scholarly journals Evaluating the Validity of the Columbia-Suicide Severity Rating Scale for Lonely Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 925-925
Author(s):  
Jacqueline Mai ◽  
Emily Bower ◽  
Kimberly Van Orden

Abstract The risk of suicide death represents a significant problem facing older adults. They are less likely to disclose suicidal ideation (SI) and more likely to die from a suicide attempt compared to younger populations. Accurate screening tools for suicide risk are necessary to identify high-risk individuals who could benefit from intervention. The Columbia-Suicide Severity Rating Scale (C-SSRS), considered the gold standard for clinician-administered suicide risk assessments, was not developed for use with older adults. The purpose of this investigation is to evaluate the C-SSRS’s sensitivity in capturing previous suicidal behavior (behavior subscale) and current intent (severity subscale), both of which are highly predictive of suicide in older adults. 105 adults 60 years and older (M=72.10, SD=9.16; 68.6% female) who endorsed loneliness or feeling like a burden in the past two weeks were enrolled in a larger controlled trial and completed baseline C-SSRS, Quick Inventory of Depressive Symptoms (QIDS), and Geriatric Suicide Ideation Scale (GSIS). Exclusion criteria included significant cognitive impairment. Concurrent validity will be evaluated using random-effects mixed linear regression to test associations between C-SSRS scores and GSIS and QIDS scores, respectively. Baseline responses indicate that 14.9% of participants reported at least one lifetime suicide attempt. Within the last month, 66.7% wished to be dead, 20% had active SI without a plan, 6.7% had active SI with some intent to act, and 6.7% had active SI with a specific plan and intent. Findings from this project will help guide safety assessment recommendations and inform interventions targeting older adult suicide risk.

Author(s):  
Leah Shelef ◽  
Jessica M Rabbany ◽  
Peter M Gutierrez ◽  
Ron Kedem ◽  
Ariel Ben Yehuda ◽  
...  

Past suicide attempts are a significant risk factor for future suicidality. Therefore, the present military-based study examined the past suicidal behavior of soldiers who recently made a severe suicide attempt. Our sample consisted of 65 active-duty soldiers (61.5% males), between the ages of 18 and 28 years old (M = 20.4, SD ± 1.3). The inclusion criterion was a recent severe suicide attempt, requiring at least a 24 h hospitalization. This sample was divided into two groups, according to previous suicidal behavior, namely whether their first suicide attempt was before or after enlistment (n = 25; 38.5% and n = 40; 61.5%, respectively). We then examined the lethality and intent of the recent event in regard to this division. Four measures were used to assess the subjects’ suicidal characteristics: the Columbia Suicide Severity Rating Scale, the Self-Harm Behavior Questionnaire, the Suicidal Behaviors Questionnaire-Revised, and the Beck Scale for Suicide Ideation. No significant difference in the severity of the suicide attempts (either actual or potential severity) were found between those who had suicide attempts before enlistment and those who had their first attempt in the service. As a matter of fact, most of the suicide attempts that occurred for the first time during military service had used a violent method (58.3%, n = 21). Finally, using multivariate analyses, we found that current thoughts and behavior, rather than past suicidality, was the strongest predictor for the lethality of suicide attempts.


2021 ◽  
Vol 11 (4) ◽  
pp. 490
Author(s):  
Giovanni Martinotti ◽  
Stefania Schiavone ◽  
Attilio Negri ◽  
Chiara Vannini ◽  
Luigia Trabace ◽  
...  

Psychoactive drugs play a significant role in suicidality when used for intentional overdose or, more frequently, when the intoxication leads to disinhibition and alterations in judgment, thereby making suicide more likely. In this study, we investigated suicidality prevalence among drug users and evaluated the differences in suicide ideation, taking into account the substance categories and the association of suicide ideation intensity with other psychiatric symptoms. Subjects admitted to the Can Misses Hospital’s psychiatry ward in Ibiza were recruited during summer openings of local nightclubs for four consecutive years starting in 2015. The main inclusion criterium was an intake of psychoactive substances during the previous 24 h. The Columbia Suicide Severity Rating Scale (C-SSRS) was used to assess the suicide risk. Suicidality was present in 39% of the study cohort. Suicide Ideation Intensity overall and in the previous month was higher in users of opioids and in general of psychodepressors compared to psychostimulants or psychodysleptics. Suicidality was not correlated with alterations in any of the major psychopathological scales employed to assess the psychiatric background of the study subjects. The presence of high levels of suicidality did not specifically correlate with any major symptom indicative of previous or ongoing psychopathological alterations. These findings suggest that impulsivity and loss of self-control may be determinants of the increased suicidality irrespectively of any major ongoing psychiatric background.


2021 ◽  
pp. 1-8
Author(s):  
Ali Bani-Fatemi ◽  
Christopher Adanty ◽  
Nasia Dai ◽  
Ariel Graff ◽  
Philip Gerretsen ◽  
...  

Background: Studies have shown that the overall copy number variant (CNV) load is associated with schizophrenia. Schizophrenia is a mental disorder that is frequently associated with suicidal behavior. Methods: We recruited 263 patients with schizophrenia from the Centre for Addiction and Mental Health. The Columbia Suicide Severity Rating Scale was used to assess the presence of lifetime suicide attempt. Genotyping was completed using the Illumina Omni 2.5 chip. We tested the association between deletion events on chromosome 22 with suicide attempt in our schizophrenia sample. Results: There was no significant difference between suicide attempters and non-attempters considering the presence/absence of deletion events on chromosome 22. Conclusion: Although our results did not show a significant association between deletions on chromosome 22 and suicide attempt in schizophrenia, CNV studies may reveal important, novel insights and open further investigation for the treatment of neuropsychiatric diseases.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S594-S594
Author(s):  
Marnin J Heisel

Abstract Older adults have the highest rates of suicide globally, necessitating theory and research investigating suicide and its prevention in later-life. The experience of loneliness is significantly associated with depression, hopelessness, negative health outcomes, and mortality among older adults. Yet, relatively little research has focused on the role of loneliness in conferring suicide risk in later life. The purpose of the present study was thus to investigate the potential associations between loneliness and suicide ideation and behavior in a sample of community-residing older adults recruited into a larger two-year longitudinal study of psychological risk and resiliency to later-life suicide ideation. We specifically recruited 173 adults, 65 years or older, from community locations in a medium-sized Canadian city, for a study on “healthy aging.” Participants completed measures of positive and negative psychological variables, including depression, loneliness, and suicide ideation at a baseline assessment, and again at 2-4 week, 6-12 month, and 1-2 year follow-up points. Findings indicated that loneliness (UCLA Loneliness Scale) was significantly positively associated with concurrent depression and suicide ideation, negatively associated with psychological well-being and perceived social support, and differentiated between participants who endorsed or denied having ever engaged in suicide behavior. Baseline loneliness also explained significant variability in the onset of suicide ideation over a 1-2 year period of follow-up, controlling for age, sex, and baseline depression and suicide ideation. These findings will be discussed in the context of the need for increased focus on psychosocial factors when assessing and intervening to reduce suicide risk in older adults.


2019 ◽  
Vol 38 (8) ◽  
pp. 627-646
Author(s):  
Arezoo Shahnaz ◽  
Boaz Y. Saffer ◽  
E. David Klonsky

Introduction: Time perspective orientation (TPO) refers to the way an individual psychologically and behaviorally connects to temporal concepts of past, present, and future. Previous studies have hypothesized that certain types of time perspectives, such as a negative orientation towards the past, predict negative psychological functioning and outcomes, including suicide risk. The current study examines whether differences in TPOs are linked to suicidal thoughts or suicidal acts using two measures of time perspective. Methods: We recruited a large online U.S.-based sample comprised of three groups: participants with (a) a history of suicide attempts (attempters; n = 107), (b) a history of suicide ideation but no history of attempts (ideators; n = 164), and (c) no history of ideation or attempts (nonsuicidal; n = 194). Results: A Positive Past (d = 0.71) and Negative Past (d = 0.89) orientation yielded large differences between individuals with a history of suicide ideation and nonsuicidal participants, where Positive Past was elevated among nonsuicidal participants and Negative Past among ideators. These differences were not accounted for by depression or anxiety. However, TPO differences between individuals with a history of suicide ideation and individuals with a history of attempts ranged from negligible to small (d range = 0.03—0.33). Discussion: The findings suggest that time perspective may be robustly associated with the development of suicide ideation, but only minimally related to suicide attempts among ideators.


2021 ◽  
Vol 11 ◽  
Author(s):  
Dong Wook Kim ◽  
Seo Eun Cho ◽  
Jae Myeong Kang ◽  
Soo Kyun Woo ◽  
Seung-Gul Kang ◽  
...  

Objective: Suicide attempts of the older adults are known to be more serious than that of the younger adults. Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters in the emergency department.Methods: Demographic data, clinical information, and the level of seriousness of suicide with Risk Rescue Rating Scale were compared between older (age ≥65) and younger (age <65) adults who visited the emergency department for a suicide attempt. Regression analyses were performed to identify the risk factors for SSA in these two groups.Results: Among 370 patients, 37 were older adults (10%; aged 74.41 ± 6.78), more likely to have another medical disease (p < 0.001), and a higher suicide completion rate (16.2 vs. 5.4%, p = 0.023). In the younger group, old age (B = 0.090, p < 0.001), male sex (B = −0.038, p = 0.019), and impression of schizophrenia (B = 0.074, p = 0.027) were associated with a higher risk-rescue ratio and interpersonal stress condition was associated with a lower risk-rescue ratio (B = −0.045, p = 0.006). In the older group, however, no variables were included significant in the regression model for the Risk Rescue Rating Scale.Conclusions: Demographic and clinical factors such as old age, male sex, interpersonal stress, and impression of schizophrenia were associated with lethality in the younger suicide attempters. However, no factors were associated with SSA in the older adult group. Different mechanisms may underly the lethality in old age suicide.


2004 ◽  
Vol 95 (3_suppl) ◽  
pp. 1092-1094 ◽  
Author(s):  
Charles James Palmer

116 consecutively admitted depressed inpatients were divided into three groups based on self-reported history of suicidal ideation and history of suicide attempt. Participants in Group 1 ( M age 34.0, SD = 14.0), 13 men and 24 women, reported no history of suicidal ideation or history of suicide attempt. Group 2 ( M age 34.0, SD = 8.6), 14 men and 25 women, reported having a history of suicidal ideation but no history of suicide attempt. Group 3 ( M age 34.0 yr., SD = 6.3), 14 men and 26 women, reported a history of suicidal ideation and at least one suicide attempt. Each participant completed the Suicide Risk Scale and the Self-esteem Scale. Analysis of variance with Tukey post hoc comparisons yielded a significant difference between Groups 1 and 2, between Groups 1 and 3, and between Groups 2 and 3 on the Suicide Risk Scale. There was a significant difference between Group 1 and Group 2 and between Group 1 and Group 3 on the Self-esteem Scale. These data indicated that suicide ideation and suicide attempt history significantly elevated suicide risk. Self-esteem was significantly decreased by suicide ideation and suicide attempt history.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. De Berardis ◽  
N. Serroni ◽  
A.M. Pizzorno ◽  
F.S. Moschetta ◽  
G. Sepede ◽  
...  

Objective:The aim of our study was to evaluate relationships between alexithymia and suicidal ideation a sample of adult outpatients with obsessive-compulsive disorder (OCD).Methods:A sample of 86 adult outpatients with OCD (44 females and 42 males), was evaluated with a series of rating scales such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Toronto Alexithymia Scale (TAS-20), the Scale for Suicide Ideation (SSI) and Montgomery-Åsberg Depression Rating Scale (MADRS). the score of item #11 on the Y-BOCS was considered as a measure of insight.Results:Alexithymics showed a more early onset, a longer duration of illness and were more suitable to have a chronic course than nonalexithymics; they also reported higher MADRS and SSI scores. Alexithymics without insight (n=21) reported higher SSI scores than alexithymics with insight, nonalexythimics without insight and nonalexithymics with insight. A linear regression showed that chronic OCD course together with DIF dimension of TAS-20 and higher MADRS scores were significantly associated with higher suicide risk.Conclusions:Alexithymia and depressive symptoms were highly correlated in OCD patients and were significantly associated with higher suicide risk. DIF dimension of TAS-20 seems to be significantly associated with presence of suicidal ideation as well as chronic course of disorder. However, further longitudinal studies on larger samples are needed to definitely clarify this topic.


2020 ◽  
pp. 1-10
Author(s):  
Claire Hatkevich ◽  
Jacqueline Grupp-Phelan ◽  
David Brent ◽  
Bradley J. Barney ◽  
T. Charles Casper ◽  
...  

Background Clinical assessments are a primary method for ascertaining suicide risk, yet the language used across measures is inconsistent. The implications of these discrepancies for adolescent responding are unknown, which is troubling as multiple research areas (i.e. on culture, mental health language, and suicide communication) indicate individuals from varying sociodemographic backgrounds may communicate differently regarding mental health concerns. The aims of the current study are to investigate whether a geographically diverse sample of adolescents respond differently to directly and indirectly phrased suicide attempt questions (i.e. directly phrased includes the term ‘suicide’ and indirectly asks about suicidal behavior without using ‘suicide’), and to examine whether sociodemographic factors and history of mental health service usage relate to endorsement differences. Methods Participants were N = 5909 adolescents drawn from the Emergency Department Screening for Teens at Risk for Suicide multi-site study. The lifetime suicide attempt was assessed with two items from an adapted version of the Columbia Suicide Severity Rating Scale (C-SSRS; Posner et al., 2008): (1) a directly phrased question asking about ‘suicide attempts’ and (2) an indirectly phrased question providing the definition of an attempt. Results An adolescent majority (83.7%) consistently reported no lifetime suicide attempt across items, 10.1% consistently reported one or more lifetime attempts across items, and 6.2% of adolescents responded discordantly to the items. Conclusions Multivariable models indicated multiple demographic and mental health service variables significantly predicted discordant responding, with a notable finding being that father/stepfather education level at or below high school education predicted endorsing only the direct question.


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