Psychometric evaluation of the Suicide Cognitions Scale-Revised (SCS-R)

ABSTRACT

The measurement of self-reported suicide risk can be complicated in medical settings due to patient apprehension about the potential consequences of self-disclosure. The Suicide Cognitions Scale (SCS) was designed to assess suicide risk by measuring a range of suicidogenic cognitions (e.g., hopelessness, perceived burdensomeness) collectively referred to as the suicidal belief system. The SCS’s concurrent, known groups, and prospective validity for suicidal thoughts and behaviors have previously been supported. The present study examined the factor structure, known-groups, and concurrent validity of a revised, 16-item version of the SCS (SCS-R), which removed two items that explicitly used the word “suicide” and changed item scoring from a 1–5 to 0–4 scale, thereby improving the interpretation of scores. In a sample of 2,690 primary care patients presenting for routine medical care at one of six US military clinics, results of bifactor analysis supported the scale’s unidimensionality. The SCS-R significantly differentiated participants with a history of suicide attempts and was significantly correlated with frequency of thoughts about death and self-harm during the previous 2 weeks. Results align with earlier research and provide psychometric support for the SCS-R.

KEYWORDS:

• Suicide
• Suicide Cognitions Scale
• validity
• factor analysis
• military

Disclaimer

Cynthia Thomsen, Craig Cunningham, Michelle Wine, and Kara Taylor are military service members or employees of the U.S. Government. This work was prepared as part of their official duties. Title 17, U.S.C. §105 provides that copyright protection under this title is not available for any work of the U.S. Government. Title 17, U.S.C. §101 defines a U.S. Government work as work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Notes

1. Participants were allowed to select more than one option.

2. In the original Suicide Cognitions Scale, responses were scored on a scale ranging from 1 to 5. In the revised version, we changed the response scale to range from 0 to 4 instead to facilitate interpretation within medical settings (specifically, the lowest possible score becomes 0).

Additional information

Funding

Report No. 20-08 was supported by the Office of the Assistant Secretary of Defense for Health Affairs, through the Defense Medical Research and Development Program under Award No. W81XWH-14-1-0272 and work unit no. N1426. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government. The study protocol was approved by the Naval Health Research Center Institutional Review Board in compliance with all applicable Federal regulations governing the protection of human subjects. Research data were derived from an approved Naval Health Research Center Institutional Review Board protocol, number NHRC.2014.0046. Craig Bryan declares grant funding from the Department of Defense, National Institute of Mental Health, and the Boeing Company; and consulting fees and salary from Neurostat Analytical Solutions and Oui Therapeutics, LLC. Alexis May declares grant funding from the Department of Defense. The remaining authors declare that they have no conflicts of interest.