1. J Relig Health. 2016 Jun;55(3):1010-23. doi: 10.1007/s10943-015-0167-6. Does Religiosity Mediate Suicidal Tendencies? A South African Study of Muslim Tertiary Students. Kazi TB(1), Naidoo S(2). Author information: (1)Discipline of Psychology, University of KwaZulu-Natal, Howard College Campus, Durban, 4041, South Africa. (2)Discipline of Psychology, University of KwaZulu-Natal, Howard College Campus, Durban, 4041, South Africa. naidoos15@ukzn.ac.za. Despite international studies into religion's protective mechanism against suicidal tendencies, within South Africa there is a paucity of research investigating this relationship. This quantitative study investigates the relationship between religiosity and suicidal tendencies in a sample of Muslim students (N = 111). Two scales were used to test the hypothesis that religion mediates suicidal tendency: the Religious Orientation Test and the Multi-Attitude Suicide Tendency Scale. The findings confirmed this hypothesis but disconfirmed our second hypothesis that there would be gender differences between the variables. We concluded that a high degree of religiosity acts as a protective mechanism against suicidal tendencies and discuss the implications of our findings. DOI: 10.1007/s10943-015-0167-6 PMID: 26661826 [PubMed - in process] 2. Child Adolesc Psychiatry Ment Health. 2012 Mar 30;6:12. doi: 10.1186/1753-2000-6-12. Non-suicidal self-injury (Nssi) in adolescent inpatients: assessing personality features and attitude toward death. Ferrara M(1), Terrinoni A, Williams R. Author information: (1)Department of Pediatrics and Child and Adolescent Neurology and Psychiatry, "Sapienza" University of Rome, Via dei Sabelli 108, 00185 Rome, Italy. mauro.ferrara@uniroma1.it. BACKGROUND: Non-suicidal self-injury (NSSI) is a common concern among hospitalized adolescents, and can have significant implications for short and long-term prognosis. Little research has been devoted on how personality features in severely ill adolescents interact with NSSI and "attitude toward life and death" as a dimension of suicidality. Developing more specific assessment methodologies for adolescents who engage in self-harm without suicidal intent is relevant given the recent proposal of a non-suicidal self-injury (NSSI) disorder and may be useful in predicting risk in psychiatrically impaired subjects. METHODS: Consecutively hospitalized adolescents in a psychiatric unit (N = 52; 71% females; age 12-19 years), reporting at least one recent episode of self-harm according to the Deliberate Self-harm Inventory, were administered the Structured Clinical Interview for DSM Mental Disorders and Personality Disorders (SCID I and II), the Children's Depression Inventory and the Multi-Attitude Suicide Tendency Scale (MAST). RESULTS: Mean age onset of NSSI in the sample was 12.3 years. All patients showed "repetitive" NSSI (high frequency of self-harm), covering different modalities. Results revealed that 63.5% of adolescents met criteria for Borderline Personality Disorder (BPD) and that the rest of the sample also met criteria for personality disorders with dysregulated traits. History of suicide attempts was present in 46.1% of cases. Elevated depressive traits were found in 53.8%. Results show a statistically significant negative correlation between the score on the "Attraction to Life" subscale of the MAST and the frequency and diversification of self-harming behaviors. CONCLUSIONS: Most adolescent inpatients with NSSI met criteria for emotionally dysregulated personality disorders, and showed a reduced "attraction to life" disposition and significant depressive symptoms. This peculiar psychopathological configuration must be addressed in the treatment of adolescent inpatients engaging in NSSI and taken into account for the prevention of suicidal behavior in self-injuring adolescents who do not exhibit an explicit intent to die. DOI: 10.1186/1753-2000-6-12 PMCID: PMC3342109 PMID: 22463124 [PubMed] 3. J Child Adolesc Ment Health. 2009 Jun;21(1):39-45. doi: 10.2989/JCAMH.2009.21.1.6.808. Preliminary validation of the Multi-Attitude Suicide Tendency (MAST) scale using a South African adolescent sample. Ramgoon S, Patel CJ, Paruk Z. OBJECTIVE: The factor structure of the Multi-Attitude Suicide Tendency (MAST) scale was examined using a sample of non-white South African adolescents. METHOD: The MAST scale was administered to 205 secondary school students between 13 and 20 years of age. RESULTS: The scale demonstrated satisfactory internal consistency with alpha values being in line with previous studies using the instrument. Factor analysis confirmed the original four-factor structure of the scale. Strong support was found for the Repulsion by Death (RD) and Attraction to Life (AL) subscales of the instrument, with moderate support for the Atttraction to Death (AD) and Repulsion by Life (RL) subscales. CONCLUSION: The authors conclude that the generalisability of the MAST can be improved by the inclusion of more culturally relevant items. DOI: 10.2989/JCAMH.2009.21.1.6.808 PMID: 25859639 [PubMed] 4. J Child Adolesc Ment Health. 2006 Oct;18(2):49-54. doi: 10.2989/17280580609486623. Could a healthy ego identity serve as a protective factor against suicidal tendencies? A pilot study. Ramgoon S, Bachoo S, Patel C, Paruk Z. OBJECTIVE: The study investigated the interrelationship between adolescent ego identity, suicidal tendencies, gender and race in a sample of South African Indian and Black secondary school students. METHOD: The Ego Identity Scale (EIS) and the Multi-attitude Suicide Tendency Scale (MAST) were administered to 63 learners between the ages of 15 and 20 years. RESULTS: Pearson correlations and t-tests were used to analyse the data. The results indicate that higher scores on the EIS correlate with lower suicidal tendencies for this sample. In addition, higher scores were recorded by females on the Attraction to Death subscale and by Black males on the Attraction to Death, Repulsion by Life and Repulsion by Death subscales of the MAST. CONCLUSION: The authors conclude that ego identity achievement is likely to serve as a protective factor against suicidal tendencies. DOI: 10.2989/17280580609486623 PMID: 25865205 [PubMed] 5. Assessment. 2004 Mar;11(1):73-84. Appropriateness of the Multi-Attitude Suicide Tendency Scale for non-White individuals. Gutierrez PM(1), Osman A, Kopper BA, Barrios FX. Author information: (1)Department of Psychology, Northern Illinois University, DeKalb 60115-2892, USA. pgut@niu.edu Analyses of data collected from 480 university students (approximately 56% White and 44% Black) challenge the utility of the Multi-Attitude Suicide Tendency Scale (MAST) for use with individuals of diverse cultural backgrounds. This size sample allowed for an examination of the psychometric properties and cultural relevance of the MAST for non-Whites. Correlations between scores on the MAST, suicide, and depression measures were in the expected directions for Whites but not for Blacks or Latinos. The White sample data fit the four-factor model of the MAST, but the model required several modifications to fit the data from the Black sample. Verification of the cultural relevance of the MAST and a revision of the scale are recommended to improve its usefulness. PMID: 14994956 [PubMed - indexed for MEDLINE] 6. Death Stud. 2004 Mar;28(2):91-110. Attitudes toward life and death among Chinese adolescents: the Chinese version of the multi-attitude suicide tendency scale. Wong WS(1). Author information: (1)Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China. Wongws@hku.hk The psychometric properties of the Chinese version of the Multi-Attitude Suicide Tendency Scale were examined in a sample of 415 Chinese adolescents. Confirmatory factor analyses of the present data disconfirmed the original 4-factor structure. Exploratory factor analysis was then conducted to explore the underlying structure of the data set. A revised 4-factor structure, with a number of differences in item factor loadings, was obtained for the present sample. The scale also demonstrated good internal consistency and convergent validity with the Depression Self-Rating Scale and Suicidal Behaviors Questionnaire. Distinct profiles of the scale were shown on non-suicidals, suicide ideators, and suicide attempters. Discrepant findings from previous work were discussed. DOI: 10.1080/07481180490264448 PMID: 14971409 [PubMed - indexed for MEDLINE] 7. East Afr Med J. 2000 Mar;77(3):165-7. Cross-cultural attitudes towards suicide among South African secondary school pupils. Peltzer K(1), Cherian VI, Cherian L. Author information: (1)Department of Psychology, University of the North, Private Bag X1106, Sovenga 0727, South Africa. OBJECTIVE: To investigate the attitudes towards suicide among Grade II secondary school pupils among three cultural groups in South Africa. DESIGN: Cross sectional study. SETTING: Grade II Secondary school pupils chosen at random from three urban schools in Pietersburg. PARTICIPANTS: The sample included 366 pupils, 150 (41%) males and 216 (59%) females, the mean age was 19.3 years (SD = 2.6), with a range from 17 to 24 years. The three cultural groups were 142 blacks, 112 whites and 112 Asians. MAIN OUTCOME MEASURES: Socioeconomic and family background (14 items), suicide data (4 items), and a 30-item Multi-Attitude Suicide Tendency Scale for Adolescents (MAST-12). RESULTS: Suicide ideation and plans to commit suicide are the highest among Asians, closely followed by Whites and lowest among Black pupils. The frequency of attempted suicide was lower among Blacks (11.3%) than that among Asians (13.5%) and Whites (13%). Analysis of variance indicated a significantly higher score among suicide attempters on attraction to death and repulsion by life and a significantly lower score on attraction to life and repulsion by death. Furthermore, this study found a significant correlation between total MAST, suicide ideation, suicide intent, history of completed suicide in family or friend, parents divorced, family size and suicide attempt. CONCLUSION: This study found differential effects across diverse ethnocultural adolescent groups for suicidal ideation, plants and attempts. This gives indications on how suicide prevention programmes can be constructed in culture-congenial ways. PMID: 12858894 [PubMed - indexed for MEDLINE] 8. Death Stud. 2001 Jun;25(4):319-40. Suicide risk factors for young adults: testing a model across ethnicities. Gutierrez PM(1), Rodriguez PJ, Garcia P. Author information: (1)Northern Illinois University, DeKalb, Illinois, USA. A general path model based on existing suicide risk research was developed to test factors contributing to current suicidal ideation in young adults. A sample of 673 undergraduate students completed a packet of questionnaires containing the Beck Depression Inventory, Adult Suicidal Ideation Questionnaire, and Multi-Attitude Suicide Tendency Scale. They also provided information on history of suicidality and exposure to attempted and completed suicide in others. Structural equation modeling was used to test the fit of the data to the hypothesized model. Goodness-of-fit indices were adequate and supported the interactive effects of exposure, repulsion by life, depression, and history of self-harm on current ideation. Model fit for three subgroups based on race/ethnicity (i.e., White, Black, and Hispanic) determined that repulsion by life and depression function differently across groups. Implications of these findings for current methods of suicide risk assessment and future research are discussed in the context of the importance of culture. DOI: 10.1080/07481180125994 PMID: 11803983 [PubMed - indexed for MEDLINE] 9. Death Stud. 2000 Dec;24(8):675-88. Exploration of the relationship between physical and/or sexual abuse, attitudes about life and death, and suicidal ideation in young women. Gutierrez PM(1), Thakkar RR, Kuczen C. Author information: (1)Northern Illinois University, DeKalb, USA. pgut@niu.edu Experiencing sexual and/or physical abuse at any point in one's life can be quite traumatic. In addition to the immediate effects of the abuse, numerous long-term consequences have been identified, including an increased risk of developing psychological disorders and attempting suicide. We sought to determine if a relationship exists between abuse experiences, attitudes about life and death, and suicidal ideation by surveying 644 college women between the ages of 18 and 24. Participants completed packets containing standardized abuse questionnaires, the Multi-Attitude Suicide Tendency Scale, and the Adult Suicidal Ideation Questionnaire. We concluded that abuse plays a role in how these young women think about life and death. Specifically, less repulsion by death and more repulsion by life were reported by women with more significant abuse histories. In addition, these same women endorsed higher levels of current suicidal ideation. It was also determined that women who had experienced more abuse tended to have been in therapy for longer periods of time. Implications of this study for mental health professionals working with suicidal young adults are discussed. DOI: 10.1080/074811800750036569 PMID: 11503717 [PubMed - indexed for MEDLINE] 10. Suicide Life Threat Behav. 2000 Winter;30(4):377-85. The multi-attitude suicide tendency scale: further validation with adolescent psychiatric inpatients. Osman A(1), Gilpin AR, Panak WF, Kopper BA, Barrios FX, Gutierrez PM, Chiros CE. Author information: (1)Department of Psychology, University of Northern Iowa, Cedar Falls 50614-0505, USA. augustine.osman@uni.edu The present study was designed to examine the construct validity and psychometric properties of the Multi-Attitude Suicide Tendency Scale in adolescent psychiatric inpatients. This new scale has four subscales: attraction to life, repulsion by life, attraction to death, and repulsion by death. Confirmatory factor analysis of the scale items provided support for the fit of the 28-item, four-factor model. Results of logistic regression analyses revealed that high scores on the repulsion by life and the attraction to death subscales were useful in assessing the risk for suicide attempts. Results of the hierarchical regression analysis showed that high repulsion by life and low attraction to life subscale scores contributed to the prediction of scores on the suicide probability scale. We also examined gender differences on the four subscales and the psychological correlates of each subscale. PMID: 11210063 [PubMed - indexed for MEDLINE] 11. Death Stud. 1999 Jun;23(4):359-70. Suicidality in parentally bereaved adolescents. Gutierrez PM(1). Author information: (1)Northern Illinois University, DeKalb, USA. The purpose of the study was to examine the effects on suicidality of exposure to suicidal behavior in other people, depression, parent perceptions, and attitudes about life and death in a sample of 25 parentally bereaved teens. Participants participated in face-to-face interviews and completed the Reynolds Adolescent Depression Scale, Suicidal Ideation Questionnaire, Multi-Attitude Suicide Tendency Scale, and the Parent Perception Inventory. These adolescents were not clinically depressed, did not express serious levels of suicidal ideation, and had relatively minor histories of suicidality. However, significant relationships were found between attitudes, exposure, depression, and suicidality in partial support of previous research. Ways in which this study extend our knowledge of bereaved teens and recommendations for future research are discussed. DOI: 10.1080/074811899201000 PMID: 10558430 [PubMed - indexed for MEDLINE] 12. Death Stud. 1996 Nov-Dec;20(6):601-10. Suicidality, hopelessness, and attitudes toward life and death in clinical and nonclinical adolescents. Cotton CR(1), Range LM. Author information: (1)University of Southern Mississippi, Hattiesburg, USA. To see if hopelessness and four attitudes (attraction to life and death and repulsion by life and death) account for the development of suicidality in children, 15 adolescent psychiatric inpatients and 84 middle and high school students, average age 15.2 years, took a four-item version of the Suicidal Behaviors Questionnaire, the Hopelessness Scale for Children (HSC), and the Multi-Attitude Suicide Tendency Scale for Adolescents (MAST-A). Profiles on the four attitudes differentiated adolescents at risk for suicide from those not at risk. Suicidality was negatively related to Attraction to Death and positively related to Repulsion by Life, Attraction to Death, Repulsion by Death, and hopelessness. Hopelessness was negatively related to Attraction to Life, and positively related to Repulsion by Life and Repulsion by Death. The best predictors of suicidality were hopelessness and Repulsion by Life. Results imply that reducing feelings of rejection by their families might lessen suicidality in adolescents. DOI: 10.1080/07481189608252765 PMID: 10169709 [PubMed - indexed for MEDLINE] 13. J Clin Psychol. 1994 Nov;50(6):847-55. Validation of the Multi-Attitude Suicide Tendency scale in adolescent samples. Osman A(1), Barrios FX, Panak WF, Osman JR, Hoffman J, Hammer R. Author information: (1)Department of Psychology, University of Northern Iowa, Cedar Falls 50614-0505. The present study extended research on the factor structure and psychometric properties of the Multi-Attitude Suicide Tendency scale (MAST). A mixed sample of 215 adolescents, aged 15 to 18 years, participated in the study. Exploratory principal-components analysis of the 30 MAST items provided support for the four-factor structure of the scale: attraction toward and repulsion by life and death. The MAST subscales showed satisfactory levels of internal consistency. Specific and subset of the MAST subscales were identified for differentiating among adolescents who differed in degrees of psychopathology and suicidal behavior. Correlational and regression analyses examined the relations among the MAST subscales and self-report measures of suicidal behavior, social desirability, and general psychopathology. Limitations and suggestions for future research are discussed. PMID: 7896918 [PubMed - indexed for MEDLINE] 14. J Clin Psychol. 1993 Sep;49(5):701-8. The Multi-Attitude Suicide Tendency Scale: psychometric characteristics in an American sample. Osman A(1), Barrios FX, Grittmann LR, Osman JR. Author information: (1)Department of Psychology, University of Northern Iowa, Cedar Falls 50614-0505. The Multi-Attitude Suicide Tendency Scale (MAST) was designed to assess suicidal tendencies in youth. This 30-item scale has four types of attitudes: attraction to life, repulsion by life, attraction to death, and repulsion by death. Normative, factor structure, and psychometric data were investigated with American youth with a range of suicidal ideations and behaviors. The reported factor structure was replicated with American youths. In addition, all four factor scales showed good reliability estimates. Finally, the relationships among the MAST factors and measures of suicidal behavior and ideation, social desirability, and general psychopathology were examined. PMID: 8254078 [PubMed - indexed for MEDLINE]