Describing Suicidality: An Investigation of Qualitative SSF Responses


  • The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the United States Air Force, Department of Defense, or the U.S. Government.

  • The authors would like to acknowledge the contributions of Jason Luoma, Rachel Mann, Aaron Jacoby, Sean Bergman, V. Holland LaSalle, Renata Cerqueira, Steve Wong, and John Drozd. We would like to express our appreciation to clinical staff members at The Catholic University Counseling Center, the John Hopkins University Counseling Center, and the Life Skills Centers of the U.S. Air Force 10th Medical Group in Colorado.

Address all correspondence to David A. Jobes, The Catholic University of America, Department of Psychology, 314 O'Boyle Hall, Washington, DC 20064; E-mail:


Given the incidence and seriousness of suicidality in clinical practice, the need for new and better ways to assess suicide risk is clear. While there are many published assessment instruments in the literature, survey data suggest that these measure are not widely used. One possible explanation is that current quantitatively developed assessment instruments may fail to capture something essential about the suicidal patient's experience. The current exploratory study examined a range of open ended qualitative written responses made by suicidal outpatients to five assessment prompts from the Suicide Status Form (SSF)—psychological pain, press, perturbation, hopelessness, and self-hate. Two different samples of suicidal outpatients seeking treatment, including suicidal college students (n = 119) and active duty U.S. Air Force personnel (n = 33), provided a wide range of written responses to the five SSF prompts. A qualitative coding manual was developed through a step-by-step methodology; two naive coders were trained to use the coding system and were able to sort all the patients' written responses into the content categories with very high interrater reliability (Kappa > .80). Certain written qualitative responses of the patients were more frequent than others, both within and across the five SSF constructs. Among a range of specific exploratory findings, one general finding was that two thirds of the 636 obtained written responses could be reliably categorized under four major content headings: relational (22%), role responsibilities (20%), self (15%), and unpleasant internal states (10%). Theoretical, research, and clinical implications of the methodology and data are discussed.