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Suicidality Assessment with PRISM-S – Simple, Fast, and Visual

A Brief Nonverbal Method to Assess Suicidality in Adolescent and Adult Patients

Published Online:https://doi.org/10.1027/0227-5910/a000164

Background: The PRISM-S task was developed at the Crisis Intervention Center (KIZ) Winterthur, Switzerland, to enable an assessment of the degree of suicidality in less than 5 minutes with a simple, visual instrument. Aims: Comparison of validity and clinical use of the new PRISM-S task with other instruments known as “gold standards”. Method: Quantitative pilot study enlisting 100 inpatients admitted to the KIZ, aged 15–42 years. Patients’ suicidality was assessed by the PRISM-S task during the first clinical interview and compared to data obtained by standardized suicidality instruments. Results: The patients completed the PRISM-S task in 2 to 5 minutes without difficulty. Data show significant positive correlations between the suicidality as assessed by PRISM-S and the gold standards, i.e., DSI-SS (r = 0.59, N = 65, p < .0001). Limitations: There is no strong evidence that PRISM-S is useful for outpatients or in other settings. The experiences gained with outpatients/patients with other disorders are promising but have not been systematically evaluated. The results do not rely on a randomized design. The sample consists of persons coming to the crisis intervention center. Conclusions: PRISM-S offers a brief, easy-to-administer, and valid method to assess patients’ suicidality. The simple instruction facilitates its use in other languages and other cultures as well. The acceptance by patients and health professionals was good, with no one refusing to complete the task.

References

  • AMDP – Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie . (2007). Das AMDP-System. Manual zur Dokumentation psychiatrischer Befunde [The AMDP system: Manual for the documentation of psychiatric indications] (8th ed.). Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Büchi, S. , Buddeberg, C. , Klaghofer, R. , Russi, E. W. , Brändli, O. , Schlösser, C. , ... Sensky, T. (2002). Preliminary validation of PRISM (Pictorial Representation of Illness and Self Measure) – A brief method to assess suffering. Psychotherapy and Psychosomatics, 71, 333–341. First citation in articleCrossref MedlineGoogle Scholar

  • Büchi, S. , Sensky, T. (1999). PRISM (Pictorial Representation of Illness and Self Measure) – A brief nonverbal measure of illness and therapeutic aid in psychosomatic medicine. Psychosomatics, 40, 314–320. First citation in articleCrossref MedlineGoogle Scholar

  • Büchi, S. , Sensky, T. , Sharpe, L. , Timberlake, N. (1998). Graphic representation of illness: A novel method of measuring patient’s perceptions of the impact of illness. Psychotherapy and Psychosomatics, 67, 222–225. First citation in articleCrossref MedlineGoogle Scholar

  • Cassel, E. J. (1982). The nature of suffering and the goals of medicine. New England Journal of Medicine, 306, 639–645. First citation in articleCrossref MedlineGoogle Scholar

  • Joiner, T. E. Jr. , Pfaff, J. J. , Acres, J. G. (2002). A brief screening tool for suicidal symptoms in adolescents and young adults in general health settings: Reliability and validity data from the Australian National General Practice Youth Suicide Prevention Project. Behavior Research and Therapy, 40, 471–481. First citation in articleCrossref MedlineGoogle Scholar

  • Lambert, M. J. , Hansen, N. B. , Umphress, V. , Lunnen, K. , Okishi, J. , Burlingame, G. , ... Reisinger, C. W. (1996). Administration and scoring manual for the Outcome Questionnaire (OQ-45.2). Wilmington, DE: American Professional Credentialing Services. First citation in articleGoogle Scholar

  • Maltsberger, J. T. (1999). The psychodynamic understanding of suicide. In D. G. Jacobs, (Ed.), The Harvard medical school guide to suicide assessment and intervention (pp. 72–82). San Francisco: Jossey-Bass. First citation in articleGoogle Scholar

  • Rudd, M. D. , Joiner, T. (1998). The assessment, management, and treatment of suicidality: Toward clinically informed and balanced standards of care. Clinical Psychology: Science and Practice, 5, 135–150. First citation in articleCrossrefGoogle Scholar

  • Shneidman, E. S. (1993). Suicide as psychache: A clinical approach to self-destructive behavior. Lanharm, MD: Rowman & Littlefield. First citation in articleGoogle Scholar