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

By K. Posner, Gregory K Brown, B. Stanley, David A. Brent, K. Yershova, Maria A Oquendo, G. Currier, Glenn A. Melvin, L. Greenhill, S. Shen and 1 more. 2011

4,533 citations recorded by the source corpus.

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.

Subfields: Clinical Psychology, Social Psychology

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In Clinical Psychology

1. Brian Marx
2. Murray B. Stein
3. T. Keane
4. I. Hwang
5. Helen Christensen
6. Roi Reichart
7. Ronald C. Kessler
8. Berk Ustun

In Social Psychology

1. I. Hwang
2. Murray B. Stein
3. Helen Christensen
4. Amit P. Sheth
5. Roi Reichart
6. Ronald C. Kessler
7. Ugur Kursuncu
8. Brian Marx

Citations in the corpus

• Developing an optimal short-form of the PTSD Checklist for DSM-5 (PCL-5) (2019, methodology): “Suicide ideation in the 30 days before the LS1 survey was assessed with a modified version of the Columbia Suicidal Severity Rating Scale (Posner et al., 2011) that asked about lifetime history of active (i.e., “Did you ever in your life have thoughts of killing yourself?”) and passive (i.e., “Did…”
• Detecting suicidality on Twitter (2015, background): “However, given the link between suicidal ideation and suicide (Large and Nielssen, 2012; Posner et al., 2011), serious consideration should be given to individuals who use Twitter to communicate thoughts of suicide.”
• Knowledge-aware Assessment of Severity of Suicide Risk for Early Intervention (2019, background): “Responses to the questions across the C-SSRS classes eventually determine the risk of suicidality of an individual [44].”
• Rumination, Suicidal Ideation, and Suicide Attempts: A Meta-Analytic Review (2017, methodology): “A wide variety of measures of suicidal ideation were utilized, including the Beck Scale for Suicide Ideation (Beck & Steer, 1991), Columbia Suicide Severity Rating Scale (Posner et al., 2011), Depressive Symptoms Inventory— Suicidality Subscale (Metalsky & Joiner, 1997), Geriatric Suicidal Ideation ”
• Health Care Contacts in the Year Before Suicide Death (2014, background): “They can be administered by a nurse or medical assistant in the office.(36,37) Positive suicide screens can initiate conversations about suicidality between the health provider and patient, and should prompt psychiatric evaluation and follow-up.”
• The Hitchhiker’s Guide to Computational Linguistics in Suicide Prevention (2021, methodology): “Suicide ideation ranges from general and somewhat amorphic thoughts about death, to an ambivalent position whether life is worth living, through thoughts about suicide, and finally to a decisive resolution (even if impulsive) to kill oneself (Galynker et al., 2017; Posner et al., 2011).”