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Background <p>Die by suicide is a significant public health issue globally, especially among individuals with mental health diagnoses. An efficient and reliable tool for suicidal intervention is urgently needed to identify those who are in danger. A widely recognized tool for assessing the risk of death by suicide around the world is the Columbia-Suicide Severity Rating Scale (C-SSRS). This study conducted an assessment of the C-SSRS's psychometric qualities among participants with mental health diagnoses in China.</p> Methods <p>Of the 614 individuals diagnosed with mental health diagnoses who participated in the study, 161 had previously attempted to take their own life. Reliability was assessed using Cronbach's alpha and McDonald's omega. The construct validity was tested using ULSMV (unweighted least squares with mean- and variance-adjusted standard errors). Discriminant and convergent validity were evaluated using the third item of the Hamilton Depression Rating Scale (HAMD-17) and the Schizophrenia Quality of Life Scale (SQLS). Participants’ history of suicide attempts was used to calculate predictive validity.</p> Results <p>The analysis demonstrated that the C-SSRS exhibited satisfactory internal consistency. The Cronbach alpha was 0.869, and McDonald's omega was 0.871. The C-SSRS's three-factor structure and the two-component structure of the suicidal ideation intensity subscale were both validated by confirmatory factor analysis (CFA). Data analysis revealed that the active-passive model has a relatively better overall scale fit (χ²/df = 3.862, RMSEA = 0.068, SRMR = 0.0605, CFI = 0.917, IFI = 0.918, AGFI = 0.884). A high composite reliability value supports convergent validity. Both discriminant and divergent validity are satisfactory. Predictive validity indicates that the four subscales of the C-SSRS can effectively predict suicide attempts.</p> Conclusions <p>This study is the first to examine the scale factor model and the active-passive model of the C-SSRS among individuals with mental health diagnoses in China. The results demonstrated that the C-SSRS has sufficient validity and reliability, making it suitable for assessing suicidal attempts and thoughts in individuals with mental health diagnoses and for distinguishing between active and passive suicidal ideation. These findings require confirmation in other populations through future research.</p>

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Psychometric characteristics of the Chinese version of the Columbia-Suicide Severity Rating Scale among people with mental health diagnosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月21日

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  • Sanrong Xiao,
  • Qing Ge,
  • Ting Wang,
  • Minxuan Zhang,
  • Anquan Hu,
  • Xiangyang Zhang

摘要

Background

Die by suicide is a significant public health issue globally, especially among individuals with mental health diagnoses. An efficient and reliable tool for suicidal intervention is urgently needed to identify those who are in danger. A widely recognized tool for assessing the risk of death by suicide around the world is the Columbia-Suicide Severity Rating Scale (C-SSRS). This study conducted an assessment of the C-SSRS's psychometric qualities among participants with mental health diagnoses in China.

Methods

Of the 614 individuals diagnosed with mental health diagnoses who participated in the study, 161 had previously attempted to take their own life. Reliability was assessed using Cronbach's alpha and McDonald's omega. The construct validity was tested using ULSMV (unweighted least squares with mean- and variance-adjusted standard errors). Discriminant and convergent validity were evaluated using the third item of the Hamilton Depression Rating Scale (HAMD-17) and the Schizophrenia Quality of Life Scale (SQLS). Participants’ history of suicide attempts was used to calculate predictive validity.

Results

The analysis demonstrated that the C-SSRS exhibited satisfactory internal consistency. The Cronbach alpha was 0.869, and McDonald's omega was 0.871. The C-SSRS's three-factor structure and the two-component structure of the suicidal ideation intensity subscale were both validated by confirmatory factor analysis (CFA). Data analysis revealed that the active-passive model has a relatively better overall scale fit (χ²/df = 3.862, RMSEA = 0.068, SRMR = 0.0605, CFI = 0.917, IFI = 0.918, AGFI = 0.884). A high composite reliability value supports convergent validity. Both discriminant and divergent validity are satisfactory. Predictive validity indicates that the four subscales of the C-SSRS can effectively predict suicide attempts.

Conclusions

This study is the first to examine the scale factor model and the active-passive model of the C-SSRS among individuals with mental health diagnoses in China. The results demonstrated that the C-SSRS has sufficient validity and reliability, making it suitable for assessing suicidal attempts and thoughts in individuals with mental health diagnoses and for distinguishing between active and passive suicidal ideation. These findings require confirmation in other populations through future research.