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

Abstract

Suicide capability is theorised to facilitate the movement from suicidal ideation to suicide attempt. Three types of contributors are posited to comprise suicide capability: acquired, dispositional, and practical. Despite suicide capability being critical in the movement from ideation-to-attempt, there has been no systematic synthesis of empirical evidence relating to suicide capability that would enable further development and refinement of the concept. This study sought to address this synthesis gap. A scoping review was conducted on suicide capability studies published January 2005 to January 2022. Eleven electronic databases and grey literature sources were searched returning 5,212 potential studies. After exclusion criteria application, 90 studies were included for final analysis. Results synthesis followed a textual narrative approach allocating studies based on contributors of suicide capability. Most studies focused on investigating only one factor within contributors. Painful and provocative events appear to contribute to acquired capability more so than fearlessness about death. Whilst emerging evidence for dispositional and practical contributors is promising, the small number of studies prevents further conclusions from being drawn. An unexpected additional cognitive contributor was identified. The focus of a single factor from most studies and the limited number of studies on contributors other than acquired capability limits the theoretical development and practical application of suicide capability knowledge. Given that suicide is a complex and multifaceted behaviour, future research that incorporates a combination of contributors is more likely to advance our understandings of suicide capability.

Changes in suicide capability during short-term partial hospital treatment

“…Different facets of capability may be influenced by separate intrapersonal and/or contextual processes and could be differentially responsive to interventions. Our results are in line with recent refinements of ideation-to-action theories (e.g., Klonsky et al, 2021) and reviews (e.g., Bayliss et al, 2022) that note the considerable heterogeneity in suicide capability. Accordingly, examining capability as a unitary construct occludes within-facet differences in short-term change that may be particularly relevant to understanding periods of heightened suicide risk.…”

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

“…Taken together, the suicidal mental imagery findings from this study provide tentative empirical support for a cognitive facet of suicide capability as suggested by Bayliss et al (2022). Furthermore, these findings are in accordance with recent research focusing on adolescents that found suicidal mental imagery differentiated ideators and attempters (De Rozario et al, 2021).…”

“…In addition to findings that imagery can differentiate suicide attempters from suicide ideators (De Rozario et al, 2021;Wetherall et al, 2018), imagery can be dynamic (Zaleskiewicz et al, 2023) and episodic (Lawrence et al, 2023) and therefore appropriate for EMA studies. Furthermore, suicidal cognitions, such as mental imagery, are not currently considered as part of suicide capability despite a recent review reporting cognitive differences between suicide attempters and ideators (Bayliss et al, 2022). Given the above, imagery warrants further investigation within suicide-focused EMA studies.…”

NSSI questionnaires revisited: A data mining approach to shorten the NSSI questionnaires

“…As supported by other studies, distress (Items 3, 6, 7, 8, 12, 14, 20) [64][65][66][67][68][69], depression and substance use disorder (SUD) ( Items 3,4,5,8,9,12,15,18,19,20,21) [1,67,[70][71][72] are strong predictors of NSSI. Despite existing in questionnaires previously, Emotional Reactivity (ER) has been recently proven to be a contributing factor for NSSI identification (Items 12, 16, 21, 22) [73].…”

“…NSSI and suicidal behaviors can be differentiated by (but not limited to) nine major factors: intent, lethality, chronicity, methods and functions, cognitions, reactions, aftermath, demographics, and prevalence [5]. While NSSI is primarily intended to eliminate 1) negative emotion, 2) body alienation (dissatisfaction), and 3) dissociation, suicide tends to be a way out of all of them at once when the injurers are not satisfied with the deceptive temporary pain caused by injuries, nor are they cured via therapies [1,5,[16][17][18][19][20][21][22][23].…”