The acquired capability for suicide: a comparison of suicide attempters, suicide ideators, and non-suicidal controls.
BACKGROUND
The Interpersonal Theory of Suicide states that to make a serious or lethal suicide attempt, a person must experience reductions in fear and pain sensitivity sufficient to overcome self preservation reflexes (i.e., the acquired capability for suicide). The purpose of this study was to examine the fearlessness component of the acquired capability for suicide using self-report assessment instruments and an objective measure of aversion (the affectively modulated startle reflex task).


METHODS
Depressed suicide ideators (n=15), depressed suicide attempters (n=15), and a group of control participants (n=14) were compared on their self-report of acquired capability and painful and provocative life events, and completed the affectively modulated startle reflex task. This task compared electromyography recordings of participants' eye-blink response to a startle probe while viewing pictures of varying hedonic valence (neutral, positive, negative, and suicide-related).


RESULTS
Suicide attempters reported the highest levels of fearlessness and pain insensitivity and a greater history of painful and provocative life events. Although no group differences were found on the psychophysiology data, participants reacted to suicide-related images with less aversion compared to neutral images with no differences between suicide-related and positive images.


CONCLUSIONS
Self-reported fearlessness and pain insensitivity can differentiate suicide attempters and suicide ideators. Results suggest that one's self-perception (i.e., cognitions regarding fear and pain tolerance) are more functionally related to suicide attempts than psychophysiological reactivity to suicide-related stimuli.
Smith
Phillip N
PN
University of Rochester School of Medicine, Department of Psychiatry, Rochester, NY, USA.
Cukrowicz
Kelly C
KC
Poindexter
Erin K
EK
Hobson
Valerie
V
Cohen
Lee M
LM
D000328:Adult; D001293:Attitude to Death; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000523:psychology; D004576:Electromyography; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010146:Pain / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011582:Psychological Theory; D012649:Self Concept; D057566:Self Report; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*; D055815:Young Adult
Suicide Life Threat Behav. 2007 Aug;37(4):379-96
17896879
Psychol Rev. 1990 Jul;97(3):377-95
2200076
Death Stud. 1996 Jul-Aug;20(4):327-41
10160569
J Consult Clin Psychol. 2008 Feb;76(1):72-83
18229985
Suicide Life Threat Behav. 2007 Jun;37(3):264-77
17579539
Behav Res Methods. 2007 May;39(2):326-34
17695361
Suicide Life Threat Behav. 2006 Feb;36(1):19-34
16676622
J Consult Clin Psychol. 1978 Oct;46(5):932-46
701572
J Abnorm Psychol. 1988 Nov;97(4):487-91
3204235
Suicide Life Threat Behav. 2010 Jun;40(3):266-75
20560748
Psychophysiology. 2005 Jan;42(1):1-15
15720576
Aust N Z J Psychiatry. 2007 Mar;41(3):257-65
17464707
J Abnorm Psychol. 1997 May;106(2):260-5
9131846
J Abnorm Psychol. 2005 May;114(2):291-303
15869359
J Behav Ther Exp Psychiatry. 1994 Mar;25(1):49-59
7962581
J Abnorm Psychol. 1996 Nov;105(4):541-50
8952187
Psychophysiology. 1995 Jul;32(4):351-7
7652111