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A Distinct Configuration of MMPI-2-RF Scales RCd and RC9/ACT Is Associated With Suicide Attempt Risk Among Suicide Ideators in a Psychiatric Outpatient Sample

Suicide is a major public health problem, claiming the lives of more than 40,000 individuals in the United States each year. Efforts are needed to (a) identify those at heightened risk for suicide, utilizing objective assessment methods and (b) determine factors that may be protective against engaging in suicidal behavior, even in the context of the desire to do so. Scales RCd (demoralization) and RC9 (hypomanic activation) of the Minnesota Multiphasic Personality Inventory (MMPI)-2 Restructured Form (MMPI-2-RF) may be valuable in this regard. Whereas individuals high on both RCd and RC9 are dysphoric and prone to reckless action, individuals high on RCd but low on RC9 are characterized by levels of high lethargy and physical unexcitability that may be protective against making a suicide attempt. The purpose of this study was to determine whether scales RCd and RC9 of the MMPI-2-RF interact to predict suicide attempts among suicide ideators. Participants were 189 psychiatric outpatients between the ages of 18 and 65 years (M = 28.8, SD = 11.8; 68.8% female, 74.5% non-Hispanic White) who reported nonzero levels of suicidal ideation on the Beck Scale for Suicide Ideation. Overall, 46.6% of patients reported a past suicide attempt. Consistent with hypotheses, RCd and RC9 interacted such that elevations on RCd were positively associated with past suicide attempts at high, but not low, levels of RC9. Alternate models demonstrated that this configuration persisted when examining the ACT Specific Problem scale as a surrogate for RC9. This study presents a novel MMPI-2-RF configuration that may enhance the assessment of suicide risk.