Suicide and Life-Threatening Behavior © 2014 The American Association of Suicidology DOI: 10.1111/sltb.12108

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Validation of the Suicide Resilience Inventory-25 with American and Chinese College Students QIJUAN FANG, MA, STACEY FREEDENTHAL, PHD, LCSW,

AND

AUGUSTINE OSMAN,PHD

This study is the first to evaluate evidence for measurement invariance and the psychometric properties of the Suicide Resilience Inventory-25 (SRI25; Osman et al., 2004) in college-age samples in both the United States and China. We found strong support for full measurement invariance of the threefactor structure of the SRI-25 in the U.S. (113 men and 238 women) and Chinese (121 men and 205 women) samples. In addition, we found that the U.S. sample scored significantly higher than the Chinese sample on all the individual scale scores. Composite scale reliability estimates ranged from moderate (q = .83) to high (q = .93) across the groups. Although not an aim of the current study, we examined estimates of internal consistency of the SRI-25 scales for men and women within each sample. Differential correlates of the SRI-25 scales were explored further for each sample. These results provide support for the use of the SRI-25 in U.S. and Chinese student samples.

Suicide constitutes a major social problem worldwide. Almost one million people die by suicide annually (Bertolote, 2001), including 100,000 adolescents (World Health Organization [WHO], 1998). China accounts for more than 30% of the world’s suicides and has a distinctive pattern of suiQIJUAN FANG, Psychology Department, Bowling Green State University, Bowling Green, OH, USA; STACEY FREEDENTHAL, Department of Social Work, University of Denver, Denver, CO, USA; AUGUSTINE OSMAN, Psychology Department, The University of Texas at San Antonio, San Antonio, TX, USA. The authors are grateful to Yang Qing, PhD, a professor at Shenzhen University in China, for assisting with data collection. We also appreciate the research assistants who were involved in data collection and the students who participated in the study. Address correspondence to Qijuan Fang, Psychology Department, Bowling Green State University, 5001 E Wooster St., Bowling Green, OH 43402; E-mail: [email protected]

cide rates (Yip, Liu, Hu, & Song, 2005). The international suicide rate in 1998 was 16.1 per 100,000 (WHO, 1999). In contrast, China’s estimated average suicide rate from 1995 to 1999 was 23 per 100,000, and suicide is responsible for 287,000 deaths each year (Phillips, Li, & Zhang, 2002). Suicide is the leading cause of death in China among people ages 15 to 34 years and continues to be the fifth leading cause of death in the general population (Zhang et al., 2004). Research has been conducted to examine the risk and protective factors for suicide in both China and the United States, although more research has been focused on examining suicide risk factors. The risk factors for suicide in both China and the United States include hopelessness and depressed moods (Stewart, Kennard, & Lee, 2005; Stewart, Lam, & Betson, 1999); social-interpersonal stressors, low selfesteem, and negative attitudes toward life

2 (Phillips et al., 2002; Zhang & Jin, 1996); and favorable attitudes toward suicide (Domino, Su, & Lee Johnson, 2002). The protective factors for suicide across these two cultures include resilience, adaptive coping, and positive attitudes toward life (Phillips et al., 2002; Zhang & Jin, 1996). Studies that focus on cross-cultural validation of assessment instruments can provide valuable information regarding the equivalence of suicide-related constructs across cultures (Lonner & Ibrahim, 1996). Empirical support of psychometric scales across cultures has received limited attention in the suicide measurement literature. In fact, only a few studies have evaluated instruments that assess specific risk or protective factors (e.g., psychological wellbeing, suicide ideation, and attitudes toward life and death) for cross-cultural investigations (Chang, Lin, Chou, Ma, & Yang, 2009; Fu, Liu, & Yip, 2007; Wong, 2004; Zhang & Brown, 2007; Zhang & Norvilitis, 2002). Specifically, the Scale for Suicide Ideation (SSI; Beck, Kovacs, & Weissman, 1979) was found to have adequate psychometric properties among Chinese high school and college students (Zhang & Brown, 2007; Zhang & Norvilitis, 2002). Wong (2004) examined the Multi-Attitude Suicide Tendency Scale (MAST; Orbach et al., 1991) in adolescents in Hong Kong. The study failed to confirm the original four-factor structure of the MAST and consequently dropped two items. The revised Chinese Multi-Attitude Suicide Tendency Scale (CMAST) showed good internal consistency and convergent validity estimates (Wong, 2004). The Chinese version of the Adult Suicidal Ideation Questionnaire (Reynolds, 1991) was found to have satisfactory internal reliability, convergent validity, factorial validity, and predictive validity (Fu et al., 2007). The Chinese version of the Positive and Negative Suicide Ideation Inventory (Osman, Gutierrez, Kopper, Barrios, & Chiros, 1998) was found to have satisfactory test–retest reliability and convergent and divergent validities (Chang et al., 2009) in Chinese adoles-

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cents. Although these scales have demonstrated adequate psychometric properties, they mostly focus on risk factors instead of protective factors for suicide. Cross-cultural studies of resilience in China also are uncommon. In one such study, Yu et al. (2011) adapted the 25-item Connor-Davidson Resilience Scale (CDRISC) to Chinese culture and administered it to 2,914 Chinese adolescents who experienced the Sichuan earthquake in China in 2008. The study replicated the five-factor model found in previous studies; the Cronbach’s a coefficient for the total scale was adequate (.89). However, Cronbach’s a for four of five factors were lower than .7 (.50 to .66), and the last factor, spiritual influences, was not significantly correlated with depression and anxiety. The items in this factor may also be interpreted differently by Chinese adolescents (Yu et al., 2011). In another study of the resilience construct in China, the 10-item CD-RISC was administered to 341 Chinese participants from a psychological relief program supported by the Institute of Psychology, Chinese Academy of Sciences, following the Sichuan earthquake in 2008. This shorter version of CD-RISC demonstrated good internal reliability (Cronbach’s a = .91) and test–retest reliability (r = .90) over a 2-week period. However, each scale only contains two items (Wang, Shi, Zhang, & Zhang, 2010). To our knowledge, there is no resilience scale specifically related to suicide that has been validated in the Chinese population. Accordingly, in the present investigation we focused on evaluating the responses of U.S. and Chinese student samples on a self-report measure of resilience, the Suicide Resilience Inventory-25 (SRI-25; Osman et al., 2004). The construct of resilience, conceptualized by Osman et al. as perceived ability to cope with suicidal thoughts, availability of external resources, and self-rated competency when faced with stressful situations, is regarded widely in Chinese and U.S. cultures as an important protective factor (Almedom & Glandon, 2007; Chan, Lai, & Wong, 2006; Chen &

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Chen, 2004; Seligman & Csikszentmihalyi, 2000). Osman et al. developed the SRI-25 to assess three dimensions of the resilience construct: internal protective factors, external protective factors, and emotional stability factors. The internal protective dimension of the SRI-25 is conceptualized as those positive intrapersonal characteristics and beliefs of the individual that minimize the risk for suicide-related behavior. The external protective dimension represents perceived emotional support in difficult life situations, and the emotional stability dimension represents the ability of the individual to handle specific life difficulties when experiencing negative or unbearable emotions. In support of these domains, Osman et al. extracted a three-factor solution in a sample of 540 U.S. high school and college students. Subsequently, Rutter, Freedenthal, and Osman (2008) reported confirmatory factor analysis findings in support of the latent structure of the SRI-25 in a sample of 241 U.S. college students. Several items of the individual SRI-25 dimensions or scales have relevancy in U.S. and Chinese cultures. As an example, an item of the internal protective dimension, “There are many things that I like about myself (Item 1),” evaluates common protective factors such as self-esteem and optimism that are relevant in U.S. and Chinese cultures (Chen & Zhang, 2004; Hermann & Betz, 2006; Hirsch & Conner, 2006). An item designed to evaluate the external protective dimension, “People close to me would find time to listen, if I were to talk seriously about killing myself (Item 3),” highlights the need for social support, which is valued in both U.S. and Chinese cultures (Fu, Watkins, & Hui, 2004; Rutter, 1987; Seligman & Csikszentmihalyi, 2000; Zhang & Norvilitis, 2002). In addition, Item 12 (“I can resist thoughts of killing myself when faced with a difficult or life-threatening situation”) of the emotional stability dimension represents the expectation in both cultures of handling emotionally laden situations (Hall, Platt, & Hall, 1999; Pearson, Phillips,

3 He, & Ji, 2002; Simon et al., 2001; Zhang, Che, & Li, 2005). Thus, it appears that dimensions that are composed of a relevant set of items of the resilience construct might be useful for assessing this construct in U.S. and Chinese college-age samples. To date, however, the SRI-25 has gained empirical support only in U.S. samples (Fang, Choma, Salvatore, Bailey, & Osman, 2006; Gutierrez, Freedenthal, Wong, Osman, & Norizuki, 2012; Osman et al., 2004; Rutter et al., 2008). To remedy this gap in the literature, we examined evidence for the measurement invariance and psychometric properties of the SRI-25 in U.S. and Chinese college student samples. The first goal of the current study was to establish measurement invariance of the factor structure of the SRI-25 across U.S. and Chinese samples. The second goal was to examine evidence for cross-cultural differences and similarities in latent variable means for the SRI-25 total and subscales. Indeed, empirical support for measurement invariance and specific group responses (i.e., differences and similarities) in latent means of the SRI-25 scale scores would enhance our understanding of the dimensions of the resilience construct across independent cultural groups. It also would establish the SRI-25 as an empirically useful instrument for cross-cultural investigations (Lonner & Ibrahim, 1996). The third goal of the current study was to reexamine estimates of internal consistency reliability for scores on the SRI-25 scales. Unlike Osman et al. (2004), however, we used a contemporary scale reliability estimation procedure (Brown, 2006; Raykov, 1997). Using the traditional procedure, Osman et al. reported estimates of internal consistency reliability for the SRI25 scales that ranged from moderate (coefficient a = .86) to high (coefficient a = .96) for scores on the SRI-25 in the instrument development samples. Likewise, Rutter et al. (2008) reported a coefficient a estimate of .92 for the Internal Protective, .92 for the Emotional Stability, and .86 for the External Protective scale scores.

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Psychometric evaluation of the SRI-25 has also involved demonstrating its associations with measures of relevant constructs such as hopelessness, perceived social support, and suicidal ideation (Fang et al., 2006; Osman et al., 2004; Rutter et al., 2008). In the current study we likewise examined associations of the SRI-25 scale scores with measures assessing related constructs, such as prior suicidal behavior and attitudes (protective and risk) toward life and death. Of note is that there was no self-report measure of the resilience construct for use with Chinese college-age samples at the time of data collection.

METHOD

Participants Participants were recruited from psychology classes at separate medium-sized universities in a southern urban Chinese city and a smaller city in the midwestern United States. Extra credits were provided as incentives only for the U.S. participants because in the Chinese university, there was no extra credit system at the time of data collection. The samples are as follows. U.S. Sample. The U.S. sample included 113 men and 238 women ranging in age from 18 to 46 years (M = 18.78, SD = 1.77). This sample was composed of 334 (95.1%) Caucasians, 6 (1.7%) African Americans, 3 (0.9%) Hispanics/Latinos, 5 (1.4%) biracial people, and 3 (0.9%) people from other ethnic groups. Men and women did not differ significantly in age, t(349) = .89, p = .37. The gender ratio represents the gender distribution in this university introductory psychology pool from which the participants were recruited. Of this sample, 272 (77.5%) were freshmen, 46 (13.1%) sophomores, 18 (5.1%) juniors, and 15 (4.3%) seniors. Chinese Sample. A total of 347 questionnaires packets were originally collected from the Chinese sample. We excluded 21 questionnaires due to missing information.

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As a result, the Chinese sample included 121 male and 205 female students with a mean age of 20.53 years (SD = 1.24, range = 18 to 25). The Chinese sample (M age = 20.53) was significantly older than the U.S. sample (M age = 18.78), t(669) = 14.67, p < .001. The gender ratio in this sample was not significantly different from the U.S. sample (v2 = 1.81, p = .18). Almost all participants (n = 323; 99.1%) were from the Han nationality (the biggest nationality in China), and 3 (0.9%) students were from minority nationalities in China. Different from the U.S. sample, Chinese male participants were significantly older than female participants, t(319) = 6.55, p < .001. The participants were students in a large public university psychology course, and the gender ratio in this study also represents the gender distribution in a typical psychology class in China. The sample contained 134 (41.1%) students who were freshmen in college, 131 (40.2%) sophomores, 52 (16%) juniors, 3 (0.9%) seniors, and 1 (0.3%) student in the fifth year (this is the student who cannot finish in 4 years). Measures and Procedures Because the Chinese university did not have an institutional review board, the research protocol was approved by the institutional review board at the midwestern university where the study took place in the United States. The informed consent was translated to Chinese and collected from Chinese students. Both the U.S. and Chinese participants completed the approved informed consent forms and then completed a package of self-report questionnaires in group settings with the presence of research assistants. The questionnaires were arranged in counterbalanced order. The American students received the English versions of the SRI-25 (Osman et al., 2004), the MAST (Orbach et al., 1991), and the Suicidal Behaviors Questionnaire-Revised (SBQ-R; Osman et al., 2001); the Chinese students received the Chinese versions of the same instruments. The study used a Chinese version of the MAST translated by Wong (2004).

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The first author translated the SRI25 (Osman et al., 2004) and the SBQ-R (Osman et al., 2001) into Chinese. Following the translations, a Chinese graduate student who has excellent English skills and did not have detailed information about the purpose of this study translated the Chinese versions back to English. Subsequently, the original and back-translated versions were compared, and appropriate changes were made to make the Chinese versions equivalent to the English versions. To confirm the translations and their comprehensiveness, a pilot study was run to examine whether the SRI-25 was worded appropriately and could be understood easily by Chinese native speakers. Twenty students were recruited from a southern Chinese university and were asked to judge whether each sentence was precise and easy to understand. If not, they were asked to give suggested changes. Only minimal changes were needed (see Appendix S1 for the Chinese version of the SRI-25). Suicide Resilience Inventory-25. The SRI-25 (Osman et al., 2004) was the primary measure used in the current study. It was used to evaluate three dimensions of the suicide resilience construct: Internal Protective (IP), External Protective (EP), and Emotional Stability (ES) (descriptions of the subscales, as well as sample items, are described earlier in this article). The scale requires a 7th- to 8th-grade reading level. Response options on the SRI-25 range from 1 (Strongly Disagree) to 6 (Strongly Agree), representing lowest level to highest level of resilience; the scale score reflects the mean item score. As noted earlier, Osman et al. (2004) reported that this inventory has an established factor structure and moderate to high internal consistency reliability estimates. Johnson (2004) found that the SRI-25 has good validity and reliability estimates for African American college students. The SRI-25 was also found to have good internal consistency (a = .96; average interitem correlation [AIC] = .49) and concurrent validity in adolescent inpatient samples (Fang et al., 2006). For the current U.S. sample, composite scale reliability

5 estimates of the SRI and its subscales were adequate: total (q = .93; 95% CI = .92–.95), IP (q = .92; 95% CI = .91–.94), ES (q = .89; 95% CI = .87–.91), and EP (q = .83; 95% CI = .80–.87). Similarly, for the Chinese sample, reliability estimates were good for the total and subscale scores: total (q = .90; 95% CI = .89–.92), IP (q = .88; 95% CI = .85–.90), ES (q = .86; 95% CI = .83–.89), and EP (q = .85; 95% CI = .81–.87). Multi-Attitude Suicide Tendency Scale. The MAST (Orbach et al., 1991) was used to assess individuals’ attitudes toward life and death. This measure contains 30 items and four subscales: Attraction to Life (AL), Repulsion by Life (RL), Attraction to Death (AD), and Repulsion by Death (RD). Except for the RD subscale (which has nine items), all other subscales include seven items. The five response options range from 1 (Totally Disagree) to 5 (Totally Agree). The internal consistency reliability estimates for each scale of the MAST have been satisfactory (i.e., coefficient a values ≥ .70; Orbach et al., 1991). Orbach et al. also found that the MAST significantly differentiated suicidal and nonsuicidal groups, suicide ideators and attempters, and suicidal inpatients and outpatients (ps < .001). Among the four subscales, only the RD scores failed to differentiate between these groups. Wong (2004) has dropped two items from the original scale and modified the factor structure. As a result, the Chinese version of the MAST (CMAST) showed good internal consistency and convergent validity (Wong, 2004). For the current U.S. sample, composite scale reliability estimates of the MAST subscales were adequate: AL (q = .82; 95% CI = .78–.84), RL (q = .74; 95% CI = .68–.79), AD (q = .76; 95% CI = .71–.79), and RD (q = .86; 95% CI = .83–.88). Similarly, for the Chinese sample, reliability estimates were good for all the subscale scores: AL (q = .83; 95% CI = .79–.87), RL (q = .77; 95% CI = .71–.80), AD (q = .73; 95% CI = .68–.77), and RD (q = .90; 95% CI = .87–.91).

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Suicidal Behaviors QuestionnaireRevised. The SBQ-R (Osman et al., 2001) is a self-report measure of suicide-related thoughts and behaviors. The instrument’s four items each evaluate different aspects of suicidality. Item 1 identifies a history of suicide ideation and attempts; Item 2 examines the frequency of suicidal thoughts in the past year; Item 3 assesses the threat of suicidal behavior in the past year; and Item 4 evaluates the individual’s perceived likelihood that he or she will attempt suicide someday. A sample question is, “Have you ever told someone that you were going to commit suicide, or that you might do it?” The SBQ-R total score shows adequate reliability estimates in college samples (a = .76, AIC = .44; Osman et al., 2001). For the current study, the scale reliability of the SBQ-R for the U.S. sample was good (q = .79, 95% CI = .70–.80), and the scale reliability of the SBQ-R for the Chinese sample was adequate (q = .71, 95% CI = .61–.77). Data Analytic Plan Previous factor-analytic investigations of the SRI-25 in U.S. samples have reported similar three-factor solutions for this instrument (see Gutierrez et al., 2012; Rutter et al., 2008). However, none of the studies to date have examined cross-cultural invariance of the three-factor structure of the SRI-25. Accordingly, the first analysis focused on examining invariance of the factor loadings (configural invariance) of the SRI-25 items across the U.S. and Chinese samples. We hypothesized that evidence for configural invariance would be strong. Furthermore, using the less restrictive multiple-group invariance procedure (see explanation that follows) recommended by Byrne (2004), we hypothesized that evidence for other levels (i.e., intercept and residual) of invariance would be adequate. The second analysis focused on examining latent variable mean differences between the U.S. and Chinese samples.

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Recently, Raykov, Marcoulides, and Li (2012) have recommended an alternative measurement invariance procedure for evaluating group differences and similarities in latent factor mean comparison investigations. Using Raykov et al.’s strategy, we hypothesized that substantive group differences in mean responses on the individual SRI-25 scales would be obtained for the U.S. and Chinese samples. The third analysis focused on examining estimates of internal consistency reliability of the SRI-25 scales for the separate U.S. and Chinese samples. Because of the small number of male and female participants within each group, we did not examine measurement invariance of the SRI-25 across gender in the current study. However, we examined estimates of internal consistency reliability of the SRI-25 scales for men and women within each sample. Based on previous studies with the SRI-25, we expected that within each group, composite scale reliability estimates for the individual SRI-25 scales would be adequate (i.e., q values ≥ .70). Specifically, we used the composite scale reliability procedure recommended by Raykov (1997) to examine estimates of scale reliability (q) of the SRI25 total and scale scores. The last analysis involved use of correlation analysis to assess differential correlates of SRI-25 scales scores for the U.S. and Chinese samples.

RESULTS

Confirmatory (Invariance) Factor Analysis We conducted a multiple-group analysis of the U.S. and Chinese sample data to evaluate invariance of the oblique three-factor model of the SRI-25. First, using data in the separate groups, we evaluated the fit of the oblique three-factor model against a plausible one-factor model in which all the SRI-25 items were constrained to load on a single factor. We used the scaled chi-square difference test

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to identify the preferred fitting model for all model comparisons (see Satorra & Bentler, 2001). Next, we followed the procedure recommended by Byrne (2004) to test invariance of the preferred model of the SRI-25 across the groups; we used the EQS for Windows 6.1 (Bentler & Wu, 1985–2010) program in all the analyses. Because of the nonnormality of the data in each group (e.g., Mardia’s normalized coefficient for the Chinese group = 37.81, p < .001), we used the robust (nonnormal) estimator in the EQS for Windows program to conduct the analyses. Following Marsh, Hau, and Grayson’s (2005) observation that conventional fit estimates are excessively restricted for multifactor measures, we determined model fit in terms of (1) robust comparative fit index (R-CFI; values = .90–.95), (2) robust nonnormed fit index (R-NNFI; values = .80–.89), (3) robust root mean square error of approximation (R-RMSEA; values of .06 or lower), and lower Akaike Information Criterion (AIC). Models with higher R-CFI and lower AIC values have been identified previously in the literature as having good fit (Bentler & Bonett, 1980; Browne & Cudeck, 1993; Lance, Butts, & Michels, 2006). Results of the CFA are presented in Table 1. Using the Satorra-Bentler difference in chi-square (DS-Bv2) test, we found that in the U.S. sample, the oblique threefactor model provided a better fit to the sample data than did the one-factor model, DS-Bv2 (3) = 258.50, p < .001. Similarly, in the Chinese sample, the oblique three-factor model showed better fit to the sample data than did the one-factor model, DS-Bv2 (3) = 317.84, p < .001. In both samples, the AIC estimates were also lower for the three-factor model than for the one-factor model. Accordingly, the oblique three-factor model served as the preferred baseline model in the subsequent invariance (multigroup) analyses. Measurement Invariance Analysis. Results of the multiple-group invariance analyses of the oblique three-factor model are pre-

7 sented in Table 1 (lower portion). In the first invariance analysis, the baseline model was tested simultaneously across the U.S. and Chinese sample data with no constraints imposed on any of the model parameters. This model provided good fit to the sample data. In the second step, we followed the recommendation of Byrne (1994) when using EQS for Windows. In particular, we constrained all the model parameters to equality across the groups. Byrne (1994) noted that when using EQS for Windows, it is “unnecessary to compare a series of restrictive models [e.g., configural vs. scalar] in order to identify the source of noninvariance in the model” (p. 161) because the program (unlike LISREL) evaluates the validity of equality constraints multivariately. This final model also provided good fit across the groups, R-CFI = .91, R-NNFI = .90, and a low AIC = 18.43. Latent Mean Differences Modeling We built on the evidence of invariance analyses (i.e., configural, metric and scalar) to conduct the structured means analysis across the samples. As noted in the plan of data analyses subsection, we used the procedure recommended by Raykov et al. (2012) to examine sample differences in the individual SRI-25 factor means. The oblique threefactor model indicated a reasonable fit to the current sample data, ΔS-Bv2 (588) = 1,503.97, p < .001; RMSEA = .068 (.064, .072). As hypothesized, we observed substantive group differences in mean responses on the individual SRI-25 scale means: the SRI-IP scale (group mean difference = 0.94, t = .12.23, p < .001); the SRI-ES scale (group mean difference = 0.84, t = 9.32, p < .001); and the SRI-EP scale (group mean difference = 0.90, t = 10.72, p < .001). Composite Scale Reliability Descriptive statistics (means standard deviations) and composite reliability estimates of the SRI-25 for group are presented in Table 2.

and scale each The

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TABLE 1

Confirmatory Factor (Invariance) Analyses of the Suicide Resilience Inventory-25 Model U.S. American sample One-factor Three-factor oblique Chinese sample One-factor Three-factor oblique Invariance analyses across Simultaneous All constraints

S-Bv2

df

1,332.75* 533.17*

275 272

R-CFI

R-NNFI

.669 .918

.638 .910

782.75 10.83

.105 (.099–.110) .052 (.046–.059)

.591 .893

721.04 15.18

.106 (.100–.111) .054 (.047–.061)

.903 .901

25.63 18.43

.053 (.048–.058) .054 (.049–.058)

1,271.04* 275 .625 528.82* 272 .903 American and Chinese samples 1,062.37* 544 .912 1,125.57* 572 .906

AIC

R-RMSEA (90% CI)

Note. S-Bv2, Satorra-Bentler scaled chi-square; R-CFI, robust comparative fit index; R-NNFI, robust nonnormed fit index; AIC, Akaike Information Criterion; R-RMSEA, robust root mean square error of approximation; CI, confidence interval. *p < .001.

obtained scale reliability estimates ranged from moderate to high and were similar for the U.S. and Chinese groups. In particular, for the U.S. sample, the estimates ranged from .83 to .93 for the SRI-25 total and scale scores. For the Chinese group, the scale estimates ranged from .85 to .90 for the SRI-25 total and scale

scores. We also computed scale reliability estimates of the SRI-25 and subscale scores for men and women in each sample (Table 3). Results were similar across genders, with the EP subscale having the lowest, but still acceptable, reliability estimates (.76–.86) and the IP subscale having the highest (.88–.93).

TABLE 2

Composite Scale Reliability and Descriptive Statistics of the Study Measures Composite Scale (q) Reliability Variables MAST-30 AL RL AD RD SRI-25 IP ES EP Total SBQ-R Total

U.S. American

Chinese

Mean (SD) U.S. American (N = 351)

Chinese (N = 326)

Cohen’s d

.82 .74 .76 .86

(.78–.84) (.68–.79) (.71–.79) (.83–.88)

.83 .77 .73 .90

(.79–.87) (.71–.80) (.68–.77) (.87–.91)

4.50 1.85 2.72 2.42

(0.49) (0.58) (0.56) (0.84)

3.95 1.96 2.17 2.56

(0.52) (0.53) (0.62) (0.76)

1.09 0.20 0.93 0.17

.92 .89 .83 .93

(.91–.94) (.87–.91) (.80–.87) (.92–.95)

.88 .86 .85 .90

(.85–.90) (.83–.89) (.81–.87) (.89–.92)

5.21 5.52 5.37 5.36

(0.69) (0.68) (0.68) (0.58)

4.51 5.06 4.64 4.73

(0.76) (0.60) (0.70) (0.56)

0.97 0.72 1.06 1.10

5.09 (2.28)

0.23

.79 (.70–.80)

.71 (.61–.77)

4.58 (2.11)

Note. MAST, Multi-Attitude Suicide Tendency Scale; AL, Attraction to Life; RL, Repulsion by Life; AD, Attraction to Death; RD, Repulsion by Death; SRI, Suicide Resilience Inventory; IP, Internal Protective; ES, Emotional Stability; EP, External Protective; SBQ-R, Suicidal Behaviors Questionnaire-Revised.

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TABLE 3

Composite Scale Reliability of the Suicide Resilience Inventory-25 by Gender for U.S. and Chinese Samples U.S.

Chinese

Variables

Male (n = 113)

Female (n = 238)

Male (n = 121)

Female (n = 205)

SRI-25 IP ES EP

.92 (.88–.95) .89 (.84–.94) .86 (.76–.95)

.93 (.91–.94) .88 (.83–.93) .79 (.74–.84)

.90 (.88–.93) .83 (.77–.90) .76 (.68–.84)

.88 (.85–.91) .87 (.83–.90) .78 (.73–84)

Note. IP, Internal Protective subscale; ES, Emotional Stability subscale; EP, External Protective subscale.

Descriptive Statistics and Conventional Group Analysis The traditional descriptive statistics (means and standard deviations) for all the study measures in the separate U.S. and Chinese samples are presented in Table 2. A oneway multivariate analysis of variance (MANOVA) showed statistically significant group effects for the three SRI-25 subscale scores, Hotelling’s T2 = 0.34, F (3, 673) = 77.01, p < .001. Follow-up independent samples t tests, with statistical significance (.05/3; p < .02) levels adjusted to account for multiple comparisons, showed that the U.S. group obtained statistically significant higher mean scores than did the Chinese students on the IP subscale, t(675) = 12.51, p < .001, Cohen’s d = 0.97, the ES subscale, t (675) = 9.26, p < .001, Cohen’s d = 0.72, and the EP subscale, t(675) = 13.73, p < .001, Cohen’s d = 1.06. Similarly, the U.S. group obtained statistically significant higher mean SRI-25 total score than the Chinese group, t(675) = 14.39, p < .001, Cohen’s d = 1.10. Correlates of the SRI-25 Total and Scale Scores The correlations between the SRI-25 total and scale scores and scores on the concurrent validation measures of suiciderelated behavior and attitudes toward life and death are presented for the U.S. and Chinese groups in Table 4. For both the U.S. and Chinese samples, moderate and

statistically significant positive correlations were observed between the SRI-25 scores and scores on the protective measure, the MAST AL subscale (range = .48 to .74). In addition, the magnitude of the correlations of the SRI-25 with the MAST RD subscale was low, with one exception. In the Chinese sample, the association between the SRI-25 ES subscale and the MAST RD subscale was statistically significant, although the magnitude of the correlation was low (r = .11, p < .05). For both the U.S. and Chinese samples, the associations between the SRI-25 and scores on the risk measures (MAST AD, MAST RL, and suicidal behavior) were negative and statistically significant. Differences in the magnitude of correlates of the SRI-25 for the separate samples were assessed with independent correlation analysis. As an example, the associations between the SRI25 total scale scores and measures of (1) suicidal behavior and (2) repulsion by life were significantly higher for the U.S. group than for the Chinese group, all ps < .05.

DISCUSSION

The present study is the first to provide empirical evidence supporting the use of the SRI-25 in both Chinese and U.S. college-age samples. In particular, we adopted several contemporary psychometric strategies to extend construct validation work with the SRI-25. Regarding the first

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TABLE 4

Correlates of the SRI-25 Total and Subscales for U.S. and Chinese Student Samples Suicide Resilience Inventory-25 U.S. (N = 351) Measures

IP Scale

Protective Factors MAST-AL .72** MAST-RD .05 Risk Factors MAST-AD .19** MAST-RL .70** SBQ-R .53**

ES Scale

EP Scale

.48** .04

.49** .01

.24** .51** .56**

.15** .52** .39**

Chinese (N = 326) Total

IP Scale

ES Scale

EP Scale

Total

.68** .04

.74** .01

.51** .11*

.51** .09

.74** .01

.23** .69** .59**

.26** .48** .41**

.37** .42** .44**

.26** .51** .29**

.35** .58** .46**

Note. SRI-25, Suicide Resilience Inventory-25; IP, Internal Protective; ES, Emotional Stability; EP, External Protective; MAST, Multi-Attitude Suicide Tendency Scale; AL, Attraction to Life; RD, Repulsion by Death; AD, Attraction to Death; RL, Repulsion by Life; SBQ-R, Suicidal Behavior Questionnaire-Revised. *p < .05; **p < .01.

goal of the study, results of the multigroup analyses provided support for invariance of the oblique three-factor structure of the SRI-25 for U.S. and Chinese college students. Findings regarding invariance of the SRI-25 suggest that both samples (1) tend to interpret the SRI-25 items in the same way and (2) use the response scale of the instrument similarly. Thus, the three-factor solution of the SRI-25 is considered appropriate for use in U.S. and Chinese undergraduate nonclinical samples. Another goal of the current study was to examine estimates of internal consistency. As expected, the findings of scale reliability are in agreement with investigations that adopted the Cronbach’s alpha estimation procedure to evaluate internal consistency reliability of the SRI-25 total and subscale scores (Fang et al., 2006; Osman et al., 2004; Rutter et al., 2008). The obtained scale estimates in the current study samples exceeded the minimum estimate recommended (i.e., values ≥ .80) for adopting a self-report instrument to an applied research setting (Clark & Watson, 1995; Fan & Thompson, 2001). We also evaluated the responses of the U.S. and Chinese study groups on the SRI-25 total and subscale scores. The find-

ings from the invariance analysis (i.e., evidence for factorial, metric, and scalar invariance) bolstered the decision to further examine the responses of the groups to the SRI-25. Results of both the latent mean and traditional multivariate analyses showed substantive differences between the samples in responses to the SRI-25 total and subscales. Specifically, a one-way MANOVA showed that the U.S. student participants scored significantly higher than the Chinese students on the total SRI-25 scale score as well as on all three subscale scores of the SRI-25, with medium to large effect sizes ranging from 0.72 to 1.10. There are several potential explanations for these group differences. First, the findings may highlight further the potential nature of the resilience construct as conceptualized by Osman et al. (2004), as a “perceived individual ability,” that may be fostered more by individualistic than collectivist cultures. Specifically, some degree of personal responsibility and independence (e.g., the ability to express emotional needs freely within a reasonable context), as fostered in individualistic cultures, might be useful for enhancing resilience. Kim, Sherman, and Taylor (2008) reviewed the studies on culture and social support and found

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that Asians and Asian Americans were more likely to benefit from social support only when they were not required to explicitly disclose personal stressful events and feelings of distress. When compared to European Americans, Asians and Asian Americans were more reluctant to explicitly ask for support from close others because they were concerned about the negative relational consequences of such behaviors. This may potentially explain why the Chinese students were less likely than their U.S. counterparts to seek external support when they were having suicidal thoughts. Furthermore, collectivistic and Confucianistic cultures may put more expectations on young generations to succeed, especially since the Chinese participants in this sample were all born after 1979, when the onechild per couple policy was implemented. Thus, most of the Chinese participants may be single children in their households with high expectations from their family members. These possibilities are speculative and merit further research. Second, it is also possible that the SRI-25 measures resilience from an individualistic perspective and that a more collectivist measure of resilience is needed for collectivist cultures; for example, resilience in collectivist cultures might be better reflected in group norms found in that culture (Ungar, 2010). Third, studies have shown that Chinese participants are more likely to choose midpoint instead of extreme scores, whereas U.S. students tend to use extreme scores (Chen, Lee, & Stevenson, 1995). Another goal of the current study was to examine differential correlates of the total SRI-25 for U.S. and Chinese students. For both groups, the strongest correlates of resilience as measured by the SRI-25 were high levels of attraction to life and decreased frequency of suicidal behavior and repulsion to life. The lack of associations between scores on the SRI-25 and repulsion by death in both groups may be due in part to questions about the content specificity of the repulsion by death measure (Gutierrez, Osman, Kopper, & Barrios,

11 2004; Osman, Barrios, Grittmann, & Osman, 1993; Wong, 2004). Although these findings highlight support for the SRI-25 as an empirically useful cross-cultural self-report instrument, it is important to note potential study limitations. First, although the SRI-25 performed well psychometrically in the Chinese sample, the scale may not tap into aspects of resilience unique to Chinese culture (Ungar, 2010). Specifically, the factorial invariance analyses support the structure of the scale and that the items grouping together in the U.S. sample also group together in the Chinese sample. However, it should be noted that factorial invariance does not validate on its own that the construct of resilience is the same for the two cultures. In other words, it does not necessarily improve on understanding of the domains of the resilience construct. Generalizability of our results is limited by our use of an almost exclusively White U.S. sample, as well as our use of college student samples in both countries. Although informed consents were obtained from all participants including Chinese students, due to the lack of a comparable institutional review board in China, the Chinese students were not awarded extra credits as the U.S. students were. The influence due to the difference in incentives is unknown. Estimates of reliability were limited to internal consistency, but could be extended to test–retest reliability or coefficient of stability. Finally, we did not use strategies such as a bifactor-analytic procedure or differential item functioning that might also be useful for evaluating the performance of the SRI-25 items within each study group. Despite limitations, the current study provided empirical support for the use of the Chinese version of the SRI-25. There are some important clinical implications for this study. Due to the strong stigma usually associated with suicide, it may be particularly helpful for mental health practitioners to measure risk factors as well as protective factors in suicide assessment. It may be less threatening

12 to measure protective factors. Moreover, Bryan, Corso, Neal-Walden, and Rudd (2009) recommended that as part of suicide assessment, behavioral health consultants should assess for protective factors to assist with developing interventions and activating social support. There are several areas for potential future studies. An instrument about resilience was adapted to Chinese culture after our data collection (Yu et al., 2011). Therefore, it may be helpful for future research to include this measure to further validate the SRI-25. Moreover, it may be helpful for future studies to assess and examine more demographic variables and their influences on group differences, such as participants’

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social economic status and whether they are originally from rural or urban areas. Further study is also needed to determine whether the inventory performs equally well, and with the same factor structure, in Chinese groups that are not comprised of college students as well as in other cultures. Additionally, gender and age group invariance should be examined in future studies. Longitudinal studies would also help determine predictive validity of the measure. Finally, it may be helpful to incorporate qualitative studies to further examine what is considered relevant and representative factors that protect people from committing suicide in a particular culture so that the constructs are more relevant to the individual culture.

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SUPPORTING INFORMATION

Additional Supporting Information may be found in the online version of this article: Appendix S1 The Chinese translated version of the Suicide Resilience Inventory-25.