Development and psychometric evaluation of the Military Suicide Attitudes Questionnaire (MSAQ)

Abstract

a b s t r a c tBackground: To date, a culturally-sensitive psychological instrument has not been developed to evaluate military attitudes toward suicide. Understanding these attitudes can inform suicide prevention research, clinical practice, and policy. We aimed to develop such an instrument and to evaluate its psychometric properties using an active-duty military sample. Methods: A team of military personnel, suicidologists, and researchers assisted with item development. A cross-sectional design was used to evaluate the psychometric properties of the Military Suicide Attitudes Questionnaire (MSAQ) via an online survey battery. Exploratory and confirmatory factor analyses were conducted. Results: A total of 317 military service members met eligibility criteria and completed the online surveys. A four-factor model that explained 46.4% of the variance was identified: (1) Individual-Based Rejection versus Acceptance; (2) Psychache versus Pathological; (3) Unit-Based Rejection versus Acceptance; (4) Moral versus Immoral. The MSAQ demonstrated high partial validity and testretest reliability. Limitations: The study used a convenience sample and did not control for social desirability. Conclusions: The newly developed MSAQ is a promising measure that fills a notable gap in the assessment of suicide attitudes within the United States military. The MSAQ has the potential for future use in evaluating suicide prevention and stigma reduction programs within the Department of Defense. Additionally, the MSAQ may serve as a useful tool for leadership in the evaluation of command climates. In clinical settings, the MSAQ could be used along with other cognitive and attitudinal measures to track suicidal patients' attitude towards suicide over the course of treatment.Published by Elsevier B.V.

Circumstances preceding suicide in U.S. soldiers: A qualitative analysis of narrative data.

“…Unfortunately, it is not uncommon for SMs to exhibit significant reluctance toward seeking professional help because of MH stigma (Coleman, Stevelink, Hatch, Denny, & Greenberg, 2017; Weeks, Zamorski, Rusu, & Colman, 2017). Addressing MH stigma is key to the military suicide prevention mission (VanSickle, Tucker, Daruwala, & Ghahramanlou-Holloway, 2016). MH stigma is multifaceted, thus a multilevel approach is required to address a current gap in the development and long-term follow-up of effective stigma reduction interventions (Coleman et al, 2017; Gronholm, Henderson, Deb, & Thornicroft, 2017; Thornicroft et al, 2016).…”

Evaluation of psychometric properties of the Persian version of the predicaments questionnaire, exploring social attitudes to suicide

“…Negative attitudes, by imposing weakness, shame, sin, or guilt on individuals, stigmatize suicide, leading them to consider suicide as a definitive option. In contrast, positive attitudes, by reducing stigma, increase people's help-seeking and, therefore, diminish suicide occurrence ( 23 ). It has been proposed that people's attitude to suicide depends heavily on their emotional closeness to the person considering attempting suicide ( 24 ).…”

“…A major challenge in measuring people's attitudes toward suicide is their subjectivity and variability over time. There are certain instruments and scales that intend to assess people's attitudes toward suicide but some are designed for a particular social group of people, for instance military ( 23 ) or nursing personnel ( 25 ). A significant number of instruments contain suicide myths, i.e., society's misconceptions about suicide.…”