title: The Rorschach Suicide Constellation: assessing various degrees of lethality.
abstract: In this article we examine the relation between the Rorschach Comprehensive System's Suicide Constellation (S-CON; Exner, 1993; Exner & Wiley, 1977) and lethality of suicide attempts during the course of patients' hospitalization at the Austen Riggs Center (Stockbridge, MA). Patient records were rated as nonsuicidal (n = 37), parasuicidal (n = 37), or near-lethal (n = 30) based on the presence and lethality of self-destructive acts. Diagnostic efficiency statistics utilizing a cutoff score of 7 or more positive indicators successfully predicted which patients would engage in near-lethal suicidal activity relative to parasuicidal patients (overall correct classification rate [OCC] = .79), nonsuicidal inpatients (OCC = .79), and college students (OCC = .89). Although these predictions were influenced by relatively high base rates in the hospital population (14.5%), base rate estimates were calculated for other hypothetical populations revealing different prediction estimates that should be considered when judging the relative efficacy of the S-CON. Logistic regression analysis revealed that an S-CON score of 7 or more was the sole predictor of near-lethal suicide attempts among 9 psychiatric and demographic variables.
authors.affiliation: The Erik H. Erikson Institute for Training and Research at the Austen Riggs Center, Stockbridge, Massachusetts 01262, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Fowler
authors.forename: C
authors.initials: C
authors.lastname: Piers
authors.forename: M J
authors.initials: MJ
authors.lastname: Hilsenroth
authors.forename: D J
authors.initials: DJ
authors.lastname: Holdwick
authors.forename: J R
authors.initials: JR
authors.lastname: Padawer
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015203:Reproducibility of Results; D012392:Rorschach Test; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology; D013997:Time Factors