Turkish Adaptation of the Psychological Strain Scale in a Non-Clinical Sample of Emerging Adults

Abstract

Suicidal behavior is a severe global health problem. For the period of emerging adulthood in particular, it represents the second-leading cause of death, followed by unintentional injuries. Therefore, there is an urgent need to develop/diversify the methods and tools that can detect the factors that make individuals vulnerable to experiencing suicidal thoughts. Strain Theory of Suicide (STS), which aims to explain socio-psychological agencies preceding suicidal behavior, hypothesizes that opposing and rivaling pressures coming from four sources (i.e., value, aspiration, deprivation, and coping) lead to suicidal behavior. In light of the premises offered by the STS, the present study aimed to adapt the Psychological Strain Scale (PSS) in Turkish and test its validity and reliability in a non-clinical sample of emerging adults. Participants were emerging adults whose ages ranged between 18 and 29. Three-hundred-ninety-eight individuals (60.05% of women) filled out the survey package consisting of the Depression, Anxiety, and Stress Scale, Psychological Strain Scale, Suicide Probability Scale, Rosenberg Self-Esteem Scale, and Marlowe-Crowne Social Desirability Scale. Construct and concurrent validity evidence was ensured by exploring the factor structure of the instrument through Confirmatory Factor Analysis (CFA) and by investigating the relationship between the scores obtained from PSS and other criterion measures. Reliability evidence was ensured through the internal consistency method. Multigroup analysis indicated that the factor structure of the PSS was invariant across gender. The results of the psychometric testing offered tangible evidence for the usefulness of the PSS as a measure of vulnerability to suicidal thoughts among emerging adults.

Keywords

• suicide
• strain theory of suicide
• emerging adulthood
• scale adaptation
• Türkiye

References

1. Atak, H., & Çok, F. (2010). İnsan yaşamında yeni bir dönem: Beliren yetişkinlik [A new period in human life: Emerging adulthood]. Journal of Childhood and Adolescence Mental Health, 17(1), 39-50.
2. Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469–480. https://doi.org/10.1037/0003-066X.55.5.469
3. Babeva, K., Hughes, J. L., & Asarnow, J. (2016). Emergency department screening for suicide and mental health risk. Current Psychiatry Reports, 18(11), 100. https://doi.org/10.1007/s11920-016-0738-6
4. Bakır, A. & Haskan-Avcı, Ö. (2023). The cultural closet: Masculinity tested by sexuality in Turkey [Paper presentation]. 6th International Conference on Gender Research, 20-21 April, Derry-Londonderry, Northern Ireland.
5. Baumgartner, H., & Homburg, C. (1996). Applications of structural equation modeling in marketing and consumer research: A review. International Journal of Research in Marketing, 13(2),139–161. https://doi.org/10.1016/0167-8116(95)00038.
6. Bilsen J. (2018). Suicide and youth: Risk factors. Frontiers in Psychiatry, 9, 540. https://doi.org/10.3389/fpsyt.2018.00540
7. Borges, G., Angst, J., Nock, M. K., Ruscio, A. M., & Kessler, R. C. (2008). Risk factors for the incidence and persistence of suicide-related outcomes: A 10-year follow-up study using the National Comorbidity Surveys. Journal of Affective Disorders, 105(1–3), 25–33. https://doi.org/10.1016/j.jad.2007.01.036.
8. Centers for Disease Control and Prevention [CDC] (2021). Suicide prevention. https://www.cdc.gov/suicide/index.html.

9. Cerel, J., Brown, M. M., Maple, M., Singleton, M., van de Venne, J., Moore, M., & Flaherty, C. (2019). How many people are exposed to suicide? Not six. Suicide & Life-Threatening Behavior, 49(2), 529–534. https://doi.org/10.1111/sltb.12450
10. Cheung, G.W. & Rensvold, R.B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9, 233-255. https://doi.org/10.1207/S15328007SEM0902_5
11. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Erlbaum.
12. Crosby, A. E., Han, B., Ortega, L. A., Parks, S. E., Gfroerer, J., & Centers for Disease Control and Prevention [CDC] (2011). Suicidal thoughts and behaviors among adults aged ≥18 years--United States, 2008-2009. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C.: 2002), 60(13), 1–22.
13. Crowne, D. P., & Marlowe, D. (1960). A new scale of social desirability independent of psychopathology. Journal of Consulting Psychology, 24(4), 349–354. https://doi.org/10.1037/h0047358
14. Çuhadaroğlu, Ö. (1986). Adolesanlarda benlik saygısı [Self-esteem in adolescents]. [Unpublished doctoral dissertation], Hacettepe University.
15. Cull, J. G. & Gill, W. S. (1982). Suicide probability scale (SPS) [Database record]. APA PsycTests. https://doi.org/ 10.1037/t01198-000
16. DiBlasi, E., Kang, J., & Docherty, A. R. (2021). Genetic contributions to suicidal thoughts and behaviors. Psychological Medicine, 51(13), 2148–2155. https://doi.org/10.1017/S0033291721001720
17. Durkheim, E. (2005). Suicide: A study in sociology (Spaulding, J. A. & Simpson, G., Trans). Taylor & Francis. (Original work published in 1897).
18. Eskin, M. (1999). Gender and cultural differences in the 12-month prevalence of suicidal thoughts and attempts in Swedish and Turkish adolescents. Journal of Gender, Culture, and Health 4, 187–200. https://doi.org/10.1023/A:1023277231880.
19. Evcili, F., & Gölbaşı, Z. (2019). The effect of peer education model on sexual myths of Turkish university students: An interventional study. Perspectives in Psychiatric Care, 55(2), 239–248. https://doi.org/10.1111/ppc.12344
20. Fisher, R. & Katz, J. (2000). Social desirability bias and the validity of self-reported values. Psychology & Marketing, 17(2), 105-120. https://doi.org/10.1002/(SICI)1520-6793(200002)17:2<105::AID-MAR3>3.0.CO;2-9
21. Fraenkel, J. R., Wallen, N. E., & Hyun, H. H. (2012). How to design and evaluate research in education. McGraw-Hill Education.
22. Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., Musacchio, K. M., Jaroszewski, A. C., Chang, B. P., & Nock, M. K. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 143(2), 187–232. https://doi.org/10.1037/bul0000084
23. Haghish, E.F., Nes, R.B., Obaidi, M., Qin, P., Stanicke, L. I., Bekkhus, M., Laeng, B. & Czajkowski, N. (2024). Unveiling adolescent suicidality: Holistic analysis of protective and risk factors using multiple machine learning algorithms. Journal of Youth Adolescence, 53(3), 507–525. https://doi.org/10.1007/s10964-023-01892-6
24. Hair, J. F., Babin, B. J., Black, W. C. & Anderson, R. E. (2019). Multivariate data analysis (8th ed.). Cengage.
25. Henry, J. D. & Crawford, J. R. (2005). The short-form version of the depression anxiety stress scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(2), 227–239. https://doi.org/10.1348/014466505X29657
26. Joiner, T. E. (2005). Why people die by suicide. Harvard University Press.
27. Katz, C., Bolton, J., & Sareen, J. (2016). The prevalence rates of suicide are likely underestimated worldwide: Why it matters. Social Psychiatry and Psychiatric Epidemiology, 51(1), 125–127. https://doi.org/10.1007/s00127-015-1158-3
28. King, C. A., Arango, A., & Ewell Foster, C. (2018). Emerging trends in adolescent suicide prevention research. Current Opinion in Psychology, 22, 89–94. https://doi.org/10.1016/j.copsyc.2017.08.037
29. Kline, R. B. (2011). Principles and practice of structural equation modeling (3rd ed.). Guilford Press.
30. Klonsky, E. D., & May, A. M. (2014). Differentiating suicide attempters from suicide ideators: A critical frontier for suicidology research. Suicide & Life-Threatening Behavior, 44(1), 1–5. https://doi.org/10.1111/sltb.12068
31. Klonsky, E. D., Dixon-Luinenburg, T., & May, A. M. (2021). The critical distinction between suicidal ideation and suicide attempts. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 20(3), 439–441. https://doi.org/10.1002/wps.20909
32. Lilly, K. J., Sibley, C. G., & Osborne, D. (2023). Perceived relative deprivation across the adult lifespan: an examination of aging and cohort effects. Personality and Social Psychology Bulletin, 0(0). https://doi.org/10.1177/01461672231195332
33. Liu, Y., Zhang, J., Hennessy, D. A., Zhao, S., & Ji, H. (2019). Psychological strains, depressive symptoms, and suicidal ideation among medical and non-medical staff in urban China. Journal of Affective Disorders, 245, 22–27. https://doi.org/10.1016/j.jad.2018.10.111
34. Lyu, J., Zhang, J. & Sun, L. (2020). Stronger psychological strains increase the odds of suicide death: A comparison between suicides and suicide attempters. Comprehensive Psychiatry, 103(5). https://doi.org/10.1016/j.comppsych.2020.152205
35. Martinez-Ales, G., Hernandez-Calle, D., Khauli, N., & Keyes, K. M. (2020). Why are suicide rates increasing in the United States? Towards a multilevel reimagination of suicide prevention. Current Topics in Behavioral Neurosciences, 46, 1–23. https://doi.org/10.1007/7854_2020_158
36. O'Connor, R. C. & Kirtley, O. J. (2018). The integrated motivational–volitional model of suicidal behaviour. Philosophical Transactions of the Royal Society B: Biological Sciences, 373(1754). https://doi.org/10.1098/rstb.2017.0268.
37. Rosenfield, S., & Smith, D. (2009). Gender and mental health: Do men and women have different amounts or types of problems? In T. Scheid & T. Brown (Eds.), A Handbook for the Study of Mental Health: Social Contexts, Theories, and Systems (pp. 256-267). Cambridge University Press. https://doi.org/10.1017/CBO9780511984945.017
38. Schumacker, R. E., & Lomax, R. G. (2010). A beginner’s guide to structural equation modeling (3rd ed.). Routledge.
39. Selin, J. & Lind, K. (2023). Gambling, social integration and sources of strain in cases of suicide: Exploring police investigation reports. Addiction Research & Theory. https://doi.org/10.1080/16066359.2023.2224965
40. Shoib, S., Armiya'u, A. Y., Nahidi, M., Arif, N., & Saeed, F. (2022). Suicide in Muslim world and way forward. Health Science Reports, 5(4), e665. https://doi.org/10.1002/hsr2.665
41. Stanley, B., & Brown, G. K. (2012). Safety planning intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256–264. https://doi.org/10.1016/j.cbpra.2011.01.001
42. Sun, L., & Zhang, J. (2016). Psychological strains and suicidal intent: An empirical study to relate the two psychopathological variables. The Journal of Nervous and Mental Disease, 204(11), 855–860. https://doi.org/10.1097/NMD.0000000000000529
43. Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics. (6th ed.). Pearson/Allyn & Bacon.
44. The World Bank (2023). Poverty & equality brief: Europe & Central Asia, Türkiye, April 2023. https://databankfiles.worldbank.org/public/ddpext_download/poverty/987B9C90-CB9F-4D93-AE8C-750588BF00QA/current/Global_POVEQ_TUR.pdf
45. Türkiye İstatistik Kurumu [TÜİK]. (2023). İntihar İstatistikleri [Suicide statistics]. https://data.tuik.gov.tr/Search/Search?text=intihar&dil=1
46. Ural, T & Özbirecikli, M. (2006). Is ethical judgement influenced by social desirability in responding? An analyse on Turkish accountants. Çukurova Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 15(1), 393-410.
47. Victor, S. E., & Klonsky, E. D. (2014). Correlates of suicide attempts among self-injurers: A meta-analysis. Clinical Psychology Review, 34(4), 282–297. https://doi.org/10.1016/j.cpr.2014.03.005
48. World Health Organization (2021). Suicide worldwide in 2019: Global health estimates. World Health Organization. https://www.who.int/publications/i/item/9789240026643
49. Yan, T. (2021). Consequences of asking sensitive questions in surveys. Annual Reviews of Statistics and Its Applications, 8(1), 109-127. https://doi.org/10.1146/annurev-statistics-040720-033353
50. Yılmaz, Ö., Boz, H. & Arslan, A. (2017). Depresyon anksiyete stres ölçeğinin (DASS-21) Türkçe kısa formunun geçerlilik-güvenilirlik çalışması [The validity and reliability of depression stress and anxiety scale (DASS-21) Turkish short form]. Finans Ekonomi ve Sosyal Araştırmalar Dergisi, 2(2), 78-91.
51. Zhang, J. (2012). A strain theory of suicide. In A. Shrivastava, M. Kimbrell, & D. Lester (Eds.), Suicide from a global perspective: Psychosocial Perspectives (pp. 119–125). Nova Science.
52. Zhang, J. (2016). From psychological strain to disconnectedness. Crisis, 37(3), 169–175. https://doi.org/10.1027/0227-5910/a000420
53. Zhang, J. (2019). The strain theory of suicide. Journal of Pacific Rim Psychology, 13, Article e27. https://doi.org/10.1017/prp.2019.19
54. Zhang, J. & Lester, D. (2008) Psychological tensions found in suicide notes: A test for the strain theory of suicide. Archives of Suicide Research, 12(1), 67-73. https://doi.org/10.1080/13811110701800962
55. Zhang, J., & Lyu, J. (2014). Reliability, validity and preliminary hypothesis tests for the English version of the Psychological strain scales (PSS). Journal of Affective Disorders, 164, 69–75. https://doi.org/10.1016/j.jad.2014.04.011
56. Zhang, J., & Tao, M. (2013). Relative deprivation and psychopathology of Chinese college students. Journal of Affective Disorders, 150(3), 903–907. https://doi.org/10.1016/j.jad.2013.05.013
57. Zhang, J., Dong, N., Delprino, R., & Zhou, L. (2009). Psychological strains found from in-depth interviews with 105 Chinese rural youth suicides. Archives of Suicide Research, 13(2), 185–194. https://doi.org/10.1080/13811110902835155
58. Zhang, J., Kong, Y., Gao, Q., & Li, Z. (2013). When aspiration fails: A study of its effect on mental disorder and suicide risk. Journal of Affective Disorders, 151(1), 243–247. https://doi.org/10.1016/j.jad.2013.05.092
59. Zhang, J., Liu, Y., & Sun, L. (2017a). Psychological strain and suicidal ideation: A comparison between Chinese and US college students. Psychiatry Research, 255, 256-262. https://doi.org/10.1016/j.psychres.2017.05.046
60. Zhang, J., Liu, Y., & Sun, L. (2017b). Life satisfaction and degree of suicide intent: A test of the strain theory of suicide. Comprehensive Psychiatry, 74, 1–8. https://doi.org/10.1016/j.comppsych.2016.12.002
61. Zhang, J., Wang, W., Huen, J. M. Y., Lyu, J., & Lew, B. (2022). Towards higher psychometric properties: testing the psychological strain scales with larger samples. Archives of Suicide Research, 26(2), 912–927. https://doi.org/ 10.1080/13811118.2020.1847707