The Rorschach Suicide Constellation: assessing various degrees of lethality

Area of Science:

• Psychological assessment
• Clinical psychology
• Psychopathology

Background:

• The Rorschach Comprehensive System's Suicide Constellation (S-CON) is a tool used to assess suicide risk.
• Understanding the relationship between S-CON indicators and suicide attempt lethality is crucial for clinical practice.

Purpose of the Study:

• To examine the predictive validity of the S-CON for suicide attempt lethality in hospitalized patients.
• To evaluate the diagnostic efficiency of the S-CON in differentiating between various levels of suicidal behavior.

Main Methods:

• Retrospective chart review of patient records at the Austen Riggs Center.
• Categorization of patients into nonsuicidal, parasuicidal, and near-lethal groups based on self-destructive acts.
• Application of diagnostic efficiency statistics and logistic regression analysis.

Main Results:

• A cutoff score of 7 or more positive S-CON indicators accurately predicted near-lethal suicide attempts.
• The overall correct classification rate (OCC) for predicting near-lethal activity was .79 for parasuicidal patients and .79 for nonsuicidal inpatients.
• An S-CON score of 7 or more was the only significant predictor of near-lethal suicide attempts among the studied variables.

Conclusions:

• The S-CON, with a cutoff of 7 or more, demonstrates significant predictive utility for near-lethal suicide attempts in a clinical population.
• Clinicians can utilize the S-CON to identify patients at higher risk for severe suicidal behavior.
• Further consideration of base rates is necessary when interpreting S-CON efficacy across different populations.