Evaluating the Validity of the Columbia-Suicide Severity Rating Scale for Lonely Older Adults

Abstract The risk of suicide death represents a significant problem facing older adults. They are less likely to disclose suicidal ideation (SI) and more likely to die from a suicide attempt compared to younger populations. Accurate screening tools for suicide risk are necessary to identify high-risk individuals who could benefit from intervention. The Columbia-Suicide Severity Rating Scale (C-SSRS), considered the gold standard for clinician-administered suicide risk assessments, was not developed for use with older adults. The purpose of this investigation is to evaluate the C-SSRS’s sensitivity in capturing previous suicidal behavior (behavior subscale) and current intent (severity subscale), both of which are highly predictive of suicide in older adults. 105 adults 60 years and older (M=72.10, SD=9.16; 68.6% female) who endorsed loneliness or feeling like a burden in the past two weeks were enrolled in a larger controlled trial and completed baseline C-SSRS, Quick Inventory of Depressive Symptoms (QIDS), and Geriatric Suicide Ideation Scale (GSIS). Exclusion criteria included significant cognitive impairment. Concurrent validity will be evaluated using random-effects mixed linear regression to test associations between C-SSRS scores and GSIS and QIDS scores, respectively. Baseline responses indicate that 14.9% of participants reported at least one lifetime suicide attempt. Within the last month, 66.7% wished to be dead, 20% had active SI without a plan, 6.7% had active SI with some intent to act, and 6.7% had active SI with a specific plan and intent. Findings from this project will help guide safety assessment recommendations and inform interventions targeting older adult suicide risk.