The Rorschach suicide constellation: Assessing various degrees of lethality

J. Christopher Fowler, Craig Piers, Mark J. Hilsenroth, Daniel J. Holdwick, Justin R. Padawer

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


In this article we examine the relation between the Rorschach Comprehensive System's Suicide Constellation (S-CON; Exner, 1993; Exner & Wiley, 1977) and lethality of suicide attempts during the course of patients' hospitalization at the Austen Riggs Center (Stockbridge, MA). Patient records were rated as nonsuicidal (n = 37), parasuicidal (n = 37), or near-lethal (n = 30) based on the presence and lethality of self-destructive acts. Diagnostic efficiency statistics utilizing a cutoff score of 7 or more positive indicators successfully predicted which patients would engage in near-lethal suicidal activity relative to parasuicidal patients (overall correct classification rate [OCC] = .79), nonsuicidal inpatients (OCC = .79), and college students (OCC = .89). Although these predictions were influenced by relatively high base rates in the hospital population (14.5%), base rate estimates were calculated for other hypothetical populations revealing different prediction estimates that should be considered when judging the relative efficacy of the S-CON. Logistic regression analysis revealed that an S-CON score of 7 or more was the sole predictor of near-lethal suicide attempts among 9 psychiatric and demographic variables.

Original languageEnglish (US)
Pages (from-to)333-351
Number of pages19
JournalJournal of Personality Assessment
Issue number2
StatePublished - Apr 2001

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health
  • Health, Toxicology and Mutagenesis


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