The Multi-dimensional Assessment of Suicide Risk in Chronic illness-20 (MASC-20): Development and validation
- Authors
- Shim, Eun-Jung; Ha, Hyeju; Kim, Bo-ram; Kim, Sun Mi; Moon, Jung Yoon; Hwang, Jin Ho; Hahm, Bong-Jin
- Issue Date
- Jul-2023
- Publisher
- Elsevier Inc.
- Keywords
- Assessment; Chronic physical illness; Distress; Psychometrics; Screening; Suicidal behavior
- Citation
- General Hospital Psychiatry, v.83, pp 140 - 147
- Pages
- 8
- Journal Title
- General Hospital Psychiatry
- Volume
- 83
- Start Page
- 140
- End Page
- 147
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/70419
- DOI
- 10.1016/j.genhosppsych.2023.03.016
- ISSN
- 0163-8343
1873-7714
- Abstract
- Background: We developed and tested the psychometric properties of the Multi-dimensional assessment of suicide risk in chronic illness-20 (MASC-20), which assess suicidal behavior (SB), and its associated distress in chronic physical illness (CPI). Methods: Items were developed by incorporating inputs from patient interviews, a review of existing instruments, and expert consultations. Pilot testing with 109 patients and field testing with 367 patients with renal, cardiovascular, and cerebrovascular diseases were conducted. We analyzed Time (T) 1 data to select items and T2 data to examine psychometric properties. Results: Forty preliminary items were selected through pilot testing; 20 were finalized from field testing. Optimal internal consistency (α = 0.94) and test-retest reliability (Intra class correlation coefficient = 0.92) of the MASC-20 supported reliability. Good fit of the four-factor model (physical distress, psychological distress, social distress, and SB) from exploratory structural equation modeling demonstrated factorial validity. Its correlations with MINI suicidality (r = 0.59) and the Schedule of Attitudes Toward Hastened Death-abbreviated scores (r = 0.62) indicated convergent validity. Higher MASC-20 scores in patients with clinical levels of depression and anxiety and low health status demonstrated known-group validity. The MASC-20 distress score predicted SB beyond known SB risk factors, supporting incremental validity. A cutoff score of 16 was optimal for identifying suicide risk. The area under the curve was within a moderately accurate range. The sum of sensitivity and specificity (1.66) indicated diagnostic utility. Limitations: MASC-20's applicability to other patient populations and its sensitivity to change requires testing. Conclusions: The MASC-20 appears to be a reliable and valid tool for assessing SB in CPI. © 2023
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