The Interactive Effects of the Capability for Suicide and Major Depressive Episodes on Suicidal Behavior in a Military Sample

Abstract

Major depressive symptoms represent a significant risk for suicidal ideation and behavior. Given that suicide is fearsome, the interpersonal theory of suicide proposes that individuals who engage in suicidal behavior possess not only the desire to die, but also the acquired capability (AC) for suicide. This study examined whether major depressive episodes (MDEs) may be particularly relevant to suicidal behavior when considered in the context of AC. History of MDEs, AC, and suicide attempt history were examined in a large (n=3,377) sample of military members. Data were analyzed using hierarchical multiple regression. Results indicated that among individuals with high AC, the number of MDEs was significantly, positively associated with number of previous suicide attempts; MDEs were not significantly related to suicide attempt history among individuals with low AC. Findings held in the presence of robust covariates associated with suicidal behavior. Findings suggest that a history of MDEs alone may not indicate severe suicide risk – increased AC for suicide appears necessary for increased suicide risk. Implications for suicide treatment and prevention in military personnel are discussed.

Suicide capability within the ideation-to-action framework: A systematic scoping review

“…However, five studies used either a small number of items or a single item from the ACSS that the researcher/s had selected, or they used the short form of the ACSS. For example, Chu et al [ 62 ] used a four-item version of the ACSS, Smith et al [ 63 ] used an eight-item version, Blankenship [ 64 ] used the single ACSS item “I am not at all afraid to die”, and Wolford-Clevenger et al [ 65 ] used the short form of the ACSS.…”

“…Studies with larger samples often used community health datasets not primarily designed for suicide research as data (see [ 71 – 75 ]). Only seven studies reported conducting a priori power analyses to determine required sample (see [ 62 , 64 , 65 , 76 – 79 ]).…”

“…Nine studies included genders other than male or female. There were 21 single gender studies and when more than one gender was represented, most studies reported gender disproportionate samples, such as 91.9% males [ 62 ] and 93.90% females [ 81 ]. Seventeen studies had a gender difference split of less than 10% (i.e., less than a 45%/55% split).…”

Implicit Measures of Suicide Risk in a Military Sample

“…Though it was not feasible to obtain information regarding when the clinical assessments were completed in relation to the time of the present study, research has provided support for using chart diagnostic information in research studies conducted at a later point in time (e.g., Fennig, Craig, Tanenberg-Karant, & Bromet, 1994; Joiner & Lonigan, 2000; Lonigan, Carey, & Finch, 1994). Studies have also supported this methodology in military contexts (e.g., Chu et al, 2016; Hom et al, 2016)…”

Adolescent suicide attempts in the United States: When suicide ideation and suicide capability interact

“…Results indicated that being sad or hopeless was positively associated with attempted suicide. Studies examining depression and acquired capability provided support for the moderating effects of capability in the relationship between depression and suicide attempts among adult samples (Chu et al, 2016; Ferriman et al, 2020); however, the evidence for adolescents is limited. There is still much more to know regarding the antecedents, the characteristics, and the contextual factors of adolescents who attempt suicide.…”