The Suicidal Intrusions Attributes Scale (SINAS): a new tool measuring suicidal intrusions

Jaël S van Bentum; Ad J F M Kerkhof; Marcus J H Huibers; Emily A Holmes; Stephan de Geus; Marit Sijbrandij

doi:10.3389/fpsyt.2023.1158340

The Suicidal Intrusions Attributes Scale (SINAS): a new tool measuring suicidal intrusions

Front Psychiatry. 2023 Jul 5:14:1158340. doi: 10.3389/fpsyt.2023.1158340. eCollection 2023.

Authors

Jaël S van Bentum^{1

2}, Ad J F M Kerkhof¹, Marcus J H Huibers^{2

3}, Emily A Holmes⁴, Stephan de Geus¹, Marit Sijbrandij^{1

5}

Affiliations

¹ Clinical, Neuro-, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
² Department of Clinical Psychology, Universiteit Utrecht, Utrecht, Netherlands.
³ NPI Center for Personality Disorders, Arkin, Amsterdam, Netherlands.
⁴ Department of Psychology, Uppsala University, Uppsala, Sweden.
⁵ World Health Organization Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.

Abstract

Introduction: Suicidal intrusions are uncontrollable, intrusive mental images (e. g., visualizing a future suicidal act). They may also be called suicidal "flash-forwards." Despite the importance of integrating the assessment of suicidal intrusions into a clinical routine assessment, quick self-report screening instruments are lacking. This study describes the development of a new instrument-Suicidal Intrusions Attributes Scale (SINAS)-to assess the severity and characteristics of suicidal intrusions and examines its psychometric properties.

Method: The sample included currently suicidal outpatients with elevated levels of depression recruited across mental health institutions in the Netherlands (N = 168). Instruments administered were 10-item SINAS, the Suicidal Ideation Attributes Scale (SIDAS), the Prospective Imagery Task (PIT), four-item Suicidal Cognitions Interview (SCI), and the Beck Depression Inventory (BDI-II).

Results: An exploratory factor analysis identified a one-factor structure. The resulting SINAS demonstrated good internal consistency (Cronbach's α = 0.91) and convergent validity, as expected.

Discussion: Overall, this study demonstrated acceptable levels of reliability and validity of the measure in a depressed clinical population with suicidal ideation. The SINAS may be a useful screening tool for suicidal intrusions in both research and clinical settings.

Keywords: Suicidal Intrusions Attributes Scale; intrusions; intrusiveness; mental imagery; suicidal imagery; suicide; validation study.

Grants and funding

The data used in the current study were collected in the context of a Large Multicenter Randomized Clinical Trial that was funded by ZonMw (the Netherlands Organisation for Health Research and Development; Project Number 537001003). The funder had no role in the study design, data collection, data analysis, data interpretation, or writing the report.