Valid and Reliable Suicide Risk Assessment for Active Duty Personnel

Four commonly used suicide risk assessments were found to be valid (i.e., construct and convergent validity) and reliable (i.e., internally consistent) when used with active duty U.S. servicemembers at risk for suicide.

  • Four widely used suicide risk assessment measures:  Columbia-Suicide Severity Rating Scale (C-SSRS),1 Self-Harm Behavior Questionnaire (SHBQ),2 Suicidal Behaviors Questionnaire-Revised (SBQ-R),3,4 and Beck Scale for Suicide Ideation (BSS), 5,6 were found to work equally well in determining if service members were likely to experience suicidal ideation or make a suicide attempt over the next three months.7
  • All were also found to be valid (i.e., construct and convergent validity) and reliable (i.e., internally consistent).8
  • The links between answers to the questionnaires and future suicidal thoughts and behavior were small.7
  • Clinicians are encouraged to use one of these measures and also include assessment of acute and chronic suicide risk factors.

This study confirmed that no one measure or combination of measures is capable of predicting if service members will have thoughts about suicide or make a suicide attempt in the near future. Suicide is just too complicated for those types of predictions to be accurate. But using one of these measures as part of a comprehensive approach to working with service members at risk of suicide is highly recommended to improve the quality of care they receive.

References

1. Posner, K. et al. The Columbia–Suicide Severity Rating Scale: Initial Validity and Internal Consistency Findings From Three Multisite Studies With Adolescents and Adults. Am. J. Psychiatry 168, 1266–1277 (2011).

2. Gutierrez, P. M. Adolescent suicide: An integrated approach to the assessment of risk and protective factors. (Northern Illinois University Press, 2008).

3. Osman, A. et al. The Suicidal Behaviors Questionnaire-Revised (SBQ-R): Validation with clinical and nonclinical samples. Assessment 8, 443–454 (2001).

4. Aloba, O., Ojeleye, O. & Aloba, T. The psychometric characteristics of the 4-item Suicidal Behaviors Questionnaire-Revised (SBQ-R) as a screening tool in a non-clinical sample of Nigerian university students. Asian J. Psychiatry 26, 46–51 (2017).

5. Beck, A. T. & Steer, R. A. Beck Scale for Suicide Ideation Manual. (The Psychological Corporation, 1993).

6. Beck, A. T., Brown, G. K. & Steer, R. A. Psychometric characteristics of the Scale for Suicide Ideation with psychiatric outpatients. Behav. Res. Ther. 35, 1039–1046 (1997).

7. Gutierrez, P. M. et al. “Clinical utility of suicide behavior and ideation measures: Implications for military suicide risk assessment.” Psychological assessment vol. 33,1 (2021): 1-13. DOI: 10.1037/pas0000876*

8. Gutierrez, P. M. et al. Psychometric properties of four commonly used suicide risk assessment measures: Applicability to military treatment settings. Mil. Behav. Health 1–8 (2019) doi:10.1080/21635781.2018.1562390*

9. Interian, A. et al. Use of the Columbia-Suicide Severity Rating Scale (C-SSRS) to classify suicidal behaviors. Arch. Suicide Res. 22, 278–294 (2018).

10. Gutierrez, P. M., Osman, A., Barrios, F. X. & Kopper, B. A. Development and initial validation of the Self-Harm Behavior Questionnaire. J. Pers. Assess. 77, 475–490 (2001).

 

*Denotes publication from an MSRC-funded study.

 

This Action Brief is supported by the Military Suicide Research Consortium (MSRC), funded by the Office of the Assistant Secretary of Defense for Health Affairs under Award No. (W81XWH-16-2-0003 & W81XWH-16-2-0004). Opinions, interpretations, conclusions and recommendations are those of the Military Suicide Research Consortium and are not necessarily endorsed by the Department of Defense.