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Protocol - Intensity of Suicidal Ideation (Continuum) - Adult

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Description:

The Scale for Suicide Ideation (SSI) is a 21-item, interviewer-administered scale that measures the current intensity of patients’ specific attitudes, behaviors, and plans to commit suicide on the day of the interview and during the time period that they were most suicidal. The first 5 items are screeners (wish to live, wish to die, and desire to attempt suicide), followed by 14 items to assess suicidal risk factors. The last 2 items capture previous suicide attempts. The respondent is first asked all questions about their suicidal ideation on the day of the interview and then queried about the most severe point of suicidal ideation.

Each item is rated on a 3-point scale ranging from 0 to 2 according to suicidal intensity. The SSI is scored by adding up the ratings (0-2) from the first 19 items.

Protocol:

Day of Interview

 

Time of Crisis/Most Severe Point of Illness

Today’s Date:

___ / ___ / ___

 

Approximate Date at Most Severe Point:

___ / ___ / ___

I. Characteristics of Attitude Toward Living/Dying

( )

1. Wish to Live

    0 Moderate to strong

    1 Weak

    2 None

 

( )

( )

2. Wish to Die

    0 None

    1 Weak

    2 Moderate to strong

 

( )

( )

3. Reasons for Living/Dying

    0 For living outweigh for dying

    1 About equal

    2 For dying outweigh for living

 

( )

( )

4. Desire to Make Active Suicide Attempt

    0 None

    1 Weak

    2 Moderate to strong

 

( )

( )

5. Passive Suicidal Attempt

    0 Would take precautions to save life

    1 Would leave life/death to chance

       (e.g., carelessly crossing a busy street)

    2 Would avoid steps necessary to save or maintain life

       (e.g., diabetic ceasing to take insulin)

( )

 

 

If all four code entries for Items 4 and 5 are "0,"

skip Sections II, III, and IV.

 

II. Characteristics of Suicide Ideation/Wish

( )

6. Time Dimension: Duration

    0 Brief, fleeting periods

    1 Longer periods

    2 Continuous (chronic), or almost continuous

 

( )

( )

7. Time Dimension: Frequency

    0 Rare, occasional

    1 Intermittent

    2 Persistent or continuous

 

( )

( )

8. Attitude Toward Ideation/Wish

    0 Rejecting

    1 Ambivalent; indifferent

    2 Accepting

 

( )

( )

9. Control Over Suicidal Action/Acting Out Wish

    0 Has sense of control

    1 Unsure of control

    2 Has no sense of control

 

( )

( )

10. Deterrents to Active Attempt

(e.g., family, religion; possibility of serious injury if unsuccessful;

irreversibility)

    0 Would not attempt suicide because of a deterrent

    1 Some concern about deterrents

    2 Minimal or no concern about deterrents

    Indicate deterrents, if any:_________________

 

( )

( )

11. Reason for Contemplated Attempt

    0 To manipulate the environment; get attention revenge

    1 Combination of "0" and "2"

    2 Escape, surcease, solve problems

 

( )

III. Characteristics of Contemplated Attempt

( )

12. Method: Specificity/Planning

    0 Not considered

    1 Considered, but details not worked out

    2 Details worked out/well formulated

 

( )

( )

13.Method: Availability/Opportunity

    0 Method not available; no opportunity

    1 Method would take time/effort; opportunity not readily available

    2a Method and opportunity available

    2b Future opportunity or availability of method anticipated

 

( )

( )

14. Sense of "Capability" to Carry Out Attempt

    0 No courage, too weak, afraid, incompetent

    1 Unsure of courage, competence

    2 Sure of competence, courage

 

( )

( )

15. Expectancy/Anticipation of Actual Attempt

    0 No

    1 Uncertain, not sure

    2 Yes

 

IV. Actualization of Contemplated Attempt

( )

    16.Actual Preparation

    0 None

    1 Partial (e.g., starting to collect pills)

    2 Complete (e.g., had pills, razor, loaded gun)

 

( )

( )

17.Suicide Note

    0 None

    1 Started but not completed; only thought about

    2 Completed

 

( )

( )

18. Final Acts in Anticipation of Death (e.g., insurance, will, gifts)

    0 None

    1 Thought about or made some arrangements

    2 Made definite plans or completed arrangements

 

( )

( )

19. Deception/Concealment of Contemplated Attempt

(Refers to communication of ideation to interviewing clinician)

    0 Revealed ideas openly

    1 Held back on revealing

    2 Attempted to deceive, conceal, lie

( )

 

V. Background Factors

( )

20. Previous Suicide Attempts

    0 None

    1 One

    2 More than one

 

( )

( )

21. Intent to Die Associated with Last Attempt (if N/A enter "8")

    0 Low

    1 Moderate; ambivalent, unsure

    2 High

 

( )

Scoring

Each item is rated on a 3-point scale ranging from 0 to 2 according to suicidal intensity. The SSI is scored by adding up the ratings (0-2) from the first 19 items.

Protocol Name from Source:

This section will be completed when reviewed by an Expert Review Panel.

Availability:

Proprietary

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.

Equipment Needs

The PhenX Working Group acknowledges these questions can be administered by the interviewer in a computerized or non-computerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Interviewer-administered questionnaire

Life Stage:

Adult

Participants:

Adults, ages 17 and older

Specific Instructions:

This protocol includes questions that can potentially identify respondents who are at risk of suicide. Investigators implementing this protocol should consider developing a risk management plan specific to their study to ensure the safety of participants. The following links provide additional information and guidelines for suicide-related research:

ora.research.ucla.edu/OHRPP/Documents/Policy/8/Risk_of_Suicide.pdf

www.nimh.nih.gov/health/topics/suicide-prevention/issues-to-consider-in-intervention-research-with-persons-at-high-risk-for-suicidality.shtml

Selection Rationale

The Scale for Suicide Ideation (SSI) is a brief, low-burden questionnaire that is widely used in clinical trials that focus on suicidal ideation. The SSI is sensitive to change, with good convergent validity, interrater reliability, internal consistency, and predictive validity for suicide attempts and death by suicide. Additionally, the SSI questions correspond to U.S. Food and Drug Administration definitions of suicidal ideation (Guidance for Industry Suicidal Ideation and Behavior: Prospective Assessment of Occurrence in Clinical Trials Office of Communications, Division of Drug Information Center for Drug Evaluation and Research Food and Drug Administration, 2012).

Language

English

Standards
StandardNameIDSource
Common Data Elements (CDE) Adult Suicidal Ideation Intensity Questionnaire Score 4588791 CDE Browser
Derived Variables

None

Process and Review

This section will be completed when reviewed by an Expert Review Panel.

Source

Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology, 47(2), 343-352.

The Scale for Suicide Ideation (SSI) is not proprietary and is available to researchers from Dr. Aaron Beck: abeck@mail.med.upenn.edu.

General References

Beck, A. T., Brown, G. K., & Steer, R. A. (1997). Psychometric characteristics of the Scale for Suicide Ideation with psychiatric outpatients. Behavior Research and Therapy, 35(11), 1039-1046.

Beck, A. T., Brown, G. K., Steer, R. A., Dahlsgaard, K. K., & Grisham, J. R. (1997). Suicide ideation at its worst point: A predictor of eventual suicide in psychiatric outpatients. Suicide and Life-Threatening Behavior 29(1), 1-9.

Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology, 47(2), 343-352.

Center for Drug Evaluation and Research (CDER). (2012). Guidance for industry suicidal ideation and behavior: Prospective assessment of occurrence in clinical trials. Rockville, MD: U.S. Department of Health and Human Services, U.S. Food and Drug Administration.

Protocol ID:

640202

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX640202_Actual_Suicide_Preparation_Current PX640202170000 Actual Preparation 4 N/A
PX640202_Actual_Suicide_Preparation_Worst PX640202390000 Actual Preparation 4 N/A
PX640202_Attitude_Toward_Ideation_Current PX640202080000 Attitude Toward Ideation/Wish 4 N/A
PX640202_Attitude_Toward_Ideation_Worst PX640202300000 Attitude Toward Ideation/Wish 4 N/A
PX640202_Control_Over_Suicidal_Action_Current PX640202090000 Control Over Suicidal Action/Acting Out Wish 4 N/A
PX640202_Control_Over_Suicidal_Action_Worst PX640202310000 Control Over Suicidal Action/Acting Out Wish 4 N/A
PX640202_Desire_Active_Suicide_Attempt_Current PX640202040000 Desire to Make Active Suicide Attempt 4 N/A
PX640202_Desire_Active_Suicide_Attempt_Worst PX640202260000 Desire to Make Active Suicide Attempt 4 N/A
PX640202_Deterrents_Active_SuicideAttempt_Current PX640202100000 Deterrents to Active Attempt (e.g., family, religion; possibility of serious injury if unsuccessful; irreversibility) 4 N/A
PX640202_Deterrents_Active_SuicideAttempt_Indicate_Current PX640202110000 Deterrents to Active Attempt (e.g., family, religion; possibility of serious injury if unsuccessful; irreversibility) Indicate deterrents, if any: 4 N/A
PX640202_Deterrents_Active_SuicideAttempt_Indicate_Worst PX640202330000 Deterrents to Active Attempt (e.g., family, religion; possibility of serious injury if unsuccessful; irreversibility) Indicate deterrents, if any: 4 N/A
PX640202_Deterrents_Active_SuicideAttempt_Worst PX640202320000 Deterrents to Active Attempt (e.g., family, religion; possibility of serious injury if unsuccessful; irreversibility) 4 N/A
PX640202_Expectancy_Anticipation_Suicide_Attempt_Current PX640202160000 Expectancy/Anticipation of Actual Attempt 4 N/A
PX640202_Expectancy_Anticipation_Suicide_Attempt_Worst PX640202380000 Expectancy/Anticipation of Actual Attempt 4 N/A
PX640202_Intent_Die_LastSuicideAttempt_Current PX640202220000 Intent to Die Associated with Last Attempt 4 N/A
PX640202_Intent_Die_LastSuicideAttempt_Worst PX640202440000 Intent to Die Associated with Last Attempt 4 N/A
PX640202_Passive_Suicidal_Attempt_Current PX640202050000 Passive Suicidal Attempt 4 N/A
PX640202_Passive_Suicidal_Attempt_Worst PX640202270000 Passive Suicidal Attempt 4 N/A
PX640202_Previous_Suicide_Events PX640202210000 Previous Suicide Attempts 4 N/A
PX640202_Previous_Suicide_Events_Worst PX640202430000 Previous Suicide Attempts 4 N/A
PX640202_Reasons_Contemplated_Suicide_Attempt_Current PX640202120000 Reason for Contemplated Attempt 4 N/A
PX640202_Reasons_Contemplated_Suicide_Attempt_Worst PX640202340000 Reason for Contemplated Attempt 4 N/A
PX640202_Reasons_For_LivingDying_Current PX640202030000 Reasons for Living/Dying 4 N/A
PX640202_Reasons_For_LivingDying_Worst PX640202250000 Reasons for Living/Dying 4 N/A
PX640202_Sense_Of_Suicide_Capability_Current PX640202150000 Sense of "Capability" to Carry Out Attempt 4 N/A
PX640202_Sense_Of_Suicide_Capability_Worst PX640202370000 Sense of "Capability" to Carry Out Attempt 4 N/A
PX640202_Suicide_Deception_Contemplated_Attempt_Current PX640202200000 Deception/Concealment of Contemplated Attempt 4 N/A
PX640202_Suicide_Deception_Contemplated_Attempt_Worst PX640202420000 Deception/Concealment of Contemplated Attempt 4 N/A
PX640202_Suicide_Final_Acts PX640202190000 Final Acts in Anticipation of Death (e.g., insurance, will, gifts) 4 N/A
PX640202_Suicide_Final_Acts_Worst PX640202410000 Final Acts in Anticipation of Death (e.g., insurance, will, gifts) 4 N/A
PX640202_Suicide_Method_Availability_Opportunity_Current PX640202140000 Method: Availability/Opportunity 4 N/A
PX640202_Suicide_Method_Availability_Opportunity_Worst PX640202360000 Method: Availability/Opportunity 4 N/A
PX640202_Suicide_Method_Specificity_Planning_Current PX640202130000 Method: Specificity/Planning 4 N/A
PX640202_Suicide_Method_Specificity_Planning_Worst PX640202350000 Method: Specificity/Planning 4 N/A
PX640202_Suicide_Note_Current PX640202180000 Suicide Note 4 N/A
PX640202_Suicide_Note_Worst PX640202400000 Suicide Note 4 N/A
PX640202_Time_Dimension_Duration_Current PX640202060000 Time Dimension: Duration 4 N/A
PX640202_Time_Dimension_Duration_Worst PX640202280000 Time Dimension: Duration 4 N/A
PX640202_Time_Dimension_Frequency_Current PX640202070000 Time Dimension: Frequency 4 N/A
PX640202_Time_Dimension_Frequency_Worst PX640202290000 Time Dimension: Frequency 4 N/A
PX640202_Wish_To_Die_Current PX640202020000 Wish to Die 4 N/A
PX640202_Wish_To_Die_Worst PX640202240000 Wish to Die 4 N/A
PX640202_Wish_To_Live_Current PX640202010000 Wish to Live 4 N/A
PX640202_Wish_To_Live_Worst PX640202230000 Wish to Live 4 N/A
Research Domain Information
Measure Name:

Intensity of Suicidal Ideation (Continuum)

Release Date:

November 21, 2014

Definition

A questionnaire to measure the degree of suicidal ideation.

Purpose

Suicidal ideation can indicate an increased risk for suicidal attempts. This measure can be used to determine levels of suicidal risk and aid in making clinical decisions about care. In contrast to the PhenX measure Classification of Suicidal Ideation and Suicidal Behavior, which distinguishes and classifies suicidal ideation and behavior separately, this measure considers suicidal ideation existing as a continuous scale within a single construct.

Keywords

Suicide, Suicide intent, Suicide Ideation, Suicidal Ideation, Wish to live, Wish to die, Reason for living, Suicidal Ideation Questionnaire-Junior, SIQ-JR, Scale for Suicide Ideation, SSI, Proprietary