Positive and Negative Suicide Ideation (PANSI)

Abstract

The Positive and Negative Suicide Ideation (PANSI) inventory is a specialized psychometric instrument developed by A. Osman and colleagues. Its unique design moves beyond simple assessment of suicidal presence by simultaneously measuring two distinct dimensions of vulnerability: Negative Ideation (risk factors) and Positive Ideation (protective factors). This 14-item, brief, self-report scale is primarily validated for use with adolescent populations, offering clinicians and researchers a nuanced tool to understand an individual’s level of risk and inherent psychological resilience against self-harm impulses. By separating these two constructs, the PANSI aligns with modern dual-factor models of mental health assessment.

Keywords

Suicide Ideation, Adolescent Suicide, Psychometric Scale, Negative Ideation, Positive Ideation, Risk Factor, Protective Factor, Clinical Assessment, Resilience.

Authors

A. Osman, P. M. Gutierrez, B. A. Kopper, F. X. Barrios, L. C. Konick, J. Jiandani, S. C. Linden, R. S. Truelove, J. J. Wrangham, C. L. Bagge.

Purpose

The primary purpose of the PANSI is to provide a reliable and comprehensive measure of suicide ideation that captures both the detrimental cognitive patterns and the adaptive resources available to an individual. Unlike instruments that solely focus on the severity or frequency of suicidal thoughts, the PANSI aims to quantify the intensity of despair and hopelessness (Negative Ideation) alongside measures of coping ability and engagement with life (Positive Ideation).

This dual measurement approach makes the PANSI a valuable clinical tool for screening, detailed risk assessment, and crucially, for tracking treatment efficacy. Given the rapid fluctuations in mood and psychological state common among adolescents, the scale’s ability to pinpoint both the presence of distress and the simultaneous lack of protective psychological resources is essential for effective prevention and intervention strategies.

Construct

The PANSI operationalizes the psychological construct of Suicide Ideation using a two-factor theoretical model. The first factor, Negative Ideation (NI), represents the traditional view of suicide risk. This subscale measures feelings associated with hopelessness, overwhelming problems, perceived failure, and the desire to end emotional pain. This dimension is strongly correlated with established risk factors for self-harm.

The second factor, Positive Ideation (PI), functions as a measure of protective factors. This dimension assesses elements of resilience, including self-efficacy, confidence in coping mechanisms, positive future orientation, and a fundamental belief that life holds intrinsic value. The inclusion of the PI factor is critical because it acknowledges that mental health status is defined not just by the absence of pathology, but also by the presence of robust psychological resources capable of mitigating suicidal impulses.

Validity

Initial validation studies conducted across diverse adolescent samples, including both normal high school students and clinical psychiatric inpatients, demonstrated robust psychometric properties for the PANSI. The scale exhibits strong construct validity, which is supported by the consistent confirmation of its hypothesized two-factor structure (NI and PI) through factor analytic techniques.

The Negative Ideation factor demonstrated high convergent validity, showing strong positive correlations with established measures of distress, such as hopelessness, depression, and general suicidal behaviors (e.g., scores on the SBQ-R). Conversely, the Positive Ideation factor exhibited high discriminant validity, correlating negatively with measures of psychological distress and positively with measures of overall well-being and adaptive functioning. Furthermore, the scale proved effective in differentiating between high-risk and low-risk adolescent groups in clinical environments, confirming its utility as a reliable screening and diagnostic aid.

Reliability

The PANSI has consistently demonstrated excellent internal consistency across numerous studies and populations. The Negative Ideation subscale, which consists of eight items reflecting suicidal distress and hopelessness, typically yields exceptionally high Cronbach’s alpha coefficients, frequently exceeding 0.90. This high homogeneity confirms that the items within the risk factor subscale measure a singular, cohesive construct.

The Positive Ideation subscale, which measures protective factors (six items), also exhibits strong reliability, generally reporting internal consistency coefficients in the upper 0.80s. Furthermore, test-retest reliability has been established across multiple independent studies, confirming the stability of the PANSI measures over time. This temporal stability is vital for researchers and clinicians who use the scale to monitor changes in risk and protective factors throughout the course of therapeutic intervention.

Factor Analysis

Both exploratory and confirmatory factor analyses performed during the scale’s development and subsequent evaluations unequivocally supported a clear, theoretically sound two-factor structure. The 14 items consistently separated into two distinct, though moderately correlated, factors: Negative Suicide Ideation (8 items) and Positive Suicide Ideation (6 items).

This validated structure provides empirical support for the dual-factor model of mental health, which posits that pathology and well-being are not simply opposite ends of a single continuum. The factors were found to provide unique predictive variance, meaning that interventions designed to increase protective factors (PI) can be assessed independently of those aimed at reducing risk factors (NI). This finding is essential for developing precise and targeted prevention and treatment protocols for vulnerable populations.

Instrument

Test Type: Self-report questionnaire / Psychometric Inventory

Format: 14 items rated on a 5-point Likert scale.

Language Available: Primarily English; adaptations may exist in other languages.

Population Group: Clinical and non-clinical adolescents.

Age Group: Adolescence (typically 12 to 18 years).

Population Details: Validated across diverse samples, including normal high school students and adolescent psychiatric inpatients.

Test Methodology: Respondents rate the frequency with which they have experienced the described thoughts or feelings over a specified period (e.g., the past month), using the following scale:

• 1 = None of the time
• 2 = Very rarely
• 3 = Some of the time
• 4 = A good part of the time
• 5 = Most of the time

Keywords

Adolescent Mental Health, Suicide Risk Assessment, Resilience, Dual-Factor Model, Psychological Inventory, Clinical Psychology, Self-Report Measure.

Authors

Author ORCID Identifier: Information not provided in source material.

Affiliation Email addresses: Information not provided in source material.

Correspondence Address: Information not provided in source material.

Permissions & Fee and Test Year

The Positive and Negative Suicide Ideation (PANSI) scale was developed in the early 2000s, with primary validation studies published in 2002 and 2003. Researchers and practitioners seeking specific information regarding permissions, licensing fees, and scale usage should contact the primary author, Dr. Augustine Osman, or the relevant journal publisher.

The original research abstract detailing the initial validation of the PANSI can be accessed online: http://onlinelibrary.wiley.com/doi/10.1002/jclp.10154/abstract.

A related study utilizing the scale in a Malaysian context is available as a PDF download: GOH LEE YING PDF.

Reference’s

Osman, A., Barrios, F. X., Gutierrez, P. M., Wrangham, J. J., Kopper, B. A., Truelove, R. S. & Linden, S. C. (2002). The Positive and Negative Suicide Ideation (PANSI) Inventory: Psychometric Evaluation With Adolescent Psychiatric Inpatient Samples. Journal of Personality Assessment; 79(3); 512-530.

Osman, A., Gutierrez, P. M., Jiandani, J., Kopper, B. A., Barrios, F. X., Linden. S. C., & Truelove, R. S. (2003). A preliminary validation of the positive and negative suicide ideation (PANSI) inventory with normal adolescent samples. Journal of Clinical Psychology, 59(4), 493-512.

Osman, A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A., & Barrios, F. X. (2001). The suicidal behaviors questionnaire-revised (SBQR): validation with clinical and nonclinical samples. Assessment, 8, 443–454.

Items of the Positive and Negative Suicide Ideation (PANSI)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

1. Seriously considered killing yourself because you could not live up to the expectations of other people?

2. Felt that you were in control of most situations in your life?

3. Felt hopeless about the future and you wondered if you should kill yourself?

4. Felt so unhappy about your relationship with someone you wished you were dead?

5. Thought about killing yourself because you could not accomplish something importantin your life?

6. Felt hopeful about the future because things were working out well for you?

7. Thought about killing yourself because you could not find a solution to a personalproblem?

8. Felt excited because you were doing well at school or at work?

9. Thought about killing yourself because you felt like a failure in life?

10. Thought that your problems were so overwhelming that suicide was seen as the onlyoption for you?

11. Felt so lonely or sad you wanted to kill yourself so that you could end your pain?

12. Felt confident about your ability to cope with most of the problems in your life?

13. Felt that life was worth living?

14. Felt confident about your plans for the future?

Scoring Key:

• Positive ideation (the protective factor) includes items 2, 6, 8, 12, 13 and 14.
• Negative ideation (the risk factor) includes items 1, 3, 4, 5, 7, 9, 10 and 11.