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

Mil Psychol. 2021 Apr 8;34(3):269-279. doi: 10.1080/08995605.2021.1897498. eCollection 2022.

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; factor analysis; military; validity.

Grants and 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.