Toward a Gold Standard for Suicide Risk Assessment for Military Personnel
Principal Investigator: 

Thomas Joiner

Peter Gutierrez

This study pits several psychometrically sound suicide risk assessment measures against one another. The measures were the C-SSRS, SHBQ, SBQ-R, and BSS. A total of 1,044 suicidal military service members completed baseline, 72.6% completed three-month follow-up. The SHBQ and either self-report measure outperformed the C-SSRS in combination with either self-report measure.

When a psychiatrist, emergency department worker, or other clinician first meets with a new patient, one of the most important questions to ask is, “How great is the risk that this person will engage in some form of suicidal behavior in the near future?” Although suicide researchers have learned a great deal about suicide risk factors and theories about why people die by suicide, there is still no clear-cut best way to gauge the likelihood of near-term suicidal behavior in a given individual. 

Jump to table of Assessments

To identify such a “gold standard” for clinical suicide risk assessment, Thomas Joiner of Florida State University and Peter Gutierrez of the Denver VA Medical Center tested four widely used measures against each other to determine which measure or combination of measures offers the most accurate prediction of suicide-related behaviors three months into the future. The four measures were tested with over 1,000 military personnel from three military installations, who were deemed at risk for suicide. Each of the military personnel that participated in the study were administered all four assessments and completed a follow up assessment three months later to determine if he or she had engaged in any self-harm behaviors since the initial assessment. 

The results indicate that the measures selected are all acceptable for use with military populations.  It was also determined scores from no one measure, or combination of measures, emerges as the clear choice to efficiently and effectively predict either suicide ideation or suicide attempts over a three-month follow-up window. But relying on the same measure(s) for all suicide assessments conducted has the advantage of ensuring that the same information is gathered for each patient in a specific treatment setting and that meaningful tracking of changes over time can be conducted. Any one of the four measures would be an acceptable choice for identifying patients who are potentially at higher risk of either future suicidal ideation or making a suicide attempt. For further information about the study please refer to the published article.

Below you will find information about each of the assessments. Permissions were granted from Cornell University Press to make the Self-Harm Behavior Questionnaire (SHBQ) and Suicidal Behaviors Questionnaire-Revised accessible to the public. 







Self-Harm Behavior Questionnaire (SHBQ)

Interview 10-40 minutes under 10 minutes FREE download

Suicidal Behavior Questionnaire-Revised (SBQ-R)

Self-reported under 5 minutes under 5 minutes FREE download

Columbia-Suicide Severity Rating Scale (C-SSRS)

Interview 10-25 minutes under 10 minutes FREE website

Beck Scale for Suicide Ideation (BSS)

Self-Reported under 10 minutes under 5 minutes $3.00APPROX website

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3 Publications Listed
Alt Metrics
29 readers on Mendeley
Gutierrez, P. M., Joiner, T., Hanson, J., Avery, K., Fender, A., Harrison, T., Kerns, K., McGowan, P., Stanley, I. H., Silva, C., & Rogers, M. L.
Psychological Assessment,
Alt Metrics
Hom, M. A., Duffy, M.E., Rogers, M.L., Hanson, J.E., Gutierrez, P.M., Joiner, T.E.
Psychological Medicine,
Alt Metrics
22 readers on Mendeley
Gutierrez, P. M., Joiner T.J, Hanson, J., Stanley, I.H., Silva, C., Rogers, M.L.
Military Behavioral Health,