The Columbia–Suicide Severity Rating Scale: Initial Validity and Internal Consistency Findings From Three Multisite Studies With Adolescents and Adults

Abstract

Objective Research on suicide prevention and interventions requires a standard method for assessing both suicidal ideation and behavior to identify those at risk and to track treatment response. The Columbia–Suicide Severity Rating Scale (C-SSRS) was designed to quantify the severity of suicidal ideation and behavior. The authors examined the psychometric properties of the scale. Method The C-SSRS’s validity relative to other measures of suicidal ideation and behavior and the internal consistency of its intensity of ideation subscale were analyzed in three multisite studies: a treatment study of adolescent suicide attempters (N=124); a medication efficacy trial with depressed adolescents (N=312); and a study of adults presenting to an emergency department for psychiatric reasons (N=237). Results The C-SSRS demonstrated good convergent and divergent validity with other multi-informant suicidal ideation and behavior scales and had high sensitivity and specificity for suicidal behavior classifications compared with another behavior scale and an independent suicide evaluation board. Both the ideation and behavior subscales were sensitive to change over time. The intensity of ideation subscale demonstrated moderate to strong internal consistency. In the adolescent suicide attempters study, worst-point lifetime suicidal ideation on the C-SSRS predicted suicide attempts during the study, whereas the Scale for Suicide Ideation did not. Participants with the two highest levels of ideation severity (intent or intent with plan) at baseline had higher odds for attempting suicide during the study. Conclusions These findings suggest that the C-SSRS is suitable for assessment of suicidal ideation and behavior in clinical and research settings.

The predictive validity of the Depression Hopelessness Suicide screening form for self-harm among prisoners

“…This is consistent with other suicide risk assessment tools, such as the Columbia Suicide Severity Rating Scale, which recommends referrals for inmates with ideation and at least some intent (Posner et al, 2011). While clinical interventions would be desirable to develop risk management plans for inmates reporting the items in models 2 through 7, this may not always be feasible.…”

Factors associated with the efficacy of smoking cessation treatments and predictors of smoking abstinence in EAGLES

“…The smoker characteristics examined were: country of study site (USA versus non‐USA); history of psychiatric diagnosis (defined as the primary diagnosis: none, mood disorder, anxiety disorder, psychotic disorder); sex; age; BMI; ethnic group (white, black, other); lifetime suicidal ideation and/or behaviour [none versus any, captured through Columbia–Suicide Severity Rating Scale (C‐SSRS)] 28; anxiety score [Hospital Anxiety and Depression scale (HADS)] 29; depression score (HADS) 29; aggression score [Buss–Perry Aggression Questionnaire (BPAQ)] 30; use of psychotropic medication, including sleeping aids (none, any); cigarette dependence [Fagerström Test for Cigarette Dependence (FTCD)] 31; age of starting smoking; and prior use of study medicines (none versus any, for each of the three medications—varenicline, bupropion or any type of NRT). Supporting information, Table S2 describes the collection of smokers’ characteristics as recorded on the patient report form used by investigators.…”

Combination Extended Smoking Cessation Treatment Plus Home Visits for Smokers With Schizophrenia: A Randomized Controlled Trial

“…[48][49][50][51][52] Psychiatric symptomrelated information was collected using the Brief Psychiatric Rating Scale (BPRS), 53 Scale for Assessment of Negative Symptoms (SANS), 54 Clinical Global Impression (CGI) 55 scale, and Beck Depression Inventory (BDI-II). 56 To evaluate issues related to safety, the ColumbiaSuicide Severity Rating Scale (C-SSRS) 57 and Abnormal Involuntary Movement Scale (AIMS) 58 were also administered.…”