Score Reliability Generalization of the Columbia-Suicide Severity Rating Scale (C-SSRS): A Meta-Analysis

This study aimed to provide meta-analytic reliability information of the Columbia-Suicide Severity Rating Scale (C-SSRS). We implemented systematic search procedures to 35 eligible studies (N = 23,247; Mage = 26.74 years) that reported reliability estimates. The synthesized average values of Cronbach's alpha were .88 (95% CI [.85, .92]) for the total C-SSRS scores, .88 (95% CI [.87, .89]) for the Suicidal Ideation Severity subscale, .76 (95% CI [.70, .83]) for the Intensity of Ideation subscale, and .81 (95% CI [.74, .88]) for the Suicidal Behavior subscale. Inter-rater reliability of the C-SSRS scores, as mostly indicated by Kappa coefficients, ranged from .67 to 1.00, suggesting substantial agreement. Additionally, other reliability estimates were examined, such as Guttman split-half reliability, McDonald's omega, and composite reliability. The findings of this study provided evidence of moderate to strong reliability for the C-SSRS scores. Implications for counselors and counseling researchers were provided. This study provides evidence of the score reliability of the C-SSRS, a crucial tool for evaluating suicidality. Furthermore, it highlights the importance of addressing score reliability in counseling research and training, with the goal of advancing measurement and assessment within this profession and to enhance the quality of counseling services.