@article{ref1,
title="The multi-dimensional assessment of suicide risk in chronic illness-20 (MASC-20): development and validation",
journal="General hospital psychiatry",
year="2023",
author="Shim, Eun-Jung and Ha, Hyeju and Kim, Bo-Ram and Kim, Sun Mi and Moon, Jung Yoon and Hwang, Jin Ho and Hahm, Bong-Jin",
volume="83",
number="",
pages="140-147",
abstract="BACKGROUND: 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). <br><br>METHODS: 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. <br><br>RESULTS: 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. LIMITATIONS: MASC-20's applicability to other patient populations and its sensitivity to change requires testing. <br><br>CONCLUSIONS: The MASC-20 appears to be a reliable and valid tool for assessing SB in CPI.<p /> <p>Language: en</p>",
language="en",
issn="0163-8343",
doi="10.1016/j.genhosppsych.2023.03.016",
url="http://dx.doi.org/10.1016/j.genhosppsych.2023.03.016"
}