Fluctuations in and associations between physical and psychological distance to suicide methods, fearlessness about death, and suicidal intent.

Abstract

Previous evidence has highlighted the potential roles of both physical and psychological distance to suicide methods as an important factor in conferring suicide risk; however, less is known about the temporal stability of and associations between these constructs, other facets of capability for suicide, and suicide-related outcomes. The present study examined fluctuations in and associations between physical and psychological distance to suicide methods, fearlessness about death, and suicidal intent using ecological momentary assessment. A sample of 237 adults at high risk for suicide (61.6% female, M age = 27.12 years) responded to six prompts daily for 2 weeks assessing their physical and psychological distance to preferred suicide methods, fearlessness about death, and suicidal intent. Results indicated that physical and psychological distance to suicide methods exhibited both traitand state-like properties, that lower physical and psychological distance and higher fearlessness about death were associated with higher concurrent suicidal intent, and that lower psychological distance was uniquely predictive of higher subsequent time-point suicidal intent, controlling for concurrent suicidal intent. Suicide attempt history and preferred suicide methods were explored as potential moderating factors. Overall, these findings highlight the importance of assessing and intervening upon psychological distance to suicide methods, in addition to physical proximity to these methods, in lethal means counseling.

Fluidity in capability: Longitudinal assessments of suicide capability using ecological momentary assessments

“…Findings indicate that there was considerable variability for facets of suicide capability. Acquired, dispositional, and perceived capability within‐person variances were greater than from previous studies (Rogers et al., 2022; Spangenberg et al., 2019). Differences may be related to previous studies including participants with a greater risk of suicide than this study.…”

“…Suicidal behaviors are not typically included in results given the low rates at which they occur within studies (Rogers et al., 2022) because of the issue of generalisability (Fisher et al., 2018). Whilst understandable, its exclusion perhaps overlooks data that can potentially contribute to meaningfully to theoretical progress.…”

“…(2018) that is reflective of the IMV (O'Connor, 2011; O'Connor & Kirtley, 2018). Based on recent findings (Rogers et al., 2022; Spangenberg et al., 2019), we expected facets of capability to fluctuate. Second, we examined facets of suicide capability occurring concurrently with and predictive of suicidal ideation.…”

“…They found reported acquired capability and perceived capability fluctuated in approximately 90% and 75% of participants. Recently, temporal stability and associations between facets of capability and suicidal intent were examined six times a day over 14 days (Rogers et al., 2022). Both acquired (i.e., fearlessness about death) and practical capability (i.e., physical and psychological distance to suicide method) were found to fluctuate.…”

Who are the patients who deny suicidal intent? Exploring patients' characteristics associated with self‐disclosure and denial of suicidal intent

“…It is thus possible that discrepancies in disclosing intent to clinicians versus RAs may be attributable, at least in part, to the patients' changes across this period. While the documented transient nature of suicidal ideation 14 would suggest such may have been the case, recent literature suggests that suicidal intent is less variable across time, 63 bolstering our confidence that the differential disclosure patterns observed are not due to the time elapsed between the assessments. Second, the specific measures used to assess disclosure of intent to RAs (item 4 on the C-SSRS) and clinicians (i.e., clinician report on the SCARS module of the MARIS that patients endorsed suicidal intent) differed, potentially contributing to the discrepancies between disclosure to RAs and clinicians.…”