ObjectiveRecent theories of suicide suggest that a construct called “capability for suicide” facilitates the progression from suicidal thoughts to attempts. Various measures of capability have been developed to assess different parts of the construct, but studies report inconsistent findings regarding reliability, validity, and structure. The present study pooled items from multiple measures to identify distinct, reliable, and valid domains of suicide capability.MethodWe administered items from several suicide capability measures to an online sample of US adults (n = 387), and utilized exploratory factor analysis to identify distinct domains of capability. We then examined the internal consistencies of and intercorrelations among these domains, as well as their associations with suicide attempts.ResultsFindings identified three domains of suicide capability: fearlessness about death, practical capability, and pain tolerance. These domains were internally consistent (αs = 0.80–0.92), and relatively independent from one another (intercorrelations = 0.15–0.35). Finally, each of these domains was moderately elevated among attempters compared to ideators (although only fearlessness about death and practical capability offered unique information about attempter status).ConclusionsFindings suggest that fearlessness about death, practical capability, and pain tolerance can be measured reliably, and may be relevant for understanding which ideators make attempts.

Risk assessment methods have been shown to be sensitive predictors of suicide and suicide attempts, but the frequency of false positives limits their clinical utility. Research to refine these methods and examine clinical applications is needed. Studies of suicide prevention interventions are inconclusive; trials of population-level interventions and promising therapies are required to support their clinical use.

Research indicates that connection to mental health care services and treatment engagement remain challenges among suicide attempt survivors. One way to improve suicide attempt survivors' experiences with mental health care services is to elicit suggestions directly from attempt survivors regarding how to do so. This study aimed to identify and synthesize suicide attempt survivors' recommendations for how to enhance mental health treatment experiences for attempt survivors. A sample of 329 suicide attempt survivors (81.5% female, 86.0% White/Caucasian, mean age ϭ 35.07 Ϯ 12.18 years) provided responses to an open-ended self-report survey question probing how treatment might be improved for suicide attempt survivors. Responses were analyzed utilizing both qualitative and quantitative techniques. Analyses identified four broad areas in which mental health treatment experiences might be improved for attempt survivors: (a) provider interactions (e.g., by reducing stigma of suicidality, expressing empathy, and using active listening), (b) intake and treatment planning (e.g., by providing a range of treatment options, including nonmedication treatments, and conducting a thorough assessment), (c) treatment delivery (e.g., by addressing root problems, bolstering coping skills, and using trauma-informed care), and (d) structural issues (e.g., by improving access to care and continuity of care). Findings highlight numerous avenues by which health providers might be able to facilitate more positive mental health treatment experiences for suicide attempt survivors. Research is needed to test whether implementing the recommendations offered by attempt survivors in this study might lead to enhanced treatment engagement, retention, and outcomes among suicide attempt survivors at large. Impact StatementThis study identifies various avenues by which mental health treatment might be improved for suicide attempt survivors. This study also highlights the importance of leveraging the perspectives of individuals with lived experience in suicide prevention research.

In this study, we examined the indirect effect of the Virtual Hope Box (VHB) smartphone application on suicidal ideation, mediated through coping self-efficacy. A total of 117 veterans with suicidal ideation completed measures on coping self-efficacy and suicidal ideation at baseline and weeks 3, 6, and 12. Participants were randomly assigned to either the VHB or enhanced treatment as usual (eTAU) condition. Parallel process growth curve modeling (-0.20 [95% CI = -0.44, 0.00]) and auto-regressive modeling (-0.12 [95% CI = -0.35, -0.01]) revealed that a higher rate of change in coping self-efficacy in the VHB group was associated with a decrease in suicidal ideation severity, as compared to the eTAU group. Findings suggest that coping self-efficacy may be one mechanism by which the VHB operates to help reduce suicidal ideation. More broadly, the role of coping self-efficacy in reducing suicidal ideation is worthy of future study.

Our ability to make scientific progress is dependent upon our interpretation of data. Thus, analyzing only those data that are an honest representation of a sample is imperative for drawing accurate conclusions that allow for robust, generalizable, and replicable scientific findings. Unfortunately, a consistent line of evidence indicates the presence of inattentive/careless responders who provide low-quality data in surveys, especially on popular online crowdsourcing platforms such as Amazon’s Mechanical Turk (MTurk). Yet, the majority of psychological studies using surveys only conduct outlier detection analyses to remove problematic data. Without carefully examining the possibility of low-quality data in a sample, researchers risk promoting inaccurate conclusions that interfere with scientific progress. Given that knowledge about data screening methods and optimal online data collection procedures are scattered across disparate disciplines, the dearth of psychological studies using more rigorous methodologies to prevent and detect low-quality data is likely due to inconvenience, not maleficence. Thus, this review provides up-to-date recommendations for best practices in collecting online data and data screening methods. In addition, this article includes resources for worked examples for each screening method, a collection of recommended measures, and a preregistration template for implementing these recommendations.

Three commonly used behavioral economic strategies were tested to investigate their utility in suicide prevention and mental health initiatives. Study 1 used a social norms nudge to potentially increase the people who accessed an online suicide risk factor intervention via e-mail ( N = 14,792). E-mails containing the social norm nudge were 164% more likely to click on the link relative to those who received the e-mail without the nudge. Study 2 used item count technique to better estimate suicidal ideation compared with direct questioning methods endorsed by two groups of online participants ( N = 787). No difference between groups was found. Study 3 used framing techniques to understand if participants ( N = 787) were more likely to access online coping skills when framed as being able to help others who may go through a suicidal crisis rather than themselves. Findings indicated more participants accessed the coping skills when framed as having utility for helping other people going through a suicidal crisis.

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Objective Children with attention-deficit/hyperactivity disorder (ADHD) are at greater risk for suicidal ideation and suicide attempts compared to those without ADHD. Increased risk is at least partially attributable to a subset of children with ADHD and comorbid depression or disruptive behavior disorders; however, the early predictors and mechanisms driving increased risk are not well understood. Here, we investigate the contributions of two candidate mechanisms for increased suicidal ideation in children with ADHD: executive function and negative affect. Methods 623 clinically well-characterized, community-recruited children classified by research criteria as ADHD (n=388) or typically-developing controls (n=253) participated. Parent-report on the Temperament in Middle Childhood Questionnaire provided a measure of negative affectivity. Children completed laboratory tasks to measure response inhibition and working memory. Suicidal ideation was evaluated by parent report during a semi-structured interview and child responses on the Children’s Depression Inventory. Results Compared to typically developing controls, children with ADHD had higher rates of suicidal ideation, more negative affect, slower stop signal reaction times, and weaker working memory. Statistical path-model analyses confirmed the hypothesis that weaker working memory in ADHD statistically mediated increased negative affect. Weaker working memory also mediated and increased suicidal ideation in these cross sectional data. Findings were not attributable to comorbid disruptive behavioral disorders. Poor response inhibition did not reliably mediate negative affect or suicidal ideation. Conclusion Impairment in working memory is an important early risk factor for suicidal ideation in children with ADHD, and may help in identifying children for prevention and early intervention efforts.