Appendix A Table 1.

Suicide Risk Screening Instruments 250

Estimated Range of
Number of time to score, Target behavior Target Time frame
Instrument Administrator items administer threshold or purpose user assessed Validation
Adult Suicidal Self- 25 5 minutes 0 to 150 Suicide ideation Adults Past month High internal consistency
Ideation administered and behavior (0.96 to 0.98); administered
Questionnaire among different populations
(ASIQ)99 and settings; highly correlated
with HRSD and other
measures of depression
Beck Depression Self- 21 (1 suicide NR Single suicide Depression Adults and NR Suicide item moderately
Inventory (BDI), administered item) item, ranges including suicide adolescents correlated with BSI (0.56 to
versions I and from 1 to 4 ideation 0.58) in inpatient and
II251,252 outpatient psychiatric patients
Beck Self- 20 5 minutes 0 to 20 Positive and Adults and Past week High internal reliability in
Hopelessness administered negative beliefs adolescents clinical and nonclinical
Scale (BHS)101 about future populations (0.87 to 0.93);
standardized in psychiatric in-
and outpatients; used in many
other populations and
settings; significant
associations with SIS and
moderately correlated with
SSI
Beck Scale for Self- 21 (19 10 minutes 0 to 38 Suicidal ideation Adults and Past week High interrater reliability (0.87
Suicide Ideation administered summed for and behavior adolescents to 0.97); development
(BSI)253 total score) samples include psychiatric
adolescent and adult in- and
outpatients; used in many
other settings and
populations; highly correlated
with SSI (0.90 to 0.94);
moderately correlated with
BDI and BHS
Harkavy Asnis Self- 21 5 to 10 NR Suicide ideation NR NR
Suicide Survey administered minutes and behavior
(HASS), versions (HASS-I and II)
I, II, and Demo254 or clinician-
administered
(HASS-Demo)
Hamilton Rating Clinician- 17-, 21-, and NR Single suicide Depressive Adults NR High interrater reliability (0.92)
Scale for administered 24-item item, ranges symptom severity for suicide item; suicide item
Depression versions (1 from 0 to 4 including suicide highly correlated with ASIQ,
(HRSD)255 suicide item) ideation and SSI, and BDI
behavior

Screening for Suicide Risk 110 Kaiser Permanente Research Affiliates EPC
Appendix A Table 1. Suicide Risk Screening Instruments 250
Estimated Range of
Number of time to score, Target behavior Target Time frame
Instrument Administrator items administer threshold or purpose user assessed Validation
Positive and Self- 20 5 minutes 20 to 100 Positive and Past 2 High internal reliability for both
Negative Suicide administered negative thoughts weeks, subscales (0.80 to 0.93);
Ideation related to suicide including standardized among
Inventory attempts today undergraduate college
(PANSI)256 students
Paykel Suicide Clinical- 5 A few NA (yes or no Suicide ideation Past week, Studied in a psychiatric
Items257 administered minutes questions; month, year, catchment area
not initially or lifetime
designed as
a scale)
Suicide Self- 4 (original 5 minutes 5 to 19 Suicidal ideation Adults Past year Adequate internal consistency
Behaviors administered version and behavior (0.75 to 0.80); used in many
Questionnaire included 34 settings and populations;
(SBQ)258 items) significantly correlated with
SSI
Suicidal Self- 34 (10 of 14 NR NR Suicidal ideation Adults Present day, High internal reliability (0.73 to
Behaviors administered items and behavior past, and 0.92); standardized among
Questionnaire measure 5 lifetime men and women, used in
Revised (SBQ- suicide many settings and
14)259 behavior populations; total score
domains for positively correlated with SSI,
total score) BDI, and BHS
Suicidal Self- 4 5 minutes NR Suicidal ideation Children NR Moderate reliability (alphas
Behaviors administered and behavior (younger 0.83 to 0.79)
Questionnaire for than age 10
Children (SBQ- years)
C)260
Symptom Driven Self- 16 (3 suicide 5 minutes NA (checklist) Suicide ideation NR
Diagnostic administered items)
System for (part 1), clinician- followed by
Primary Care, administered 6 5-minute
Suicide Items (part 2) modules by
(SDDS-PC)261,262 clinician

Screening for Suicide Risk 111 Kaiser Permanente Research Affiliates EPC
Appendix A Table 1. Suicide Risk Screening Instruments 250
Estimated Range of
Number of time to score, Target behavior Target Time frame
Instrument Administrator items administer threshold or purpose user assessed Validation
Self-Harm Self- 22, four NR 0 to 78; Comprehensive Adolescents Lifetime College students, ethnically
Behavior administered sections suicide screening for (attempts), diverse high school students
Questionnaire attempt (0 to suicidal thoughts past year (all U.S.); assessed internal
(SHBQ)263 25), suicide and behavior and (attempts), consistency (alphas all ≥0.90),
threat (0 to nonsuicidal self- current convergent validity
21), and harm. 4 (ideation, (correlation 0.25 to 0.49 with
suicide subscales: plans, SIQ, correlation -0.11 to -0.48
ideation (0 to nonsuicidal self- behavior) with Reasons for Living
14) harm, suicide Scale); factor structure
attempts, suicide consistent for Caucasian,
0 to 22 for threat, and suicide African American, and
inpatients ideation Hispanic students; some
differences in strength of
correlation between the
groups264
Suicidal Ideation Self- 30 (adult 10 minutes 0 to 180; 41 Suicidal ideation Adolescents Past month Strong reliability (alphas of
Questionnaire administered form has 25 is raw cutoff grades 10- 0.97 for adolescents, 0.96 for
(SIQ)265 items) score 12 young adults, and 0.93 for
indicative of younger adolescents [SIQ-
potential for JR]); high consistency (0.72 to
suicidal risk 0.76); failed to discriminate
between high and low risk for
suicide attempt among
adolescents
Suicidal Ideation Self- 15 NR 0 to 90 Suicidal ideation Adolescents Past month See SIQ
Questionnaire- administered junior high
Junior (SIQ- (ages 12 to
JR)265 14 years)
Suicide Ideation Self- 10 5 minutes 10 to 50 Suicidal ideation College Past year High internal consistency
Scale (SIS)266 administered students (0.86); standardized with
(age NR) college psychology students;
moderately correlated with
CES-D and BHS
Suicidal Ideation Clinician- 4 NR NR Suicide ideation; Past year Correctly identified 84% of
Screening administered sleep disturbance, general medical population
Questionnaire mood with suicide ideation; studied
(SIS-Q)267 disturbance, and in adults and general medical
hopelessness settings

Screening for Suicide Risk 112 Kaiser Permanente Research Affiliates EPC
Appendix A Table 1. Suicide Risk Screening Instruments 250
Estimated Range of
Number of time to score, Target behavior Target Time frame
Instrument Administrator items administer threshold or purpose user assessed Validation
Suicide Self- 36 10 minutes 36 to 144 Suicidal ideation, Adolescents Current High internal reliability (0.93),
Probability Scale administered hopelessness, and also high for subscales (0.62
(SPS)268 negative self- children to 0.89); standardized with
evaluation, and (age NR) adolescents and adults from
hostility general population;
significantly associated with
SPSS, BHS, and BDI in
college students and adult
psychiatric inpatients
Scale for Suicide Clinician- 21 (19 10 minutes 0 to 38 Suicide ideation Day of Moderately high internal
Ideation (SSI)269 administered summed for and behavior interview consistency (0.84 to 0.89);
total score) high interrater reliability (0.83
to 0.98); standardized with
adult psychiatric in- and
outpatients; used in many
other settings and
populations; significantly
associated with suicide items
from BDI and HRSD
Scale for Suicide Self- 21 (19 10 minutes 0 to 38 Suicide ideation High internal consistency
Ideation, Self- administered summed for and behavior (0.90 to 0.97); positive
Report (SSI- total score) correlation with SSI and BDI;
SR)270 respondents typically score
higher with computer-
generated test than paper
Abbreviations: CES-D = Center for Epidemiologist Studies Depression Scale; NA = not applicable; NR = not reported; SPSS: Social Problem Solving Scale.

Screening for Suicide Risk 113 Kaiser Permanente Research Affiliates EPC