Multifacet assessment of capability for suicide: Development and prospective validation of the Acquired Capability With Rehearsal for Suicide Scale.

Abstract

The interpersonal theory of suicide proposes that acquired capability facilitates transformation of suicidal desire into lethal self-destructive behavior (Joiner, 2005). A new measure, the Acquired Capability With Rehearsal for Suicide Scale (ACWRSS), was devised to capture the key facets of acquired capability-pain tolerance and fearlessness of death-while also incorporating deliberate and active means to increase preparedness for suicide. The factor structure of the ACWRSS was tested using confirmatory factor analysis (n = 611). The 7-item ACWRSS conformed to the hypothesized 3-factor structure, demonstrating excellent fit and good internal consistency (α = .83). Measurement invariance across gender was also demonstrated on configural, metric, and scalar levels. Next, in the first longitudinal study of the association between acquired capability and suicide ideation, intention, and readiness (n = 234), the acquired capability facets prospectively predicted specific phases in the motivational-volitional pathway toward suicide readiness. Moreover, 2 of the acquired capability components mediated the relationship between baseline nonsuicidal self-injury and suicide readiness at follow-up. In an inpatient psychiatric sample (n = 108), the ACWRSS was significantly correlated with prior suicide attempts and thoughts and episodes of nonsuicidal self-injury, and its facets demonstrated differential sensitivity to change. The ACWRSS is the first measure of acquired capability that reliably and validly captures all key facets of this critical component of the interpersonal theory of suicide. Its brevity enhances its utility for both research and clinical settings. (PsycINFO Database Record

Differential predictors of DSM-5 PTSD and ICD-11 complex PTSD among African American women

“…To meet criteria for PTSD based on DSM-5, individuals need to have at least one threshold criterion B symptom (re-experiencing), one threshold criterion C symptom (avoidance), two criterion D symptoms (negative cognitions and mood), and two criterion E symptoms (reactivity and arousal), as well as duration longer than one month and functional impairment present (score ≥ 1). CAPS has been used in both civilian and veteran populations and shown good to excellent reliability and validity across multiple studies (Blake et al, 1995; Bovin et al, 2016; Pupo et al, 2011; Weathers, Keane, & Davidson, 2001). Interrater reliability (IRR) was calculated on a subsample of participants (6.0%, n  = 12) and showed good IRR for diagnosis of PTSD ( k =  0.83).…”

(In)stability of Capability for Suicide in Psychiatric Inpatients: Longitudinal Assessment Using Ecological Momentary Assessments

“…While long‐term CS has been described theoretically and several cross‐sectional studies have supported its associations with suicide attempts within the framework of the ITS (Glaesmer et al., ; Ma, Batterham, Calear, & Han, ), the IMV (Dhingra, Boduszek, & O'Connor, ), and the 3‐ST (Dhingra, Klonsky, & Tapola, ), empirical evidence from prospective studies about its development and its predictive value for suicidal behavior is rare (Ma et al., ; George, Page, Hooke, & Stritzke, ; May & Victor, ).…”

“…Moreover, George et al. () have evaluated the sensitivity of the CS facets to change after treatment in a prospective study in clinical inpatients demonstrating that the two facets differ in terms of stability: While fearlessness about death decreased after inpatient treatment (psychiatric acute care), pain tolerance did not change significantly. Although this provides first evidence that CS is subject to change over time (i.e., casting further doubt on the initially assumed static nature of the construct and supporting the assumption by Smith and Cukrowicz that there is a short‐term component of CS that may change in rather short periods), neither its temporal dynamics nor factors contributing to momentary shifts have been studied to date (Anestis et al., ; May & Victor, ).…”

“…In line with more recent reconceptualizations of CS (Anestis et al., ; Smith & Cukrowicz, ), we expected that CS will be subject to change over time (i.e., indicated by measures of within‐person variability and temporal instability). More specifically, we assumed perceived CS and pain tolerance to be more stable in comparison with fearlessness about death as shown by two recent studies (George et al., ; Rimkeviciene et al., ). To support the initially assumed static nature of CS, indicators of within‐person variability and temporal instability should be close to zero.…”

Examining Patterns of Change in the Acquired Capability for Suicide Among Eating Disorder Patients

“…In an examination of the role of emotion regulation and self‐injury on suicidal behavior, Heffer and Willoughby () found that emotion dysregulation predicted lower ACS among undergraduates at yearly measurements, controlling for earlier levels of ACS. A scale was recently developed to measure the facets of ACS as well as preparations for suicide; initial testing of this scale in an inpatient sample showed that mean levels of FAD by suicide and preparedness for suicide reduced between admission and discharge (George, Page, Hooke, & Stritzke, ). Both of these studies provide convergent evidence that ACS may not increase monotonically, as originally predicted, but neither examined person‐level changes in ACS over time.…”