Adaptation and validation of the semi-structured interview for Psychological Autopsy (SSIPA) in Spanish

The aim of this work was to adapt and validate into Spanish the Semi-Structured Interview for Psychological Autopsy (SSIPA).

The SSIPA consists of 69 items distributed into four modules: precipitants and/or stressors, motivation, lethality, and intentionality. The original instrument was translated from Portuguese into Spanish and backtranslated by bilinguals persons. The resulting questionnaire was compared with the original and discussed by an expert panel. The adapted instrument was then applied to the relatives of 26 presumed suicide cases in Ourense (Spain) who voluntarily accepted to participate. Interviews were digitally recorded and evaluated using a decision-making algorithm by the interviewer and two independent judges blind to the results of the others.

Interrater agreement was measured using Kappa statistics. Participation in the study (27.6%) was similar to that obtained in the original study in Brazil >(20%). The Kappa values obtained were statistically significant. Correlation index was considered good (k>0.60) or very good (k> 0.80) in 15 steps including 3 out of 4 final steps of each module and the final result of the autopsy; moderate (k> 0.40) in 8 steps, 3 of them located in the motivation’s module; and weak (k> 0.20) just in 2 steps.

The Spanish version of the SSIPA is a reliable instrument for psychological autopsy studies. Low correlation in two of the algorithm steps for decision making may be due to the lack of accuracy of the questionnaire and should be improved.