Xiao Sanrong, Ge Qing, Wang Ting, Zhang Minxuan, Hu Anquan, Zhang Xiangyang
School of Public Policy and Administration, Nanchang University, Nanchang, Jiangxi, China.
Jiangxi College Of Foreign Studies, Nanchang, Jiangxi, China.
BMC Psychiatry. 2025 Aug 21;25(1):803. doi: 10.1186/s12888-025-07187-3.
Die by suicide is a significant public health issue globally, especially among individuals with mental health diagnoses. An efficient and reliable tool for suicidal intervention is urgently needed to identify those who are in danger. A widely recognized tool for assessing the risk of death by suicide around the world is the Columbia-Suicide Severity Rating Scale (C-SSRS). This study conducted an assessment of the C-SSRS's psychometric qualities among participants with mental health diagnoses in China.
Of the 614 individuals diagnosed with mental health diagnoses who participated in the study, 161 had previously attempted to take their own life. Reliability was assessed using Cronbach's alpha and McDonald's omega. The construct validity was tested using ULSMV (unweighted least squares with mean- and variance-adjusted standard errors). Discriminant and convergent validity were evaluated using the third item of the Hamilton Depression Rating Scale (HAMD-17) and the Schizophrenia Quality of Life Scale (SQLS). Participants' history of suicide attempts was used to calculate predictive validity.
The analysis demonstrated that the C-SSRS exhibited satisfactory internal consistency. The Cronbach alpha was 0.869, and McDonald's omega was 0.871. The C-SSRS's three-factor structure and the two-component structure of the suicidal ideation intensity subscale were both validated by confirmatory factor analysis (CFA). Data analysis revealed that the active-passive model has a relatively better overall scale fit (χ²/df = 3.862, RMSEA = 0.068, SRMR = 0.0605, CFI = 0.917, IFI = 0.918, AGFI = 0.884). A high composite reliability value supports convergent validity. Both discriminant and divergent validity are satisfactory. Predictive validity indicates that the four subscales of the C-SSRS can effectively predict suicide attempts.
This study is the first to examine the scale factor model and the active-passive model of the C-SSRS among individuals with mental health diagnoses in China. The results demonstrated that the C-SSRS has sufficient validity and reliability, making it suitable for assessing suicidal attempts and thoughts in individuals with mental health diagnoses and for distinguishing between active and passive suicidal ideation. These findings require confirmation in other populations through future research.
自杀是全球一个重大的公共卫生问题，尤其是在有心理健康诊断的人群中。迫切需要一种高效且可靠的自杀干预工具来识别处于危险中的人。全球广泛认可的一种评估自杀死亡风险的工具是哥伦比亚自杀严重程度评定量表（C-SSRS）。本研究对中国有心理健康诊断的参与者中C-SSRS的心理测量学特性进行了评估。
在参与研究的614名被诊断为有心理健康问题的个体中，有161人曾有过自杀未遂经历。使用克朗巴哈α系数和麦克唐纳ω系数评估信度。使用ULSMV（均值和方差调整标准误的非加权最小二乘法）检验结构效度。使用汉密尔顿抑郁评定量表（HAMD-17）的第三项和精神分裂症生活质量量表（SQLS）评估区分效度和聚合效度。参与者的自杀未遂史用于计算预测效度。
分析表明C-SSRS表现出令人满意的内部一致性。克朗巴哈α系数为0.869，麦克唐纳ω系数为0.871。C-SSRS的三因素结构和自杀意念强度子量表的两成分结构均通过验证性因素分析（CFA）得到验证。数据分析显示主动-被动模型具有相对更好的整体量表拟合度（χ²/df = 3.862，RMSEA = 0.068，SRMR = 0.0605，CFI = 0.917，IFI = 0.918，AGFI = 0.884）。较高的组合信度值支持聚合效度。区分效度和发散效度均令人满意。预测效度表明C-SSRS的四个子量表能够有效预测自杀未遂。
本研究首次在中国有心理健康诊断的个体中检验了C-SSRS的量表因素模型和主动-被动模型。结果表明C-SSRS具有足够的效度和信度，使其适用于评估有心理健康诊断的个体的自杀未遂和自杀想法，并区分主动和被动自杀意念。这些发现需要通过未来的研究在其他人群中得到证实。
