Predictive Validity of the Columbia-Suicide Severity Rating Scale for Short-Term Suicidal Behavior: A Danish Study of Adolescents at a High Risk of Suicide

Abstract

Using the Columbia-Suicide Severity Rating Scale (C-SSRS), we examined the predictive and incremental predictive validity of past-month suicidal behavior and ideation for short-term suicidal behavior among adolescents at high risk of suicide. The study was conducted in 2014 on a sample of 85 adolescents (90.6% females) who participated at follow-up (85.9%) out of the 99 (49.7%) baseline respondents. All adolescents were recruited from a specialized suicide-prevention clinic in Denmark. Through multivariate logistic regression analyses, we examined whether baseline suicidal behavior predicted subsequent suicidal behavior (actual attempts and suicidal behavior of any type, including preparatory acts, aborted, interrupted and actual attempts; mean follow-up of 80.8 days, SD = 52.4). Furthermore, we examined whether suicidal ideation severity and intensity incrementally predicted suicidal behavior at follow-up over and above suicidal behavior at baseline. Actual suicide attempts at baseline strongly predicted suicide attempts at follow-up. Baseline suicidal ideation severity and intensity did not significantly predict future actual attempts over and above baseline attempts. The suicidal ideation intensity items deterrents and duration were significant predictors of subsequent actual attempts after adjustment for baseline suicide attempts and suicidal behavior of any type, respectively. Suicidal ideation severity and intensity, and the intensity items frequency, duration and deterrents, all significantly predicted any type of suicidal behavior at follow-up, also after adjusting for baseline suicidal behavior. The present study points to an incremental predictive validity of the C-SSRS suicidal ideation scales for short-term suicidal behavior of any type among high-risk adolescents.

The association of non-suicidal self-injurious and suicidal behaviors with religiosity in hospitalized Jewish adolescents

“…Non-suicidal self-injurious and suicidal behaviors. The Colombia Suicide Severity Rating Scale (C-SSRS) (Conway et al, 2017;Gipson et al, 2015;Posner et al, 2011) is a semi-structured interview used to measure suicide ideation and behavior. The scale consists of four subscales, each rated separately: severity of ideation (score ranges between 0 and 5), intensity of ideation, behavior subscale, and behavior lethality.…”

Suicide in the pediatric population: screening, risk assessment and treatment

“…The sixth and last item on the tool asks about any lifetime history of preparations and/or plans to end one's life, and if yes, whether these have been done in the last six months. We could find only one specific validation study of the C-SSRS -Screen Version (The Columbia Lighthouse Project, n.d.) among adults (Wilson, 2017), although the longer risk assessment version of the C-SSRS has been validated across several settings and among children and adolescents (see below) Conway, Erlangsen, Teasdale, Jakobsen, & Larsen, 2016;Gipson, Agarwala, Opperman, Horwitz, & King, 2015;Horwitz, Czyz, & King, 2015;Posner et al, 2011). There is a version of the C-SSRS Screener with triage points for schools (Heise, York, & Thatcher, 2016; The Columbia Lighthouse Project, n.d.) suggesting its applicability to an adolescent population.…”

“…The suicidal behaviour and actual attempt section consists of yes/no answers related to actual attempts, self-injurious behaviour, interrupted and aborted attempts, preparatory acts or behaviours, and lethality (Posner et al, 2011). Strengths of the C-SSRS include that it has been used and validated with adults and adolescents (Gipson et al, 2015;Posner et al, 2011), and been found to predict short-term suicidal behaviour among high-risk adolescents (Conway et al, 2016). Despite the C-SSRS' promise, several authors have noted challenges with classifying both intent and imminence (Interian et al, 2018), and with implementation (e.g.…”

Suicide and Lyme and associated diseases

“… 3 Deterrents to suicide include mental fitness, frustration tolerance, cognitive abilities, coping skills, parenthood, supportive relationships, community and other social connections, purpose, ethical and religious beliefs, good medical and neurological health, and access to social services and psychiatric and medical care. 4 …”