title: The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults.
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.
  
  
  METHODS
  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.
authors.affiliation: Department of Psychiatry, Division of Child and Adolescent Psychiatry, Columbia University, College of Physicians and Surgeons, New York, USA. posnerk@nyspi.columbia.edu
authors.forename: Kelly
authors.initials: K
authors.lastname: Posner
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Brown
authors.forename: Barbara
authors.initials: B
authors.lastname: Stanley
authors.forename: David A
authors.initials: DA
authors.lastname: Brent
authors.forename: Kseniya V
authors.initials: KV
authors.lastname: Yershova
authors.forename: Maria A
authors.initials: MA
authors.lastname: Oquendo
authors.forename: Glenn W
authors.initials: GW
authors.lastname: Currier
authors.forename: Glenn A
authors.initials: GA
authors.lastname: Melvin
authors.forename: Laurence
authors.initials: L
authors.lastname: Greenhill
authors.forename: Sa
authors.initials: S
authors.lastname: Shen
authors.forename: J John
authors.initials: JJ
authors.lastname: Mann
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology