Measuring acquired capability for suicide within an ideation-to-action framework.

Abstract

These findings implicate the PPEs that may be most important to assess in determining suicide risk, and, further, call into question the utility of acquired capability in differentiating between individuals along the suicide continuum.

Emotion Dysregulation and Military Suicidality Since 2001: A Review of the Literature

“…When individuals have high distress tolerance and “utilize coping methods that are sufficiently painful and/or provocative” (Law et al, , p. 31), such as fasting (Zuromski & Witte, ) and NSSI (Anestis et al, ; Anestis, Pennings, Lavender, Tull, & Gratz, ), their risk of progressing from ideation to suicidal behavior is pronounced. Indeed, frequent NSSI is empirically one of the strongest predictors of attempts (Burke et al, ; Hamza, Willoughby, & Good, ). Similarly, Burke et al () found that experiencing childhood abuse or neglect—which may habituate individuals to pain—significantly distinguished suicide attempters from ideators (see also Hadland et al, ; Rajalin, Hirvikoski, & Jokinen, ).…”

“…Indeed, frequent NSSI is empirically one of the strongest predictors of attempts (Burke et al, ; Hamza, Willoughby, & Good, ). Similarly, Burke et al () found that experiencing childhood abuse or neglect—which may habituate individuals to pain—significantly distinguished suicide attempters from ideators (see also Hadland et al, ; Rajalin, Hirvikoski, & Jokinen, ).…”

“…Though significant correlations exist between suicidal ideation and both perceived burdensomeness and thwarted belongingness (see O'Connor & Nock, 2014 for a review), according to IPTS only the presence of all three factors predicts a completed suicide. While approximately 9-13% of individuals may experience ideation during their life, only one-third of them will take suicidal action (Burke, Ammerman, Knorr, Alloy, & McCloskey, 2018;Nock et al, 2009). This is because the third factor, the capability for lethal self-harm, defies the basic human impulse of self-preservation (DeCatanzaro, 1980) and necessarily takes considerable effort and three additional capacities to overcome (Joiner, 2005).…”

“…Empirical evidence of 3ST shows that the interaction between pain and hopelessness significantly accounts for variance in ideation across genders and age groups, with connectedness playing a moderating role (Klonsky & May, 2015). While a recent meta-analysis (May & Klonsky, 2016) found that most traditional risk factors (e.g., depression, post-traumatic stress, past abuse) fail to significantly predict the transition from ideation to action, there is modest empirical evidence of dispositional, acquired, and practical capacities as specific predictors of that transition (Burke et al, 2018;Klonsky & May, 2015;Smith, Cukrowicz, Poindexter, Hobson, & Cohen, 2010).…”

Lethality of Previous Suicidal Behavior among Patients Hospitalized for Suicide Risk Predicts Lethality of Future Suicide Attempts

“…Importantly, acquired capability, characterized as habituation of fear and pain related to suicide (Van Orden et al., ), is considered a critical feature that may lead an individual to engage in high lethality suicidal behavior during acute high‐risk suicidal periods. Recently, Burke, Ammerman, Knorr, Alloy, and McCloskey () found people who reported an intent to die in a previous suicide attempt also endorsed a history of more painful and provocative events (e.g., nonsuicidal self‐injury) as compared to individuals with lower suicidal risk (e.g., suicidal ideation only). In the fluid vulnerability theory of suicidal behavior, the nonlinear patterns of suicide risk are emphasized, and repeated activation of a “suicidal mode” is thought to increase future risk by decreasing one's baseline threshold for suicidal behavior (Rudd, ).…”