Linguistic adaptation and psychometric properties of the Columbia-Suicide Severity Rating Scale among a heterogeneous sample of adolescents in Turkey

Abstract

Objective The Columbia-Suicide Severity Rating Scale is a semistructured, interview-based assessment tool, which is increasingly being used for clinical and research purposes across the globe, despite its limited psychometric evaluation outside of English-speaking populations. The aim of this study was to linguistically adapt the measure and investigate reliability, validity, and factor structure of the Turkish version of the Columbia-Suicide Severity Rating Scale in a heterogeneous sample of psychiatric and nonpsychiatric outpatient adolescents. Method The study included four clinical groups: two psychiatric, nonsuicidal outpatient groups (depression group (N = 50) and nondepression group (N = 50)), suicidal group (N = 43), and nonpsychiatric general practitioners' group (N = 70). All participants were interviewed with the Columbia-Suicide Severity Rating Scale and suicidality module of the Mini International Neuropsychiatric Interview for children and adolescents. They also completed the Suicide Probability Scale, Child Depression Inventory, Beck Hopelessness Scale, and their parents filled in the Child Behavior Checklist. Results The scale was found to be a solidly reliable measure with good internal consistency and agreement among interviewers. It correlated in the expected direction with self- and parent-report measures of associated constructs (e.g., depression) as well as suicidality. Consistent with the developers' intent of theoretical subscales, a three-factor solution (i.e., the severity of suicidal ideation, the intensity of suicidal ideation, and suicidal behavior) fit the data well, and it fit the data significantly better than the alternative models. Last, the Turkish Columbia-Suicide Severity Rating Scale successfully discriminated the adolescents with a recent history of suicide attempts from other clinical groups. Conclusion The Turkish version of the Columbia-Suicide Severity Rating Scale is a reliable and valid instrument to assess suicide risk among adolescents.