Use of the acquired capability for suicide scale (ACSS) among United States military and Veteran samples: A systematic review

Kramer, Emily B.; Gaeddert, Laurel A; Jackson, Christine; Harnke, Ben; Nazem, Sarra

doi:10.1016/j.jad.2020.01.153

Cited by 16 publications

(14 citation statements)

References 47 publications

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“…Because the overall model exhibited such poor fit, we did not proceed with testing of measurement invariance. Instead, we contend that, consistent with previous recommendations (Ribeiro et al, 2014) that have not been fully implemented by researchers (Chu et al, 2017;Kramer et al, 2020), use of the full ACSS to assess capability for suicide is inadvisable.…”

Section: Discussionmentioning

confidence: 56%

“…Accordingly, the ACSS was shortened to the seven items assessing fearlessness about death, the Acquired Capability for Suicide Scale—Fearlessness About Death (ACSS-FAD; Ribeiro et al, 2014), which exhibits improved psychometric properties but only captures fearlessness about death. Nonetheless, despite psychometric issues with the ACSS and recommendations to use the ACSS-FAD, the ACSS and its various iterations are still predominantly used to assess capability for suicide (see Chu et al, 2017; Kramer et al, 2020).…”

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confidence: 99%

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Examination of measurement invariance of the Acquired Capability for Suicide Scale.

Rogers¹,

Bauer²,

Gai³

et al. 2021

Psychological Assessment

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Capability for suicide is frequently assessed using the Acquired Capability for Suicide Scale (ACSS) or the Acquired Capability for Suicide Scale-Fearlessness About Death (ACSS-FAD); however, the measurement invariance of these self-report measures across relevant demographic groups has not been tested. The current study aimed to examine the measurement invariance of the ACSS and ACSS-FAD across (a) gender; (b) suicide attempt status; and (c) military deployment history in a sample of 2,551 participants (M = 28.92, SD = 10.73; 56.7% male, 68.5% White) who participated in one of several studies funded by the Military Suicide Research Consortium. Results indicated that the ACSS exhibited poor model fit; thus, further investigation of measurement invariance was not conducted. Furthermore, although partial measurement invariance of the ACSS-FAD was met for gender, scalar invariance was not supported across military deployment history, and no form of measurement invariance was met across suicide attempt status. Overall, given the lack of strong model fit and measurement invariance in the ACSS and ACSS-FAD across several demographic groups, new or modified self-report measures for capability for suicide may be warranted. Public Significance StatementThis study examines the psychometric properties of the most commonly used measures for capability for suicide, the Acquired Capability for Suicide Scale (ACSS) and the Acquired Capability for Suicide Scale-Fearlessness About Death (ACSS-FAD). Results suggested that the ACSS was not suitable for assessing capability for suicide, and that the ACSS-FAD may be understood differently by different groups of people.

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Section: Discussionmentioning

confidence: 56%

mentioning

confidence: 99%

Examination of measurement invariance of the Acquired Capability for Suicide Scale.

Rogers¹,

Bauer²,

Gai³

et al. 2021

Psychological Assessment

View full text Add to dashboard Cite

show abstract

“…Unlike many civilian samples (Klonsky et al, 2016), there were no associations between demographic variables and suicide‐related behaviors in our high‐risk veterans. One potential reason for this is limited demographic variability among veteran relative to civilian samples (Kramer et al, 2020). Alternatively, the lack of demographic associations may suggest that high‐risk suicide behaviors were more closely related to the severity of underlying psychopathology than demographic factors.…”

Section: Discussionmentioning

confidence: 99%

Associations between veteran encounters with suicide prevention team and suicide‐related outcomes

Doran

Bismark

Khalifian

et al. 2021

Suicide & Life Threat Behav

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Objective Suicide rates have been of increasing concern across the United States, particularly among military veterans. The Veterans Health Administration has initiated multiple suicide prevention initiatives, but little research has examined the impact of these programs. The purpose of this study was to test the hypothesis that more frequent contact with suicide prevention clinicians would predict lower odds of suicidal behavior. Method Retrospective medical record review was performed for 1364 veterans identified as high risk for suicide during 2012–2018. Logistic regression was used to test whether the number of suicide prevention contacts predicted the odds of suicide attempt, any self‐directed violence, or reactivation of high‐risk status in the next year, accounting for age, sex, length of high‐risk episode, and other mental health contacts. Results Each additional suicide prevention coordinator contact was associated with 4%–5% lower odds of suicide attempt, suicidal behavior, and reactivation of high‐risk status in the next year (ps < 0.05). For suicide attempt and self‐directed violence, associations were stronger when considering only initial high‐risk episodes (8%–10% lower odds, ps < 0.05). Conclusions Findings suggest ongoing support from suicide prevention clinicians can have a significant protective effect. Additional research is needed to identify mechanisms by which this support reduces risk.

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“…This finding raises questions about the validity of previous studies using this scale in adults, because they frequently combine individuals with varying histories of suicide attempt. However, a review of suicide capability among military personnel found that the FAD was the best IPTS-based assessment of capability, while emphasizing that their mixed findings suggest that the construct is in need of refinement (Kramer et al, 2020).…”

Section: Interpersonal-psychological Theory Of Suicide and Fadmentioning

confidence: 99%

“…Research suggests that these changes might impact cognitions and risk factors for suicidal thoughts and behaviors (Bar-Joseph & Tzuriel, 1990). Furthermore, characteristics, events, and risk factors specific to military personnel limit the generalization of findings to nonmilitary populations (Kramer et al, 2020).…”

Section: Interpersonal-psychological Theory Of Suicide and Fadmentioning

confidence: 99%

Fearlessness about death and suicide planning predict lethality of adolescent suicide attempts during and following treatment

et al. 2022

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Introduction The rate of adolescent suicide attempt has increased drastically over the past 10 years. However, little is known regarding what predicts a more versus less lethal attempt, which is of critical interest to clinicians managing this at‐risk population. We sought to extend the study of lethality in adolescents by exploring its relationship with two recognized risk‐factors for suicide attempt: fearlessness about death (FAD) and suicide planning. Methods Participants (N = 254) were administered measures of FAD and depressive symptoms upon entering intensive outpatient treatment for adolescents exhibiting suicidal thoughts and behaviors. Attempts made between treatment entry and 6 months following discharge (n = 47) were scored on a 4‐point ordinal scale of lethality. The resulting continuum ranged from no attempt to attempts of low to moderate levels of lethality. Results FAD and suicide planning distinguished between levels of lethality of future attempt at the bivariate and multivariate level. FAD's predictive relationship with lethality while controlling for age, sex, depression, and prior attempt diminished when suicide planning was covaried. Conclusion FAD and suicide planning significantly predicted more versus less lethal future attempts in our sample of adolescents in a clinical setting. Our findings suggest that FAD influences the lethality of a future attempt by promoting planning for suicide. More studies are needed to assess whether the brief FAD scale might be a valuable adjunct in the clinical management of youth with suicidal thoughts and behaviors.

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Use of the acquired capability for suicide scale (ACSS) among United States military and Veteran samples: A systematic review

Cited by 16 publications

References 47 publications

Examination of measurement invariance of the Acquired Capability for Suicide Scale.

Examination of measurement invariance of the Acquired Capability for Suicide Scale.

Associations between veteran encounters with suicide prevention team and suicide‐related outcomes

Fearlessness about death and suicide planning predict lethality of adolescent suicide attempts during and following treatment

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