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Pierce Suicide Intent Scale
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About Pierce Suicide Intent Scale
Scale Name
Pierce Suicide Intent Scale
Author Details
D. W. Pierce
Translation Availability
English
Background/Description
The Pierce Suicide Intent Scale (PSIS-12) was developed to assess the degree of suicidal intent during a self-harm episode or suicide attempt. Unlike broader ideation-screening tools, it focuses on the circumstances surrounding an attempt, the individual’s self-reported intent, and the medical risk of the attempt.
- Structure: The PSIS-12 contains 12 items, divided into three sub-categories:
- Items 1 to 6: Circumstances of the attempt (e.g., isolation, timing, precautions)
- Items 7 to 10: Self-report of intent (e.g., wish to die, expectations of outcome)
- Items 11 to 12: Medical risk associated with method (e.g., lethality, rescue probability)
Its purpose is to provide clinicians and researchers with a quantitative index of intent, which may help in risk assessment, intervention planning, and research on suicidal behaviour severity.
Administration, Scoring and Interpretation
- Obtain the authorised PSIS-12 questionnaire and scoring instructions.
- Explain the purpose: to assess the seriousness of intent during the most recent suicide attempt/self-harm episode.
- Provide instructions: Respondent (or interviewer) should consider the most recent attempt, and answer each of the 12 items according to circumstances, thoughts, and method of the attempt.
- Approximate time: Usually 10–15 minutes for completion, depending on circumstances.
- Administer the scale: Items 1-6 rated for objective circumstances, 7-10 based on self-report, and 11-12 on method risk.
- Score: Each item typically receives a score (often 0-2 or 0-3 depending on version), sum the responses to yield a total intent score; higher scores indicate stronger suicidal intent.
- Use: Interpret the total and sub-scores to supplement clinical judgment about risk and to monitor changes (e.g., in follow-up assessments).
Reliability and Validity
Although the PSIS is less widely cited than some other intent scales (e.g., the SUICIDE INTENT SCALE [SIS] by Beck et al.), available research supports its utility:
- A study in Estonia using a revised version of the PSIS found that suicidal intent levels (as measured by the PSIS) varied by age and were associated with severity of attempt.
- The PSIS demonstrates construct validity in distinguishing higher-intent attempts versus lower-intent, and correlates with severity indicators of self-harm.
- Psychometric data (e.g., internal consistency, test-retest reliability) are less widely published than for some more modern scales; users are advised to check for local validation if applying in new cultural settings.
Available Versions
12-Items
Reference
Pierce, D. W. (1977). Suicidal intent in self-injury. The British journal of psychiatry, 130(4), 377-385.
Important Link
Scale File:
Frequently Asked Questions
Q1: What exactly does the PSIS measure?
It measures the intent to die during a suicide attempt, by assessing the circumstances of the attempt, the individual’s intent and expectation, and the lethality/medical risk of the method.
Q2: Who should complete the PSIS?
Typically administered by a trained clinician or researcher in the context of a patient who has made a recent suicide attempt. It may also be used in research interviews.
Q3: How is the PSIS different from other suicide intent scales?
PSIS emphasises three components (circumstance, self-report, medical risk) in a 12-item format. Some other scales are longer or focus more on ideation rather than attempt circumstances.
Q4: Can the PSIS predict future suicide attempts?
Higher PSIS scores indicate stronger prior intent, which is associated with more severe attempts; while not a standalone predictive tool, it adds meaningful data to risk assessment.
Q5: Is the PSIS suitable for adolescents or non-clinical populations?
It was developed for self-injurers/attempters; for screening general populations or adolescents without attempts, other dedicated tools may be more appropriate.
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