# Widely Used Screening Tool Shown to Successfully Predict Suicide Attempts



## David Baxter PhD (Nov 11, 2011)

*Widely Used Screening Tool Shown to Successfully Predict Suicide Attempts*
NIMH
Nov 11, 2011

A widely used suicide screening tool can  help determine who is most at risk for suicide by pinpointing the  threshold at which a person?s suicidal thinking is severe enough to  warrant professional intervention, according to a recent study published  online ahead of print November 8, 2011, in the _American Journal of Psychiatry_.

Developing effective suicide prevention strategies is a priority of the Action Alliance for Suicide Prevention,  a public-private partnership developed to advance the national strategy  for suicide prevention. One of its main goals is to more efficiently  identify those at risk so as to better target intervention.  Standardized, reliable screening tools are needed to achieve that. The  Columbia-Suicide Severity Rating Scale (C-SSRS) was developed by a team  of researchers from Columbia University, the University of Pennsylvania  and the University of Pittsburgh to be used as part of the NIMH-funded Treatment of Adolescent Suicide Attempters (TASA)  study. It was developed to meet the need for tracking changes in a  person?s suicidal thinking and behavior over time, and to determine who  is most at risk. The scale addresses the full range of suicidal behavior  and thinking, but includes only the most essential, evidence-based  items required for thorough assessment. The scale is now widely used for  assessing suicidal thinking and behavior across research and practice  in both psychiatric and non-psychiatric settings. It is used  domestically and internationally by numerous stakeholders such as first  responders (e.g., police, EMTs, fire departments), the U.S. Army,  National Guards, prisons, hospitals, schools, and judicial systems to  better identify those in need and to direct limited resources.

In  this current analysis, Kelly Posner Ph.D., of Columbia University, and  colleagues compared the C-SSRS to other similar measures, all of which  were administered in three separate studies that featured teens who had  attempted suicide or adults presenting to emergency rooms with  psychiatric problems. They aimed to determine the scale?s validity,  reliability and internal consistency, compared to the other measures.

The  researchers found that compared to other measures, the C-SSRS could  reliably predict a potential suicide attempt in those who had previously  attempted suicide. It also was able to determine clinically meaningful  points at which a person may be at risk for an impending suicide  attempt, something that other scales have been unable to consistently  determine. According to the researchers, this type of predictive  information can more precisely identify who needs the most help and  when, while saving time and money by not having to refer people for  treatment who are not at imminent risk.

This  was the first major study showing how well the C-SSRS works with regard  to identifying those most at risk for suicidal behavior. It was able to  show, for the first time, that behaviors beyond previous suicide  attempts?such as self-injury or making preparations for an attempt?may  be used as predictors of subsequent suicide attempts.

Because  the studies used in this analysis were not widely representative,  additional research is needed to replicate the findings among diverse  community samples.

*Reference*
Posner K, Brown GK, Stanley  B, Brent DA, Yershova KV, Oquendo MA, Currier GW, Melvin GA, Greenhill  L, Shen S, Mann JJ. The Columbia-Suicide Severity Rating Scale: Initial  Validity and Internal Consistency Findings from Three Multisite Studies  with Adolescents and Adults. _American Journal of Psychiatry_. Online  ahead of print Nov 8,2011.


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