Using a Spiritual Distress Scale to Assess Suicide Risk in Veterans: An Exploratory Study

This exploratory study (1) examined the ability of a spiritual distress scale used by chaplains to identify Veterans with certain suicide risk factors and (2) provided an initial assessment of the reliability and validity of this scale to screen for Veterans at increased risk of suicide based on the presence of these risk factors. The scale consisted of five questions examining the presence or absence of guilt, sadness or grief, anger or resentment, despair or hopelessness, and feeling that life has no meaning or purpose. The scale was analyzed using Chronbach’s α-coefficient, factor analysis, Student’s t-tests, and logistic regression. Cut-off values were determined using the maximum Youden statistic. The five questions had a high level of internal consistency (α =0.88). Factor analysis suggested the presence of a common underlying factor, with correlations ranging from 0.42 to 0.78. Those identified with a suicide risk factor had significantly higher mean composite scores on this scale. Further, scores were significantly associated with increased odds of being identified with a suicide risk factor. A score ≥10 may be best suited for differentiating between individuals with and without certain suicide risk factors. This scale shows promise for identifying Veterans who may be at increased risk of suicide.