Lily A Brown1, Edwin D Boudreaux2, Sarah A Arias1, Ivan W Miller1, Alexis M May1, Carlos A Camargo3, Craig J Bryan4, Michael F Armey1. 1. Department of Psychosocial Research, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. 2. Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 3. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston,, Massachusetts, USA. 4. Department of Psychology, University of Utah, Salt Lake City, Utah, USA.
Abstract
OBJECTIVE: To evaluate the psychometric and predictive performance of the Columbia-Suicide Severity Rating Scale (C-SSRS) in emergency department (ED) patients with suicidal ideation or attempts (SI/SA). METHODS: Participants (n = 1,376, mean age 36.8, 55% female, 76.8% white) completed the C-SSRS during the ED visit and were followed for one year. Reliability analyses, exploratory structural equation modeling, and prediction of future SA were explored. RESULTS: Reliability of the Suicidal Ideation subscale was adequate, but was poor for the Intensity of Ideation and Suicidal Behavior subscales. Three empirically derived factors characterized the C-SSRS. Only Factor 1 (Suicidal Ideation and Attempts) was a reliable predictor of subsequent SA, though odds ratios were small (ORs: 1.09-1.10, CI95% : 1.04, 1.15). The original C-SSRS Suicidal Ideation and Suicidal Behavior subscales and the C-SSRS ED screen predicted subsequent SA, again with small odds ratios (ORs: 1.07-1.19, CI95% : 1.01, 1.29). In participants without a SA history, no C-SSRS subscale predicted subsequent SA. History of any SA (OR: 1.98, CI95% : 1.43, 2.75) was the strongest predictor of subsequent SA. CONCLUSIONS: The psychometric evidence for the C-SSRS was mixed. History of a prior SA, as measured by the C-SSRS, provided the most parsimonious and powerful assessment for predicting future SA.
OBJECTIVE: To evaluate the psychometric and predictive performance of the Columbia-Suicide Severity Rating Scale (C-SSRS) in emergency department (ED) patients with suicidal ideation or attempts (SI/SA). METHODS:Participants (n = 1,376, mean age 36.8, 55% female, 76.8% white) completed the C-SSRS during the ED visit and were followed for one year. Reliability analyses, exploratory structural equation modeling, and prediction of future SA were explored. RESULTS: Reliability of the Suicidal Ideation subscale was adequate, but was poor for the Intensity of Ideation and Suicidal Behavior subscales. Three empirically derived factors characterized the C-SSRS. Only Factor 1 (Suicidal Ideation and Attempts) was a reliable predictor of subsequent SA, though odds ratios were small (ORs: 1.09-1.10, CI95% : 1.04, 1.15). The original C-SSRS Suicidal Ideation and Suicidal Behavior subscales and the C-SSRS ED screen predicted subsequent SA, again with small odds ratios (ORs: 1.07-1.19, CI95% : 1.01, 1.29). In participants without a SA history, no C-SSRS subscale predicted subsequent SA. History of any SA (OR: 1.98, CI95% : 1.43, 2.75) was the strongest predictor of subsequent SA. CONCLUSIONS: The psychometric evidence for the C-SSRS was mixed. History of a prior SA, as measured by the C-SSRS, provided the most parsimonious and powerful assessment for predicting future SA.
Authors: Guillaume Vaiva; Guillaume Vaiva; François Ducrocq; Philippe Meyer; Daniel Mathieu; Alain Philippe; Christian Libersa; Michel Goudemand Journal: BMJ Date: 2006-05-27
Authors: Megan S Chesin; Barbara Stanley; Emily A P Haigh; Sadia R Chaudhury; Kristin Pontoski; Kerry L Knox; Gregory K Brown Journal: Arch Suicide Res Date: 2016-04-20
Authors: Sarah A Arias; Ivan Miller; Carlos A Camargo; Ashley F Sullivan; Amy B Goldstein; Michael H Allen; Anne P Manton; Edwin D Boudreaux Journal: Psychiatr Serv Date: 2015-12-01 Impact factor: 3.084
Authors: Kelly Posner; Gregory K Brown; Barbara Stanley; David A Brent; Kseniya V Yershova; Maria A Oquendo; Glenn W Currier; Glenn A Melvin; Laurence Greenhill; Sa Shen; J John Mann Journal: Am J Psychiatry Date: 2011-12 Impact factor: 18.112
Authors: Sarah A Ting; Ashley F Sullivan; Edwin D Boudreaux; Ivan Miller; Carlos A Camargo Journal: Gen Hosp Psychiatry Date: 2012-05-02 Impact factor: 3.238
Authors: Ivan W Miller; Carlos A Camargo; Sarah A Arias; Ashley F Sullivan; Michael H Allen; Amy B Goldstein; Anne P Manton; Janice A Espinola; Richard Jones; Kohei Hasegawa; Edwin D Boudreaux Journal: JAMA Psychiatry Date: 2017-06-01 Impact factor: 21.596
Authors: Edwin D Boudreaux; Carlos A Camargo; Sarah A Arias; Ashley F Sullivan; Michael H Allen; Amy B Goldstein; Anne P Manton; Janice A Espinola; Ivan W Miller Journal: Am J Prev Med Date: 2015-12-04 Impact factor: 5.043
Authors: Lily A Brown; Craig J Bryan; Jonathan E Butner; Jeffrey V Tabares; Stacey Young-McCaughan; Willie J Hale; Brooke A Fina; Edna B Foa; Patricia A Resick; Daniel J Taylor; Hillary Coon; Douglas E Williamson; Katherine A Dondanville; Elisa V Borah; Carmen P McLean; Jennifer Schuster Wachen; Kristi E Pruiksma; Ann Marie Hernandez; Brett T Litz; Jim Mintz; Jeffrey S Yarvis; Adam M Borah; Karin L Nicholson; Douglas M Maurer; Kevin M Kelly; Alan L Peterson Journal: Contemp Clin Trials Commun Date: 2021-02-16