Psychometric properties of Persian version of Columbia Suicide Severity Rating Scale (C-SSRS) in Iranian soldiers

Abstract

Abstract Background: Suicide is an important health issue, nearly all over the world. Columbia suicide severity rating scale (C-SSRS) is a well-known instrument for suicide risk assessment. Our purpose in this study is to provide a Persian version of C-SSRS and evaluate its psychometric properties in Iranian military population, particularly suicide risk leveling characteristic of C-SSRS. Material & method: for linguistic adaptation, we gathered opinions of expert panel, including 23 professionals in mental health sciences. Furthermore, this version was employed in two groups of soldiers, one of them a sample of normal population (N=338) and the other a sample of clinical population from a referral psychiatric hospital (N=348). Beside the C-SSRS, Beck Scale for Suicidal Ideation (BSSI), Beck hopelessness scale (BSS) and general health questionnaire 28 (GHQ28) was obtained from the participants. Correlation coefficient, internal consistency and factor analysis was evaluated, using Statistical Package for the Social Sciences (version 23) software. Results: all items of Persian version of C-SSRS had acceptable content validity and face validity. This tool had high correlation coefficient with BSSI (r=0.73, P<0.001)and BHS (r=0.64, p<0.001) but low CC with GHQ28 (r=0.22, p<0.001). especially, suicide risk level based on C-SSRS had high correlation with BSSI and BHS. Also, its internal consistency was satisfactory (Cronbach's alpha=0.89). And finally, factor analysis, two factors were obtained that is consistent with suicidal ideation and suicidal behavior factor. Conclusion: our results indicated acceptable validity and reliability for Persian version of C-SSRS and capability of this instrument in classifying the suicide risk. It could be concluded that ordinal suicide risk level (as red, orange, yellow and green) is a valid index for application of C-SSRS.