Love and Suicide: The Structure of the Affective Intensity Rating Scale (AIRS) and Its Relation to Suicidal Behavior

Abstract

BackgroundSuicide has been linked to intense negative affect. However, little is known about the range of affects experienced by suicidal persons, or the separate effects of affect valence and intensity. We examine a novel self-report scale, the 17-item Affective Intensity Rating Scale (AIRS), and its relation to suicidality in a high-risk sample.Methodology/Principal FindingsPatients presenting with suicidality were recruited from the Emergency Department in a large urban hospital, and completed a battery of assessments there. Structure of the AIRS was assessed using Maximum Likelihood Factor Analysis with Oblimin rotation. Convergent and divergent validity were assessed by regressing AIRS subscales against Brief Symptom Inventory subscales. Relation to suicidality was assessed by regression of suicide attempt status against scale and subscale scores, and individual items and two-way item interactions, along with significant clinical and demographic factors. 176 subjects were included in analyses. Three reliable subscales were identified within the AIRS measure: positive feelings towards self, negative feelings towards self, and negative feelings towards other. Only individual AIRS items associated significantly with suicide attempt status; strong ‘feelings of love’ associated positively with actual suicide attempt, while ‘feelings of calm’ and ‘positive feelings towards self’ associated negatively. Interaction analyses suggest ‘calm’ moderates the association of ‘love’ with suicide attempt.Conclusions/SignificanceFactor analysis of the AIRS is consistent with a circumplex model of affect. Affective dimensions did not predict suicidal behavior, but intense feelings of love, particularly in the absence of protective feelings of calm or positive self-view associated with current attempt.

Fear of Dying in Panic Attacks Predicts Suicide Attempt in Comorbid Depressive Illness: Prospective Evidence From the National Epidemiological Survey on Alcohol and Related Conditions

“…Further, growing evidence of insecure attachment as a common root developmental factor underlying and interacting with dysregulated self-esteem and affect, [31,[49][50][51] stress-sensitivity and HPA-axis dysregulation, [52] and, ultimately, suicide risk, [53][54][55] is also consistent with HPA-axis dysregulation in anxiety. [56,57] Further, our findings and proposed conceptualization are consistent with, though distinct from, the findings of Schnyder et al, [58] who observed that feelings of panic and "loss of control" were frequently reported to immediately precede SA in patients presenting to the emergency room after a nonlethal attempt, and the findings of Yaseen et al, [59,60] and Hendin et al, [61,62] regarding the role of intense negative punishment and separationdistress-related experiences (such as feelings of entrapment, dread, and desperation) in SA. Finally, the finding of Deisenhammer et al [63] that the average interval between SI and SA is a mere 10 minutes is consistent with the acuity of the panic state and the accelerative nature of positive-feedback mechanisms.…”

Predictive Validity of Proposed Diagnostic Criteria for the Suicide Crisis Syndrome: An Acute Presuicidal State

“…The Affect Intensity Rating Scale (Yaseen, Fisher, Morales, & Galynker, ) assesses current (i.e., in the past 3 days) state affect. Items are rated on a 5‐point Likert‐type scale, from 0 ( not at all ) to 4 ( extreme ).…”

Predictive Validity of the Suicide Trigger Scale (STS-3) for Post-Discharge Suicide Attempt in High-Risk Psychiatric Inpatients

“…Measures of associated symptom domains included the Beck Depression Inventory (BDI) [19], [20], the Affective Intensity Rating Scale (AIRS) [21], and the Barratt Impulsivity Scale (BIS-11) [22]. The Brief Symptom Inventory (BSI) [23] was included as a general measure of symptomatology.…”