Australian & New Zealand Journal of Psychiatry
1–7
DOI: 10.1177/0004867415621393
© The Royal Australian and
New Zealand College of Psychiatrists 2015
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Australian & New Zealand Journal of Psychiatry
Introduction
A recent review of suicide and suicidal behaviour provides
a comprehensive overview of high- and low-income coun-
tries, noting that Australia has relatively high rates of sui-
cidal ideation and attempts in line with other high-income
countries (Tricky and Brent, 2015). In Australia, deliberate
self-harm and suicidal behaviour account for 0.5% of all
hospital presentations and clinical practice guidelines avail-
able (Boyce et al., 2003). A recent systematic review and
meta-analysis of 177 studies reported estimates with
reported repetition of non-fatal deliberate self-harm of
16.3% after 1 year and suicide rates of 1.6% after 1 year
and 3.9% after 5 years (Carroll et al., 2014). They also
Exploring the validity of the Fantastic
Lifestyle Checklist in an inner city
population of people presenting with
suicidal behaviours
Kay Wilhelm
1,2,3
, Tonelle Handley
4
and Prasuna Reddy
2,4
Abstract
Purpose: Although patients demonstrate a range of problematic health-related lifestyle behaviours preceding suicidal
behaviour, there is little research that routinely measure these behaviours. This paper seeks to establish the utility of
health-related lifestyle measure (Fantastic Lifestyle Checklist) in people presenting to a major inner city Emergency
Department with a range of suicidal behaviours.
Methods: From 2007–2014, data from the 366 patients who had completed the Fantastic Lifestyle Checklist, after refer-
ral by the Emergency Department to a service for people with deliberate self-harm or suicidal ideation, were included in
the analysis study. A Maximum Likelihood factor analysis was performed to assess the factor structure of the Fantastic
Lifestyle Checklist and the resultant factors were explored in relation to measures of health; namely the Depression,
Anxiety and Stress Scale and the 12-item Short-Form Health Survey.
Results: A three-component factor structure emerged comprising Component 1 ‘positive life investments’, Component 2
‘poor emotional regulation’ and Component 3 ‘poor health behaviours’. There was a significant negative correlation between
‘positive life investments’ and each of the Depression, Anxiety and Stress scales subscales and significant positive associa-
tions with ‘poor emotional regulation’ and Short Form Health Survey-12 mental health scores. Only the Short Form Health
Survey-12 physical health subscale was weakly correlated with ‘poor health behaviours’, in females.
Conclusion: Our findings support the construct and concurrent validity of the Fantastic Lifestyle Checklist measure.
The three factors obtained for the Fantastic Lifestyle Checklist were coherent and seem useful for research and clinical
practice.
Keywords
Deliberate self-harm, depression, factor analysis, lifestyle, lifestyle measure
1
School of Psychiatry, Faculty of Medicine and Black Dog Institute,
University of New South Wales, Randwick, NSW, Australia
2
Faces in the Street, Urban Mental Health and Wellbeing Research
Institute, St Vincent’s Hospital Sydney, Sydney, NSW, Australia
3
Consultation Liaison Psychiatry Service, St Vincent’s Hospital,
Darlinghurst, NSW, Australia
4
School of Medicine and Public Health, University of Newcastle,
Callaghan, NSW, Australia
Corresponding author:
Kay Wilhelm, Consultation Liaison Psychiatry Service, St Vincent’s
Hospital, Level 4 O’Brien Centre, 394 Victoria Street, Darlinghurst,
NSW 2010, Australia.
Email: kay.wilhelm@svha.org.au
621393ANP 0 0 10.1177/0004867415621393ANZJP ArticlesWilhelm et al.
research-article 2015
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