The topic of suicide is of increasing concern given its continued spread, especially among the adolescent population. One of the major problems encountered concerns the lack of preventive action, which is also due to the difficulty in identifying adolescents at risk. In this regard, this study investigates the predictive effectiveness of the Minnesota Multiphasic Personality Inventory (version for adolescents; MMPI-A) exploring whether any scale of the MMPI-A was able to discriminate adolescents at risk of suicide, and also whether it detected differences between subjects with suicidal ideation or previous attempted suicide. Finally, we wanted to investigate the predictive effectiveness of MMPI-A in relation to the areas of attraction/repulsion for life and death (AL, RL, AD, RD), assessed with the Multi-Attitude Suicide Tendency scale (MAST). To achieve this objective, 128 adolescents (outpatient or inpatient) admitted to the Child Neuropsychiatry department of Lecco and Pavia (Italy) were involved, identifying 104 subjects at risk and 24 belonging to the clinical control group. Beyond MAST and MMPI-A, the Columbia-Suicide Severity Rating Scale (C-SSRS) was used to distinguish adolescents with suicide ideation, with a previous attempted suicide and the control group. A statistically significant difference in means is observed in almost all MMPI-A scales except for ANG, MAC-R, PRO, R (Anger, Alcoholism, tendency to abuse alcohol or drugs, Repression) between the at-risk group and control one. It was also possible to identify two scales which distinguish adolescents who move from ideation to engaging in suicidal behavior: CON (whose high scores indicate conduct problems) and ALN (alienation as emotional distance from others). The regression analysis carried out indicates that IMM and DEP are negatively related to AL, while ANG links in the opposite direction. ALN, LSE, and FAM are related to RL. DEP, BIZ, and PRO are positively related to AD and FAM is negatively related to AD. Immaturity (IMM) and depression (DEP) appear to be risk factors for a lower drive for life. Low self-esteem (LSE), alienation, and family mental distress (FAM) lead the adolescent to repel life, just as bizarre thoughts (BIZ), the tendency to abuse alcohol or drugs and depression are present in those attracted by death. The MMPI-A proves capable of discriminating the different groups identified, it could be an excellent tool for early detection of subjects whose responses correspond to the personological profile identified as at risk. Furthermore, once the relationship between MMPI-A and MAST has been ascertained, we become able to identify adolescents who may develop an attraction to death or revulsion by life. Sometimes one of the problems in prevention concerns the fact that in patients who come for other problems, a complete assessment is not carried out: the use of the MMPI-A could provide valuable help, at least in identifying risk factors. Despite its innovativeness, this is a preliminary study and needs to be carried on.
L'argomento del suicidio desta una preoccupazione crescente data la sua diffusione continua, soprattutto tra la popolazione adolescenziale. Uno dei principali problemi incontrati riguarda la mancanza di azione preventiva, che è anche dovuta alla difficoltà di identificare gli adolescenti a rischio. A tal proposito, questo studio indaga l'efficacia predittiva del Minnesota Multiphasic Personality Inventory (versione per adolescenti; MMPI-A) esplorando se una qualsiasi delle scale del MMPI-A sia in grado di discriminare gli adolescenti a rischio di suicidio, e se rilevavi anche differenze tra soggetti con ideazione suicidaria o tentato suicidio precedente. Infine, si vuole analizzare l'efficacia predittiva del MMPI-A in relazione alle aree di attrazione / repulsione per la vita e la morte (AL, RL, AD, RD), valutate con la scala Multi-Attitude Suicide Tendency (MAST). Per raggiungere questo obiettivo, sono stati coinvolti 128 adolescenti (ambulatoriali o ricoverati) ammessi al dipartimento di Neuropsichiatria Infantile di Lecco e Pavia (Italia), identificando 104 soggetti a rischio e 24 appartenenti al gruppo di controllo clinico. Oltre a MAST e MMPI-A, è stata utilizzata la Scala di valutazione della gravità del suicidio di Columbia (C-SSRS) per distinguere gli adolescenti con ideazione suicidaria, con un tentativo di suicidio precedente e il gruppo di controllo. Si osserva una differenza statisticamente significativa in quasi tutte le scale del MMPI-A tranne per ANG, MAC-R, PRO, R (rabbia, alcolismo, tendenza all'abuso di alcol o droghe, repressione) tra il gruppo a rischio e quello di controllo. È stato inoltre possibile identificare due scale in grado di distinguere gli adolescenti che passano dall'ideazione al comportamento suicidario: CON (i cui punteggi alti indicano problemi di condotta) e ALN (alienazione come distanza emotiva dagli altri). L'analisi di regressione effettuata indica che IMM e DEP sono negativamente correlati ad AL, mentre ANG correla nella direzione opposta. ALN, LSE e FAM sono correlati a RL. DEP, BIZ e PRO sono positivamente correlati ad AD e FAM è negativamente correlato ad AD. L'immaturità (IMM) e la depressione (DEP) sembrano essere fattori di rischio per un minore desiderio di vita. Una bassa autostima (LSE), l'alienazione e il disagio mentale familiare (FAM) portano l'adolescente a respingere la vita, così come i pensieri bizzarri (BIZ), la tendenza all'abuso di alcol o droghe e la depressione sono presenti in coloro che sono attratti dalla morte. Il MMPI-A si dimostra capace di discriminare i diversi gruppi identificati, potrebbe essere un ottimo strumento per la rilevazione precoce dei soggetti le cui risposte corrispondono al profilo personologico identificato come a rischio. Inoltre, una volta accertata la relazione tra MMPI-A e MAST, si potrebbe divenire in grado di identificare gli adolescenti inclini a sviluppare un'attrazione per la morte o repulsione per la vita. A volte uno dei problemi nella prevenzione riguarda il fatto che, nei pazienti che si presentano per altri problemi, non viene effettuata una valutazione completa: l'uso del MMPI-A potrebbe fornire un aiuto prezioso, almeno nell'identificazione dei fattori di rischio. Nonostante la sua innovatività, questo è uno studio preliminare e deve essere ulteriormente ampliato.
La caratterizzazione psicologica e comportamentale dell'adolescente con ideazione o condotte suicidarie con l'ausilio del Minnesota Multiphasic Personality Inventory per adolescenti
CAUSHI, ANNA
2022/2023
Abstract
The topic of suicide is of increasing concern given its continued spread, especially among the adolescent population. One of the major problems encountered concerns the lack of preventive action, which is also due to the difficulty in identifying adolescents at risk. In this regard, this study investigates the predictive effectiveness of the Minnesota Multiphasic Personality Inventory (version for adolescents; MMPI-A) exploring whether any scale of the MMPI-A was able to discriminate adolescents at risk of suicide, and also whether it detected differences between subjects with suicidal ideation or previous attempted suicide. Finally, we wanted to investigate the predictive effectiveness of MMPI-A in relation to the areas of attraction/repulsion for life and death (AL, RL, AD, RD), assessed with the Multi-Attitude Suicide Tendency scale (MAST). To achieve this objective, 128 adolescents (outpatient or inpatient) admitted to the Child Neuropsychiatry department of Lecco and Pavia (Italy) were involved, identifying 104 subjects at risk and 24 belonging to the clinical control group. Beyond MAST and MMPI-A, the Columbia-Suicide Severity Rating Scale (C-SSRS) was used to distinguish adolescents with suicide ideation, with a previous attempted suicide and the control group. A statistically significant difference in means is observed in almost all MMPI-A scales except for ANG, MAC-R, PRO, R (Anger, Alcoholism, tendency to abuse alcohol or drugs, Repression) between the at-risk group and control one. It was also possible to identify two scales which distinguish adolescents who move from ideation to engaging in suicidal behavior: CON (whose high scores indicate conduct problems) and ALN (alienation as emotional distance from others). The regression analysis carried out indicates that IMM and DEP are negatively related to AL, while ANG links in the opposite direction. ALN, LSE, and FAM are related to RL. DEP, BIZ, and PRO are positively related to AD and FAM is negatively related to AD. Immaturity (IMM) and depression (DEP) appear to be risk factors for a lower drive for life. Low self-esteem (LSE), alienation, and family mental distress (FAM) lead the adolescent to repel life, just as bizarre thoughts (BIZ), the tendency to abuse alcohol or drugs and depression are present in those attracted by death. The MMPI-A proves capable of discriminating the different groups identified, it could be an excellent tool for early detection of subjects whose responses correspond to the personological profile identified as at risk. Furthermore, once the relationship between MMPI-A and MAST has been ascertained, we become able to identify adolescents who may develop an attraction to death or revulsion by life. Sometimes one of the problems in prevention concerns the fact that in patients who come for other problems, a complete assessment is not carried out: the use of the MMPI-A could provide valuable help, at least in identifying risk factors. Despite its innovativeness, this is a preliminary study and needs to be carried on.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/3276