The Columbia–Suicide Severity Rating Scale: Initial Validity and Internal Consistency Findings From Three Multisite Studies With Adolescents and Adults
2011/12/01 by Kelly Posner, Gregory K. Brown, Barbara Stanley +13 · 5,114 citations
Medicine · Psychology · #COVID-19 and Mental Health #Clinical psychology #Depression (economics) #Developmental psychology #Human factors and ergonomics #Injury prevention #Internal consistency #Medical emergency #Medicine #Mental Health Treatment and Access #Poison control #Psychiatry #Psychology #Psychometrics #Rating scale #Scale (ratio) #Suicidal ideation #Suicide and Self-Harm Studies #Suicide attempt #Suicide prevention #Test validity
paper · doi:10.1176/appi.ajp.2011.10111704
published in American Journal of Psychiatry 168(12), 1266-1277 (American Psychiatric Association)
openalex publication_date 2011/12/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/05
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.
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