Validation of Fearlessness about Death Scale in adolescents.

Abstract

Recent theories of suicide behavior have proposed a risk factor that differentiates suicide ideators from suicide attempters: Suicide capability. Fearlessness about death, one component of capability, has predicted the likelihood of a future attempt in adult samples. Although there is preliminary evidence about its value in youth, the fearlessness about death scale (FAD) has not yet been validated in clinical adolescents. We sought to examine the psychometric properties of this scale in adolescents at high risk for making a future suicide attempt. Youth who were evaluated for an intensive outpatient program (IOP) for suicidal adolescents (N = 496; M, SD for age = 14.78, 1.59) reported lifetime history of suicide attempts and NSSI, suicide ideation, depressive symptoms, and completed the FAD at entry and at discharge (n = 329). Confirmatory factor analysis showed structural validity of the FAD scale and its invariance across age, sex, and time. Independent t-tests indicated that FAD scores distinguished between those with and without NSSI, as well as those with single versus multiple attempts. When depression was covaried in logistic regression analyses, FAD’s relationship with suicide attempt history persisted, showing the construct’s divergence from depression. Our findings present psychometric validity in adolescents for a widely used scale developed for adults. This validation offers confidence that this promising risk factor can be adequately investigated in adolescents. If future studies can confirm its predictive validity, the brevity of this scale would make it a practical addition to a clinical assessment.

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

“…FAD reliability in our sample was strong (Cronbach's α = 0.85). The scale has shown strong convergent and discriminant validity in young adults (Ribeiro et al, 2014), and recently shown invariance across age, sex, and time in adolescents (Krantz et al, 2021).…”

“…A recent study found that the FAD predicted adolescent attempts during and in the short term following treatment for suicidal thoughts and behaviors, while controlling for other frequently cited risk variables (Ferm et al, 2020). Most recently, the scale's psychometric properties were validated in adolescents (Krantz et al, 2021). Additional investigations have shown invariance across suicide attempt history and in‐ versus outpatient status in adolescents (Yang et al, in review).…”

Traducción y validez del Acquired Capability for Suicide Scale Fearlessness About Death en adultos peruanos

“…Al respecto, el Acquired Capability for Suicide Scale -Fearlessness About Death (ACSS-FAD) es una versión reducida de la escala original de Capacidad Adquirida para el Suicidio (Ribeiro et al, 2014). El ACSS-FAD evalúa específicamente la intrepidez ante la muerte y ha sido adaptado en Alemania, Corea del Sur, Italia y Estados Unidos (Krantz et al, 2021;Magliocca et al, 2022;Seo & Kwon, 2017;Spangenberg et al, 2016). De acuerdo con los antecedentes, la población objetivo de estudio estuvo mayormente constituida por estudiantes universitarios de diferentes carreras profesionales (Magliocca et al, 2022;Seo & Kwon, 2017).…”

“…De acuerdo con los antecedentes, la población objetivo de estudio estuvo mayormente constituida por estudiantes universitarios de diferentes carreras profesionales (Magliocca et al, 2022;Seo & Kwon, 2017). Un estudio se basó en población general de adolescentes, adultos jóvenes y mayores (Spangenberg et al, 2016) y otro estudio en población clínica adolescente con antecedentes de conductas suicidas (Krantz et al, 2021). Respecto del enfoque y análisis estadístico, los cuatro países realizaron sus resultados a partir de la teoría clásica de los test (TCT) mediante las técnicas de análisis factorial confirmatorio, relación con otras variables y confiabilidad con los coeficientes omega y alfa; sin embargo, solo Estados Unidos analizó la estabilidad temporal de la confiabilidad (Krantz et al, 2021).…”

“…Un estudio se basó en población general de adolescentes, adultos jóvenes y mayores (Spangenberg et al, 2016) y otro estudio en población clínica adolescente con antecedentes de conductas suicidas (Krantz et al, 2021). Respecto del enfoque y análisis estadístico, los cuatro países realizaron sus resultados a partir de la teoría clásica de los test (TCT) mediante las técnicas de análisis factorial confirmatorio, relación con otras variables y confiabilidad con los coeficientes omega y alfa; sin embargo, solo Estados Unidos analizó la estabilidad temporal de la confiabilidad (Krantz et al, 2021). Por otro lado, solo tres países evaluaron la invarianza de medición entre los grupos de sexo y edad (Krantz et al, 2021;Seo & Kwon, 2017;Spangenberg et al, 2016), y solo Alemania incorporó valores normativos para sexo y edad (Spangenberg et al, 2016).…”