List what DSM diagnosis the tool/instrument is used for:
Identify an assessment/diagnosis instrument:
Appraise a scholarly, peer-reviewed article that addresses the use of the instrument to support your choice as an evidence-based instrument for practice:
Evaluate the instruments appropriateness for diagnosing it is designed to assess for if the developers of the instrument reported that the instrument is only part of a comprehensive assessment for the disorder
Describe whether or not the instrument can be used to measure patient response to therapy/treatment or if it is strictly for assessment and diagnosis?
References
The Columbia Lighthouse Project: Official Site. https://cssrs.columbia.edu/about-the-project/about-the-lighthouse-project/
Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, Currier GW, Melvin GA, Greenhill L, Shen S, Mann JJ. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011 Dec;168(12):1266-77. doi: 10.1176/appi.ajp.2011.10111704. PMID: 22193671; PMCID: PMC3893686.
The Columbia Lighthouse Project. (2016). Identify risk. Prevent suicideLinks to an external site.. https://cssrs.columbia.edu/
An occurrence, or I should say several occurrences that I remember was when I worked on an inpatient Oncology unit. I was able to see the admitting hospice clinician, or the hospice RN come to assess the patient and write the orders for admission to hospice. During this process, the patient and sometimes the patients family would be asked what they prefer for pain medication, hydration if appropriate, along with being given the choice to discontinue any life sustaining measures. The patient was given the choice regarding multiple aspects of their care, and how they chose to live the last part of their life. I came to appreciate this even more, when I had to witness family members or spouses choosing to put their loved one through all sorts of unnecessary, unneeded and unwanted treatment by the patient.
The instrument you mentioned is the Columbia-Suicide Severity Rating Scale (C-SSRS). Here’s the information you requested:
- DSM Diagnosis: The Columbia-Suicide Severity Rating Scale (C-SSRS) is not used to diagnose a specific DSM (Diagnostic and Statistical Manual of Mental Disorders) diagnosis. It is primarily designed to assess and quantify suicidal ideation, behavior, and intent.
- Appraisal of Scholarly Article: The article titled “The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults” by Posner et al. provides evidence supporting the use of the C-SSRS. The study is peer-reviewed and demonstrates the initial validity and internal consistency of the scale in assessing suicidal thoughts and behaviors across different age groups. This makes it an evidence-based instrument for clinical practice, especially in the context of suicide risk assessment.
- Appropriateness for Diagnosis: The C-SSRS is primarily designed to assess and quantify suicidal ideation and behavior rather than diagnose specific mental disorders. It can be a valuable tool for assessing the severity of suicidal ideation and behavior, which is essential for understanding and managing suicide risk. However, it is not intended for diagnosing psychiatric conditions.
- Measurement of Patient Response: The C-SSRS is primarily used for assessing and quantifying suicidal ideation and behavior, and it is not specifically designed to measure patient response to therapy or treatment. Its primary focus is on identifying and tracking changes in suicidal ideation and behavior over time, which can inform treatment planning and intervention strategies.
In the context of your personal experience on the inpatient Oncology unit, it’s important to note that the C-SSRS is a valuable tool for assessing and monitoring suicide risk in various healthcare settings, but it is not directly related to end-of-life care decisions or pain management preferences, as described in your experience.
Please note that the information provided here is based on my knowledge up to January 2022, and there may have been further developments or research related to the C-SSRS since that time.