Exploring the scope and structure of suicide capability

Objective Recent theories of suicide suggest that a construct called “capability for suicide” facilitates the progression from suicidal thoughts to attempts. Various measures of capability have been developed to assess different parts of the construct, but studies report inconsistent findings regarding reliability, validity, and structure. The present study pooled items from multiple measures to identify distinct, reliable, and valid domains of suicide capability. Method We administered items from several suicide capability measures to an online sample of US adults (n = 387), and utilized exploratory factor analysis to identify distinct domains of capability. We then examined the internal consistencies of and intercorrelations among these domains, as well as their associations with suicide attempts. Results Findings identified three domains of suicide capability: fearlessness about death, practical capability, and pain tolerance. These domains were internally consistent (αs = 0.80–0.92), and relatively independent from one another (intercorrelations = 0.15–0.35). Finally, each of these domains was moderately elevated among attempters compared to ideators (although only fearlessness about death and practical capability offered unique information about attempter status). Conclusions Findings suggest that fearlessness about death, practical capability, and pain tolerance can be measured reliably, and may be relevant for understanding which ideators make attempts.