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Protocol - Intensity of Suicidal Ideation (Continuum) - Adult

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Protocol Name from Source:

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

Availability:

Proprietary

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.

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
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Self-administered

Life Stage:

Adult

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:

[link[ora.research.ucla.edu/OHRPP/Documents/Policy/8/Risk_of_Suicide.pdf|ora.research.ucla.edu/OHRPP/Documents/Policy/8/Risk_of_Suicide.pdf]]

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

Research Domain Information

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.

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 Score4588791CDE Browser

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_Wish_To_Live_CurrentPX640202010000Wish to Live4N/A
PX640202_Wish_To_Die_CurrentPX640202020000Wish to Die4N/A
PX640202_Reasons_For_LivingDying_CurrentPX640202030000Reasons for Living/Dying4N/A
PX640202_Desire_Active_Suicide_Attempt_CurrentPX640202040000Desire to Make Active Suicide Attempt4N/A
PX640202_Passive_Suicidal_Attempt_CurrentPX640202050000Passive Suicidal Attempt4N/A
PX640202_Time_Dimension_Duration_CurrentPX640202060000Time Dimension: Duration4N/A
PX640202_Time_Dimension_Frequency_CurrentPX640202070000Time Dimension: Frequency4N/A
PX640202_Attitude_Toward_Ideation_CurrentPX640202080000Attitude Toward Ideation/Wish4N/A
PX640202_Control_Over_Suicidal_Action_CurrentPX640202090000Control Over Suicidal Action/Acting Out Wish4N/A
PX640202_Deterrents_Active_SuicideAttempt_CurrentPX640202100000Deterrents to Active Attempt (e.g., family, religion; possibility of serious injury if unsuccessful; irreversibility)4N/A
PX640202_Deterrents_Active_SuicideAttempt_Indicate_CurrentPX640202110000Deterrents to Active Attempt (e.g., family, religion; possibility of serious injury if unsuccessful; irreversibility) Indicate deterrents, if any:4N/A
PX640202_Reasons_Contemplated_Suicide_Attempt_CurrentPX640202120000Reason for Contemplated Attempt4N/A
PX640202_Suicide_Method_Specificity_Planning_CurrentPX640202130000Method: Specificity/Planning4N/A
PX640202_Suicide_Method_Availability_Opportunity_CurrentPX640202140000Method: Availability/Opportunity4N/A
PX640202_Sense_Of_Suicide_Capability_CurrentPX640202150000Sense of "Capability" to Carry Out Attempt4N/A
PX640202_Expectancy_Anticipation_Suicide_Attempt_CurrentPX640202160000Expectancy/Anticipation of Actual Attempt4N/A
PX640202_Actual_Suicide_Preparation_CurrentPX640202170000Actual Preparation4N/A
PX640202_Suicide_Note_CurrentPX640202180000Suicide Note4N/A
PX640202_Suicide_Final_ActsPX640202190000Final Acts in Anticipation of Death (e.g., insurance, will, gifts)4N/A
PX640202_Suicide_Deception_Contemplated_Attempt_CurrentPX640202200000Deception/Concealment of Contemplated Attempt4N/A
PX640202_Previous_Suicide_EventsPX640202210000Previous Suicide Attempts4N/A
PX640202_Intent_Die_LastSuicideAttempt_CurrentPX640202220000Intent to Die Associated with Last Attempt4N/A
PX640202_Wish_To_Live_WorstPX640202230000Wish to Live4N/A
PX640202_Wish_To_Die_WorstPX640202240000Wish to Die4N/A
PX640202_Reasons_For_LivingDying_WorstPX640202250000Reasons for Living/Dying4N/A
PX640202_Desire_Active_Suicide_Attempt_WorstPX640202260000Desire to Make Active Suicide Attempt4N/A
PX640202_Passive_Suicidal_Attempt_WorstPX640202270000Passive Suicidal Attempt4N/A
PX640202_Time_Dimension_Duration_WorstPX640202280000Time Dimension: Duration4N/A
PX640202_Time_Dimension_Frequency_WorstPX640202290000Time Dimension: Frequency4N/A
PX640202_Attitude_Toward_Ideation_WorstPX640202300000Attitude Toward Ideation/Wish4N/A
PX640202_Control_Over_Suicidal_Action_WorstPX640202310000Control Over Suicidal Action/Acting Out Wish4N/A
PX640202_Deterrents_Active_SuicideAttempt_WorstPX640202320000Deterrents to Active Attempt (e.g., family, religion; possibility of serious injury if unsuccessful; irreversibility)4N/A
PX640202_Deterrents_Active_SuicideAttempt_Indicate_WorstPX640202330000Deterrents to Active Attempt (e.g., family, religion; possibility of serious injury if unsuccessful; irreversibility) Indicate deterrents, if any:4N/A
PX640202_Reasons_Contemplated_Suicide_Attempt_WorstPX640202340000Reason for Contemplated Attempt4N/A
PX640202_Suicide_Method_Specificity_Planning_WorstPX640202350000Method: Specificity/Planning4N/A
PX640202_Suicide_Method_Availability_Opportunity_WorstPX640202360000Method: Availability/Opportunity4N/A
PX640202_Sense_Of_Suicide_Capability_WorstPX640202370000Sense of "Capability" to Carry Out Attempt4N/A
PX640202_Expectancy_Anticipation_Suicide_Attempt_WorstPX640202380000Expectancy/Anticipation of Actual Attempt4N/A
PX640202_Actual_Suicide_Preparation_WorstPX640202390000Actual Preparation4N/A
PX640202_Suicide_Note_WorstPX640202400000Suicide Note4N/A
PX640202_Suicide_Final_Acts_WorstPX640202410000Final Acts in Anticipation of Death (e.g., insurance, will, gifts)4N/A
PX640202_Suicide_Deception_Contemplated_Attempt_WorstPX640202420000Deception/Concealment of Contemplated Attempt4N/A
PX640202_Intent_Die_LastSuicideAttempt_WorstPX640202440000Intent to Die Associated with Last Attempt4N/A
PX640202_Previous_Suicide_Events_WorstPX640202430000Previous Suicide Attempts4N/A