The Multi-dimensional Assessment of Suicide Risk in Chronic illness-20 (MASC-20): Development and validation

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). Items were developed by incorporating inputs from patient inter...

Full description

Saved in:
Bibliographic Details
Published in:General hospital psychiatry 2023-07, Vol.83, p.140-147
Main Authors: Shim, Eun-Jung, Ha, Hyeju, Kim, Bo-ram, Kim, Sun Mi, Moon, Jung Yoon, Hwang, Jin Ho, Hahm, Bong-Jin
Format: Article
Language:English
Subjects:
Assessment
Chronic physical illness
Distress
Psychometrics
Screening
Suicidal behavior
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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). 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. 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. MASC-20's applicability to other patient populations and its sensitivity to change requires testing. The MASC-20 appears to be a reliable and valid tool for assessing SB in CPI. •Multidimensional and multifactorial assessment of suicidal behavior is important in chronic physical illness.•MASC-20 is a reliable and valid tool to measure it.•Suicidal behavior is more psychosocial distress-dependent in chronic physical illness.
ISSN:0163-8343
1873-7714
DOI:10.1016/j.genhosppsych.2023.03.016