These assessment scales are primarily utilized as research tools to better understand and quantify suicidal ideation and behavior. It is hoped that through these efforts, we will attain knowledge and skills that will aid in suicide prevention. They are presented below to help the interviewer develop better probes (questions) to refine his assessment of suicidal ideation and behavior in the clinical setting.
Beck Scale for Suicidal Ideation
This is a self- report scale with 5 screening questions and 19 items. Below are the 19 items that are rated on a three-point scale (0-2). There is no formal cut-off score for serious suicidal ideation. However, in the clinical setting it may be helpful qualitatively to gauge how seriously the patient has been contemplating suicide and how far the planning toward making an actual attempt has progressed. When using this scale it is also important to specify a timeframe for assessment, eg, in the last week, to more accurately assess the severity of current thinking.
Beck Hopelessness Scale
The presence of hopelessness is a potentially ominous sign of future suicidal behavior. The presence of hopelessness has been found to correlate more closely with future suicidal behavior than the actual severity of depression. This scale is self-rating and is intended to measure hopelessness as a factor in suicidal behavior. The scale consists of 20 items each scored as 0 or 1. Scores provide a measure of the severity of reported hopelessness and are scored: 0-3 minimal; 4-8 mild; 9-14 moderate; and 15-20 severe.
Suicide Intent Scale
This scale has 15 items that are each scored 0-2. It is used as an evaluative tool to assess the seriousness previous suicide attempts through exploration of the motivation behind the attempt(s) and the behaviors associated with carrying out the attempt.
Beck Depression Inventory
This 21-item self-report scale was not specifically designed to assess suicidal ideation or behavior but is a useful tool for measuring the current level of depression, the most frequently occurring psychiatric syndrome associated with risk of suicide. Items are rated on a 4-point scale (0-3) with severity of self-reported depression: 0-9 minimal; `10-16 mild; 17-29 moderate; and 30-63 severe.
Reasons for Living Inventory
The Reasons for Living Inventory (RFL; 98), a 45-item questionnaire, taps expectancies about the consequences of living verses killing oneself and assesses the importance of reasons for living. The measure has six sub-scales: Survival and Coping Beliefs, Responsibility of Family, Child-Related Concerns, Fear of Suicide, Fear of Social Disapproval, and Moral Objections. The instrument is negatively and uniquely related to suicidal behavior, independent of its relationship to depression and hopelessness. It is not related to general psychopathology.
Parasuicide History Interview
The Parasuicide History Interview (PHI; 96) measures the topography, intent, medical severity, social context, precipitating and concurrent events, and outcomes of parasuicidal behavior during a target time period. Each episode of parasuicide is coded separately. Major PHI outcome variables are the frequency of parasuicidal behaviors, and, for each parasuicide at medical risk, suicide intent, a risk/rescue score, instrumental intent and impulsiveness. Three of the factors (suicide intent, medical risk, risk/rescue) represent characteristics commonly associated with the lethality of parasuicide. The fourth factor, instrumental intent, represents characteristics usually linked to behaviors labeled by others and DSM-III-R as "suicide gestures." Each act is also coded by the assessor (based on all information) as to whether or not it is a suicide attempt. Average inter-rater reliabilities on the PHI combined over four-month periods in our current study have ranged from .59 to .91, with an overall average of .80.
Suicidal Behaviors Questionnaire
The Suicidal Behaviors Questionnaire (SBQ; 97) is used to assess suicide ideation, suicide expectancies, and suicide threats and communications. The instrument is widely used in suicide research and has very good psychometric properties.
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