Factor structure, reliability, and validity of the revised Suicide Crisis Inventory in major depression: A multicentric Indian study

Abstract

Background: The revised Suicide Crisis Inventory (SCI)-2 is a self-report measure to assess the suicide crisis syndrome (SCS). We aimed to assess the factor structure, reliability, and validity of SCI-2 among adults with major depression.

Methods: Using a cross-sectional design, between November 2021 and August 2022, the Hindi SCI-2, along with other self-report measures, was administered to Indian adult respondents clinically diagnosed with major depression across 24 centers in India. Confirmatory factor analysis was carried out to test the factor structure of SCI-2. Additionally, convergent, discriminant, and criterion validity were tested using bivariate or biserial correlations, as appropriate.

Results: We obtained responses from 654 participants (Mean age = 36.9 ± 11.9 years, 50.2 % female). The SCI-2 fit both a one-factor (χ²[1769] = 14,150.74, p < .001, CFI = 0.98, RMSEA = 0.10), and five-factor solution (χ²[1759] = 13,130.83, p < .001,CFI = 0.98, RMSEA = 0.10) with the five-factor solution providing a significantly better fit. Internal consistencies of the SCI-2 total and subscale scores ranged from good to excellent. Most subscales significantly converged with each other and with other relevant measures although these associations were weak for thwarted belongingness and goal reengagement subscales. Small to moderate associations were noted in support of discriminant and criterion validity.

Limitations: We could not assess the predictive validity of SCI-2 for suicidal behaviors.

Conclusion: Consistent with prior data, the Hindi SCI-2 fit a five-factor solution and showed good psychometric properties. These findings support the use of SCI-2 to assess SCS among Indian adults with major depression.

Keywords: India; Suicidal narrative; Suicide; Suicide Crisis Inventory; Suicide crisis syndrome; Suicide risk assessment.