title: Improving the detection and prediction of suicidal behavior among military personnel by measuring suicidal beliefs: an evaluation of the Suicide Cognitions Scale.
abstract: BACKGROUND
  Newer approaches for understanding suicidal behavior suggest the assessment of suicide-specific beliefs and cognitions may improve the detection and prediction of suicidal thoughts and behaviors. The Suicide Cognitions Scale (SCS) was developed to measure suicide-specific beliefs, but it has not been tested in a military setting.
  
  
  METHODS
  Data were analyzed from two separate studies conducted at three military mental health clinics (one U.S. Army, two U.S. Air Force). Participants included 175 active duty Army personnel with acute suicidal ideation and/or a recent suicide attempt referred for a treatment study (Sample 1) and 151 active duty Air Force personnel receiving routine outpatient mental health care (Sample 2). In both samples, participants completed self-report measures and clinician-administered interviews. Follow-up suicide attempts were assessed via clinician-administered interview for Sample 1. Statistical analyses included confirmatory factor analysis, between-group comparisons by history of suicidality, and generalized regression modeling.
  
  
  RESULTS
  Two latent factors were confirmed for the SCS: Unloveability and Unbearability. Each demonstrated good internal consistency, convergent validity, and divergent validity. Both scales significantly predicted current suicidal ideation (βs >0.316, ps <0.002) and significantly differentiated suicide attempts from nonsuicidal self-injury and control groups (F(6, 286)=9.801, p<0.001). Both scales significantly predicted future suicide attempts (AORs>1.07, ps <0.050) better than other risk factors.
  
  
  CONCLUSIONS
  Self-report methodology, small sample sizes, predominantly male samples.
  
  
  CONCLUSIONS
  The SCS is a reliable and valid measure that predicts suicidal ideation and suicide attempts among military personnel better than other well-established risk factors.
authors.affiliation: National Center for Veterans Studies, Salt Lake City, UT, United States; The University of Utah, United States. Electronic address: craig.bryan@utah.edu.
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Bryan
authors.affiliation: National Center for Veterans Studies, Salt Lake City, UT, United States; The University of Memphis, United States.
authors.forename: M
authors.initials: M
authors.lastname: David Rudd
authors.affiliation: Fort Carson, CO, United States.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Wertenberger
authors.affiliation: Maxwell Air Force Base, AL, United States.
authors.forename: Neysa
authors.initials: N
authors.lastname: Etienne
authors.affiliation: National Center for Veterans Studies, Salt Lake City, UT, United States.
authors.forename: Bobbie N
authors.initials: BN
authors.lastname: Ray-Sannerud
authors.affiliation: Hurlburt Field, Mary Esther, FL, United States.
authors.forename: Chad E
authors.initials: CE
authors.lastname: Morrow
authors.affiliation: The University of Texas Health Science Center at San Antonio, United States.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Peterson
authors.affiliation: The University of Texas Health Science Center at San Antonio, United States.
authors.forename: Stacey
authors.initials: S
authors.lastname: Young-McCaughon
mesh_terms: D003071:Cognition; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012307:Risk Factors; D057566:Self Report; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data
keywords: Fluid vulnerability theory; Military; Suicidal belief system; Suicide; Unbearability; Unloveability