, on this question. Thanks!
Dear Tony,
Here is a paper on the issue:
Suicide and Life-Threatening Behavior
Volume 35, Issue 5, pages 536–546, October 2005
Utah Youth Suicide Study: Psychological Autopsy
Michelle Moskos et al.
"While traditional psychological autopsy studies primarily focus on the administration of psychometric measures to identify any underlying diagnosis of mental illness for the suicide decedent, we focused our interviews to identify which contacts in the decedent's life recognized risk factors for suicidal behavior, symptoms of mental illness, as well as barriers to mental health treatment for the decedent. Parents and friends recognized most symptoms universally, although friends better recognized symptoms of substance abuse than any other contact."
Tony-
Just to clarify, psychological autopsies involve patients that have completed suicide. Are you referring to screening measures that could be used to identify people at risk? Do you mean members of the public who seek emergency services, or are you referring to folks entering jails or prisons? In jails and prisons, in theory, everyone is screened upon arrival using screening measures designed to 'screen in' folks according to certain known risk factors. In the case of emergency services in the community, I am less familiar with the procedure, but I assume it is similar--everyone is screen using standardized measures.
In Cook County Jail, we screen folks using the measure developed by Carlson for the Federal Bureau of Prisons. The publication is by Kevin Correia. I hope this helps.
Thanks.
Regards,
Pierre
Pierre,
My question is if a questionnaire for identifying psychological variables is designed to be completed by n and validated for use on, living subjects how can you use that instrument to gather data on decedents by having their family members answer the questions?
Tony
Tony-
I am not familiar with this practice as part of a psychological autopsy. This is not something we would do in our setting, and I am not aware of psychological instruments that have been standardized for this purpose.
My understanding of psychological autopsy is that it involves gathering of existing data rather than the creation of new data after the fact using proxies to answer questions about the state of mind of the autopsy subject on standardized personality measures.
If there were tests completed by the autopsy subject prior to his or her death, of course these could be included, and if there were other reports, clinic or hospital records, and testimony from 'fact witnesses', these could all serve as sources. However, having family member go back after the fact and complete paper-and-pencil instruments to stand in for the person who died, that is something I have never heard of.
Is this being used in litigation or something like that? This sounds off to me.
I hope I have responded in the spirit of your question here. Thanks for the opportunity.
Regards,
Pierre
Pierre,
You have "the spirit" of my question exactly correct when you say: "...having family member go back after the fact and complete paper-and-pencil instruments to stand in for the person who died, that is something I have never heard of." I recently saw a study where that is what was done and it obviously concerns me. Psychological autopsies have been termed "the gold standard" in suicide research and they are virtually immune to critical comment of any kind. This being the case it is troubling that questionable methodological practices are used in some PA research and not being challenged because the PA has become, if you'll pardon the expression, a virtually "sacred cow" within suicide research and suicide prevention.
Thank you for your comments.
Tony
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