Reliable and clinically significant change in Suicide Cognitions Scale-Revised (SCS-R) scores among high-risk...

A key challenge for clinical practitioners is the lack of assessment methods that can be used to determine if a high-risk patient has experienced meaningful reductions in suicide risk. The Suicide Cognitions Scale-Revised has been shown to differentiate patients who will attempt suicide, but its utility for monitoring treatment response remains unknown. We used data from three independent samples, including two samples of psychiatric outpatients reporting recent suicidal ideation and/or behaviors (Study 1, n = 96; Study 2, n = 44) and one primary care sample (Study 3, n = 2,744) to calculate the reliable change index and clinically significant change thresholds for the Suicide Cognitions Scale-Revised. In both Studies 1 and 2, change scores ≥20 indicated reliable change, and total scores ≤21 indicated patients were more likely to belong to the nonsuicidal population than the suicidal population. Participants meeting clinically significant change criteria had significantly lower suicide attempt rates in Studies 1 and 3 and reported significantly better social-occupational functioning in Studies 1 and 2. Results suggest the clinically significant change threshold is a useful marker of reduced suicide risk among high-risk patients. (PsycInfo Database Record (c) 2026 APA, all rights reserved).