Khazem Lauren R, Keen Megan A, Rodriguez Taylor R, Ingram Paul B, Hay Jarrod M, Long Cameron M, Bryan Craig J, Anestis Joye C
Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA.
Suicide Life Threat Behav. 2025 Apr;55(2):e13170. doi: 10.1111/sltb.13170.
We continue to have limited success in identifying Veterans at high risk of suicide, due in part to reticence of disclosing suicidal ideation.
This study used a simulated groups experimental design to evaluate the MMPI-3's ability to assess suicide risk underreporting in Veterans with past-month death/suicide ideation.
Thirty-nine Veterans (53.85% men) were randomized to standard and simulated underreporting groups and provided valid data on the MMPI-3 and collateral measures. We examined (1) whether simulated underreporting on the MMPI-3 (indexed by L and K scale scores) impacts SUI scale scores, (2) if these effects generalize to underreporting on extratest suicide and non-suicide measures, and (3) if MMPI-3 L and K scales incrementally predict and differentiate between Veterans with recent death/suicide ideation who were instructed to answer honestly and those instructed to underreport.
Groups scored significantly differently on K (g = 0.99: M = 57.83, M = 43.72), but not L. Underreporting captured by K generalized to lower MMPI-3 SUI scale scores (g = 2.00; M = 46.33, M = 66.81) and collateral measures of suicide risk (g = 0.69-0.79). K scores significantly predicted group membership and added incrementally to L.
The limitations and clinical implications of these findinga are discussed.
MMPI-3 K, but not L, scale scores most reliably capture defensive reporting of suicidal ideation and intent and psychopatholpgy, more boradly. However a signifcant amount of underreporrting of suicidal ideation and intent may go undetected.
ClinicalTrials.gov identifier: NCT04896151.
我们在识别有高自杀风险的退伍军人方面仍然成效有限,部分原因是他们不愿透露自杀念头。
本研究采用模拟分组实验设计,以评估明尼苏达多相人格测验第三版(MMPI - 3)在评估过去一个月有死亡/自杀念头的退伍军人自杀风险瞒报情况方面的能力。
39名退伍军人(53.85%为男性)被随机分为标准组和模拟瞒报组,并提供了关于MMPI - 3及辅助测量的有效数据。我们研究了:(1)MMPI - 3上的模拟瞒报(以L量表和K量表分数为指标)是否会影响自杀量表(SUI)分数;(2)这些影响是否会推广到测验外的自杀和非自杀测量的瞒报情况;(3)MMPI - 3的L量表和K量表是否能逐步预测并区分被指示如实作答和被指示瞒报的近期有死亡/自杀念头的退伍军人。
两组在K量表上得分差异显著(g = 0.99:M = 57.83,M = 43.72),但在L量表上无显著差异。K量表所反映的瞒报情况导致MMPI - 3自杀量表得分降低(g = 2.00;M = 46.33,M = 66.81)以及自杀风险的辅助测量得分降低(g = 0.69 - 0.79)。K量表分数能显著预测分组情况,并且在L量表基础上有增量预测作用。
讨论了这些发现的局限性和临床意义。
MMPI - 3的K量表分数,而非L量表分数,能最可靠地捕捉自杀念头、意图及更广泛的精神病理学方面的防御性报告。然而,大量的自杀念头和意图瞒报情况可能未被发现。
ClinicalTrials.gov标识符:NCT04896151