AAS Risk Assessment & Screening Tools 4 — Questions and Answers
Question 1: Which of the following is a WARNING SIGN of imminent suicide risk, as distinguished from a long-term risk factor?
- Family history of suicide
- Chronic major depressive disorder diagnosis
- Giving away prized possessions (Correct answer)
- Male gender
Correct answer: Giving away prized possessions
Giving away prized possessions is a behavioral warning sign indicating possible imminent intent, unlike demographic or historical risk factors.
Question 2: The Suicidal Ideation Attributes Scale (SIDAS) is unique because it measures:
- Lifetime history of attempts
- Frequency, controllability, closeness to attempt, distress, and functional impairment (Correct answer)
- Medical lethality of previous attempts
- Current mood episode severity
Correct answer: Frequency, controllability, closeness to attempt, distress, and functional impairment
SIDAS assesses five ideation attributes—frequency, controllability, closeness to acting, distress, and interference—yielding a continuous severity score.
Question 3: In the Joiner Interpersonal Theory of Suicide, the concept of 'thwarted belongingness' refers to:
- A belief that one is a burden to others
- A perceived absence of social connection and feeling alone (Correct answer)
- The capacity to endure physical pain
- Repeated exposure to painful experiences
Correct answer: A perceived absence of social connection and feeling alone
Thwarted belongingness is the painful belief that one lacks meaningful social bonds and does not belong to a valued group.
Question 4: A patient reports ideation with a plan but states they would never act because of their children. Clinically, this most directly reflects:
- A low level of suicidal intent
- Strong protective factors buffering against action (Correct answer)
- Absence of suicidal ideation
- Denial of current risk
Correct answer: Strong protective factors buffering against action
Children as a reason for living is a potent protective factor that can reduce the likelihood of acting on ideation, even when intent exists.
Question 5: The InterSePT scale (InterSePT Scale for Suicidal Thinking) was originally developed to monitor suicidal ideation in patients with:
- Borderline personality disorder
- Schizophrenia and schizoaffective disorder (Correct answer)
- Major depressive disorder with psychosis
- Bipolar I disorder during manic episodes
Correct answer: Schizophrenia and schizoaffective disorder
InterSePT was developed as an outcome measure in the landmark study of clozapine's anti-suicidal effects in schizophrenia and schizoaffective disorder.
Question 6: When a clinician documents 'low acute / high chronic' risk, which management approach is most appropriate?
- Immediate involuntary hospitalization
- Outpatient safety planning with close follow-up and means restriction (Correct answer)
- Discharge with no further services
- Emergency medication management only
Correct answer: Outpatient safety planning with close follow-up and means restriction
Low acute / high chronic risk typically indicates intensive outpatient care with a robust safety plan, not hospitalization unless acute risk escalates.
Question 7: The concept of 'plan specificity' in suicide risk assessment refers to:
- How often suicidal thoughts occur per day
- The degree of detail the patient has developed about how, when, and where (Correct answer)
- Whether the patient has told others about their plan
- The number of previous plans the patient has made
Correct answer: The degree of detail the patient has developed about how, when, and where
A highly specific plan (method, time, place, preparations) indicates greater seriousness and elevated risk compared to a vague or unformulated plan.
AAS Risk Assessment & Screening Tools 4
Which of the following is a WARNING SIGN of imminent suicide risk, as distinguished from a long-term risk factor?