Appendix A Table 1.

Suicide Risk Screening Instruments250

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-administered 25 5 minutes 0 to 150 Suicide ideation Adults Past month High internal consistency (0.96
Ideation and behavior to 0.98); administered among
Questionnaire different populations and
(ASIQ)99 settings; highly correlated with
HRSD and other measures of
depression
Beck Depression Self-administered 21 (1 suicide NR Single suicide Depression Adults and NR Suicide item moderately
Inventory (BDI), 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-administered 20 5 minutes 0 to 20 Positive and Adults and Past week High internal reliability in
Hopelessness 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-administered 21 (19 10 minutes 0 to 38 Suicidal ideation Adults and Past week High interrater reliability (0.87
Suicide Ideation summed for and behavior adolescents to 0.97); development samples
(BSI)253 total score) 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-administered 21 5 to 10 NR Suicide ideation NR NR
Suicide Survey (HASS-I and II) minutes and behavior
(HASS), versions or clinician-
I, II, and Demo254 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
Positive and Self-administered 20 5 minutes 20 to 100 Positive and Past 2 High internal reliability for both
Negative Suicide negative thoughts weeks, subscales (0.80 to 0.93);
Ideation Inventory related to suicide including standardized among
(PANSI)256 attempts today undergraduate college
students

Screening for Suicide Risk 110 Kaiser Permanente Research Affiliates EPC
Appendix A Table 1. Suicide Risk Screening Instruments250

Estimated Range of
Number of time to score, Target behavior Target Time frame
Instrument Administrator items administer threshold or purpose user assessed Validation
Paykel Suicide Clinical- 5 A few NA (yes or no Suicide ideation Past week, Studied in a psychiatric
Items257 administered minutes questions; not month, year, catchment area
initially or lifetime
designed as a
scale)
Suicide Behaviors Self-administered 4 (original 5 minutes 5 to 19 Suicidal ideation Adults Past year Adequate internal consistency
Questionnaire version and behavior (0.75 to 0.80); used in many
(SBQ)258 included 34 settings and populations;
items) significantly correlated with
SSI
Suicidal Self-administered 34 (10 of 14 NR NR Suicidal ideation Adults Present day, High internal reliability (0.73 to
Behaviors 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-administered 4 5 minutes NR Suicidal ideation Children NR Moderate reliability (alphas
Behaviors and behavior (younger 0.83 to 0.79)
Questionnaire for than age 10
Children (SBQ- years)
C)260
Symptom Driven Self-administered 16 (3 suicide 5 minutes NA (checklist) Suicide ideation NR
Diagnostic (part 1), clinician-
items)
System for administered followed by 6
Primary Care, (part 2) 5-minute
Suicide Items modules by
(SDDS-PC)261,262 clinician
Self-Harm Self-administered 22, four NR 0 to 78; Comprehensive Adolescents Lifetime College students, ethnically
Behavior 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 (correlation
21), and harm. 4 subscales: (ideation, 0.25 to 0.49 with SIQ,
suicide nonsuicidal self- plans, correlation -0.11 to -0.48 with
ideation (0 to harm, suicide behavior) Reasons for Living Scale);
14) attempts, suicide factor structure consistent for
threat, and suicide Caucasian, African American,
0 to 22 for ideation and Hispanic students; some
inpatients differences in strength of
correlation between the
groups264

Screening for Suicide Risk 111 Kaiser Permanente Research Affiliates EPC
Appendix A Table 1. Suicide Risk Screening Instruments250

Estimated Range of
Number of time to score, Target behavior Target Time frame
Instrument Administrator items administer threshold or purpose user assessed Validation
Suicidal Ideation Self-administered 30 (adult 10 minutes 0 to 180; 41 is Suicidal ideation Adolescents Past month Strong reliability (alphas of
Questionnaire form has 25 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-administered 15 NR 0 to 90 Suicidal ideation Adolescents Past month See SIQ
Questionnaire- junior high
Junior (SIQ- (ages 12 to
JR)265 14 years)
Suicide Ideation Self-administered 10 5 minutes 10 to 50 Suicidal ideation College Past year High internal consistency
Scale (SIS)266 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 disturbance, with suicide ideation; studied
(SIS-Q)267 and hopelessness in adults and general medical
settings
Suicide Self-administered 36 10 minutes 36 to 144 Suicidal ideation, Adolescents Current High internal reliability (0.93),
Probability Scale hopelessness, and children also high for subscales (0.62
(SPS)268 negative self- (age NR) to 0.89); standardized with
evaluation, and 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

Screening for Suicide Risk 112 Kaiser Permanente Research Affiliates EPC
Appendix A Table 1. Suicide Risk Screening Instruments250

Estimated Range of
Number of time to score, Target behavior Target Time frame
Instrument Administrator items administer threshold or purpose user assessed Validation
Scale for Suicide Self-administered 21 (19 10 minutes 0 to 38 Suicide ideation High internal consistency (0.90
Ideation, Self- summed for and behavior to 0.97); positive correlation
Report (SSI- total score) with SSI and BDI; respondents
SR)270 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