Please update your browser

You're using a version of Internet Explorer that isn't supported by Questia.
To get a better experience, go to one of these sites and get the latest
version of your preferred browser:

Validity of Best-Estimate Methodology in Assessing Psychosocial Risk Factors and Making Psychiatric Diagnoses in Hong Kong Chinese Who Attempt Suicide

By Chan, Sandra S. M.; Pang, Edwin P. F. et al. | Hong Kong Journal of Psychiatry, June 2007 | Go to article overview

Validity of Best-Estimate Methodology in Assessing Psychosocial Risk Factors and Making Psychiatric Diagnoses in Hong Kong Chinese Who Attempt Suicide


Chan, Sandra S. M., Pang, Edwin P. F., Chiu, Helen F. K., Hong Kong Journal of Psychiatry


Abstract

Objectives: To examine the validity of the best-estimate method for making psychiatric diagnoses and determine potential psychosocial risk factors in a cohort of Hong Kong Chinese who attempted suicide.

Participants and Methods: Seventy-one persons attempting suicide and their proxy-informants were interviewed separately to ascertain each patient's diagnosis (according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I diagnosis), psychosocial profile, and life circumstances surrounding the index suicide attempt.

Results: There were substantial levels of agreement, high sensitivity and specificity on Axis I psychiatric diagnoses in subject-proxy pairs. Levels of subject-proxy agreement were substantial for other risk factor domains such as physical diagnoses, suicidal behaviour profile, social networking, and most life-event items. Fair-to-modest levels of agreement were observed in perceived well-being in general health, health service utilisation and life-events involving interpersonal conflicts within family and peer groups.

Conclusions: Results support the validity of the best-estimate methodology for assessing psychosocial risk factors and making psychiatric diagnosis among Hong Kong Chinese who attempt suicide.

Key words: Interview, psychological; Suicide, attempted

Introduction

Suicide is a major public health problem affecting all nations. In 2000, the World Health Organization (WHO) reported that more than one million suicide deaths occurred worldwide. (1) Such a figure approximates to 14.5 suicide deaths per 100,000 people or one suicide death occurring every 40 seconds. From a public health perspective, suicide is the 13th leading cause of death worldwide and its detrimental effect has impacted all age-groups. To address the worldwide public health challenge posed by suicidal behaviour, there have been an increasing number of risk factor studies over the past few decades. The two main research approaches depend on community surveillance and psychological autopsy (PA). The PA approach, first developed and systematically described by Shneidman and Farberow in 1961, (2) involves enquiries into individual suicide cases, using in-depth psychosocial interviewing to gather information from proxy-informants. The psychosocial interview is designed to elicit detailed psychological profiles and psychosocial circumstances leading to suicide deaths. This method is generally regarded as the hallmark for risk factor research into suicide, despite its unavoidable limitations such as recall and attribution bias of the informants. (3) One indirect way to assess the validity of PA is by the 'best-estimate methodology among suicide attempters'. This method involves living subjects with risk factors that are otherwise comparable to those of deceased persons. Another interviewer conducts the same interview with a proxy-informant related to the living subjects. The degree of agreement between the information obtained from the two sources can be determined. Suicide attempters, despite their heterogeneous clinical profiles, may serve as the best 'proxy' study population to our reference population of suicide completers. (4)

A few studies have examined the reliability of proxy information in various elderly and adolescent psychiatric populations, (5,6) and suggest that informants under-report mood and substance abuse problems. Using the best-estimate method in late-life suicide attempters, Conner et al (4) reported satisfactory proxy-subject agreement on diagnoses of mood and substance dependency diagnoses; and some degree of agreement on behavioural profiles of suicide attempters and certain aspects of social support and stressful life events.

Suicide research in Chinese communities is challenged by social taboos. (7) The response rates for PA studies in Hong Kong Chinese were much lower than the rates encountered in Caucasian populations.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Validity of Best-Estimate Methodology in Assessing Psychosocial Risk Factors and Making Psychiatric Diagnoses in Hong Kong Chinese Who Attempt Suicide
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.