The acquired capability for suicide: a comparison of suicide attempters, suicide ideators, and non-suicidal controls
Open accessAbstract
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.
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Attempters did not differ from suicide ideators or healthy volunteers in psychophysiological reactivity to suicide-specific images; however, self-reported fearlessness was highest among attempters.
“Others have found that attempters did not differ from suicide ideators or healthy volunteers in psychophysiological reactivity to suicide-specific images; however, self-reported fearlessness was highest among attempters (Smith et al., 2010).”
From Toward objective characterizations of suicide risk: A narrative review of laboratory-based cognitive and behavioral tasks (2023) · cites this paper as Smith et al., 2010
Having fearlessness about death and reduced pain sensitivity appear to be important mechanisms in increasing the ability to act upon one's thoughts of suicide.
“Specifically, having fearlessness about death and reduced pain sensitivity appear to be important mechanisms in increasing the ability to act upon one's thoughts of suicide (Smith et al., 2010).”
From From ideation to action: Differentiating between those who think about suicide and those who attempt suicide in a national study of young adults (2018) · cites this paper as Smith et al., 2010
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Cites
Measuring emotion: The self-assessment manikin and the semantic differential
Bradley, M. M., & Lang, P. J. (1994) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/0005-7916(94)90063-9 · Cited by 9,538 · see citing works
(2005) · CTIT technical reports series · Cited by 5,307 · see citing works
Joiner, T. E. (2007) · Harvard University Press eBooks · doi:10.2307/j.ctvjghv2f · Cited by 2,891 · see citing works
Assessing the impact of life changes: Development of the Life Experiences Survey.
Sarason, I. G., Johnson, J. H., & Siegel, J. M. (1978) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.46.5.932 · Cited by 2,788 · see citing works
Emotion, attention, and the startle reflex
Lang, P. J., Bradley, M. M., & Cuthbert, B. N. (1990) · Psychological Review · doi:10.1037/0033-295x.97.3.377 · Cited by 2,205 · see citing works
Committee report: Guidelines for human startle eyeblink electromyographic studies
Blumenthal, T. D., Cuthbert, B. N., Filion, D. L., Hackley, S., Lipp, O. V., & Van Boxtel, A. (2005) · Psychophysiology · doi:10.1111/j.1469-8986.2005.00271.x · Cited by 1,169 · see citing works
The Handbook of emotion elicitation and assessment
(2008) · Choice Reviews Online · doi:10.5860/choice.46-1769 · Cited by 1,127 · see citing works
Van Orden, K. A., Witte, T. K., Gordon, K. H., Bender, T. W., & Joiner, T. E. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.1.72 · Cited by 1,126 · see citing works
Silverman, M. M., Berman, A. L., Sanddal, N. D., O'Carroll, P. W., & Joiner, T. E. (2007) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2007.37.3.264 · Cited by 991 · see citing works
The psychophysiology of emotion.
Larsen, J. T., Berntson, G. G., Poehlmann, K. M., Ito, T. A., & Cacioppo, J. T. (1993) · Cited by 957 · see citing works
The International Affective Picture System (IAPS) in the Study of Emotion and Attention
Bradley, M. M., & Lang, P. J. (2007) · Handbook of Emotion Elicitation and Assessment · doi:10.1093/oso/9780195169157.003.0003 · Cited by 915 · see citing works
The startle probe response: A new measure of emotion?
Vrana, S. R., Spence, E. L., & Lang, P. J. (1988) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.97.4.487 · Cited by 603 · see citing works
The startle probe response: A new measure of emotion?
Vrana, S. R., Spence, E. L., & Lang, P. J. (1988) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.97.4.487 · Cited by 467 · see citing works
The Interpersonal Theory of Suicide: Guidance for Working with Suicidal Clients
Joiner, T. E., Orden, K. V. V., Witte, T., & Rudd, M. (2009) · American Psychological Association eBooks · doi:10.1037/11869-000 · Cited by 417 · see citing works
Joiner, T. E., Conwell, Y., Fitzpatrick, K. K., Witte, T. K., Schmidt, N. B., Berlim, M. T., Fleck, M. P., & Rudd, M. D. (2005) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.114.2.291 · Cited by 354 · see citing works
Relationships among suicide ideators, attempters, and multiple attempters in a young-adult sample.
Rudd, M. D., Joiner, T., & Rajab, M. H. (1996) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.105.4.541 · Cited by 290 · see citing works
Christiansen, E., & Frank Jensen, B. (2007) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670601172749 · Cited by 283 · see citing works
Multidimensional normative ratings for the International Affective Picture System
Libkuman, T. M., Otani, H., Kern, R. P., Viger, S. G., & Novak, N. (2007) · Behavior Research Methods · doi:10.3758/bf03193164 · Cited by 190 · see citing works
Smith, P. N., & Cukrowicz, K. C. (2010) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2010.40.3.266 · Cited by 184 · see citing works
Self-citationJr. Joiner Thomas, E., Rudd, M. D., & Rajab, M. H. (1997) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.106.2.260 · Cited by 133 · see citing works
Haw, C., Bergen, H., Casey, D., & Hawton, K. (2007) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2007.37.4.379 · Cited by 116 · see citing works
Reynolds, S. K., Lindenboim, N., Comtois, K. A., Murray, A., & Linehan, M. M. (2006) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2006.36.1.19 · Cited by 100 · see citing works
Joiner, T. E., Rudd, M. D., & Rajab, M. H. (1997) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.106.2.260 · Cited by 98 · see citing works
Tolerance for physical pain in suicidal subjects
Orbach, I., Palgi, Y., Stein, D. J., Har‐Even, D., Lotem‐Peleg, M., Asherov, J., & Elizur, A. (1996) · Death Studies · doi:10.1080/07481189608252786 · Cited by 69 · see citing works
Emotional modulation of skin conductance and eyeblink responses to a startle probe
Vrana, S. R. (1995) · Psychophysiology · doi:10.1111/j.1469-8986.1995.tb01217.x · Cited by 57 · see citing works
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Cited by
Sorted by citations
Chu, C., Buchman-Schmitt, J. M., Stanley, I. H., Hom, M. A., Tucker, R. P., Hagan, C. R., Rogers, M. L., Podlogar, M. C., Chiurliza, B., Ringer, F. B., et al. (2017) · Psychological Bulletin · doi:10.1037/bul0000123 · Cited by 1,231 · see citing works
The psychology of suicidal behaviour
O'Connor, R. C., & Nock, M. K. (2014) · The Lancet Psychiatry · doi:10.1016/s2215-0366(14)70222-6 · Cited by 1,193 · see citing works
Klonsky, E. D., & May, A. M. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12068 · Cited by 740 · see citing works
Reconsidering the link between impulsivity and suicidal behavior
Anestis, M. D., Soberay, K. A., Gutierrez, P. M., Hernández, T. D., & Joiner, T. E. (2014) · Personality and Social Psychology Review · doi:10.1177/1088868314535988 · Cited by 307 · see citing works
Psychological pain, depression, and suicide: Recent evidences and future directions
Conejero, I., Olié, E., Calati, R., Ducasse, D., & Courtet, P. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0893-z · Cited by 206 · see citing works
Dhingra, K., Boduszek, D., & O’Connor, R. C. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.07.007 · Cited by 169 · see citing works
Wetherall, K., Cleare, S., Eschle, S., Ferguson, E., O'Connor, D. B., O'Carroll, R. E., & O'Connor, R. C. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.07.074 · Cited by 131 · see citing works
Glenn, C. R., Cha, C. B., Kleiman, E. M., & Nock, M. K. (2017) · Clinical Psychological Science · doi:10.1177/2167702616686854 · Cited by 113 · see citing works
A structural test of the integrated motivational-volitional model of suicidal behaviour
Dhingra, K., Boduszek, D., & O'Connor, R. C. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.03.023 · Cited by 105 · see citing works
Smith, P., Poindexter, E., & Cukrowicz, K. (2010) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2010.40.6.535 · Cited by 72 · see citing works
Self-citationGranato, S. L., Smith, P. N., & Selwyn, C. N. (2015) · Psychology of Men & Masculinity · doi:10.1037/a0038181 · Cited by 70 · see citing works
Self-citationA test of the interpersonal theory of suicide in a large sample of current firefighters
Chu, C., Buchman-Schmitt, J. M., Hom, M. A., Stanley, I. H., & Joiner, T. E. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.03.041 · Cited by 62 · see citing works
Zou, Y., Li, H., Shi, C., Lin, Y., Zhou, H., & Zhang, J. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2016.12.046 · Cited by 54 · see citing works
The differences between suicide ideators and suicide attempters: simple, complicated, or complex
Huang, X., Ribeiro, J. D., & Franklin, J. C. (2020) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000498 · Cited by 50 · see citing works
Smith, P. N., Stanley, I. H., Joiner, T. E., Sachs-Ericsson, N. J., & Van Orden, K. A. (2016) · Archives of Suicide Research · doi:10.1080/13811118.2016.1162245 · Cited by 35 · see citing works
Self-citationBallard, E. D., Ionescu, D. F., Voort, J. L. V., Slonena, E. E., Franco-Chaves, J. A., Zarate, C. A., & Grillon, C. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.03.027 · Cited by 33 · see citing works
The neural correlates of low social integration as a risk factor for suicide
Cáceda, R., James, G. A., Stowe, Z. N., Delgado, P. L., Kordsmeier, N., & Kilts, C. D. (2020) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-019-00990-6 · Cited by 25 · see citing works
Hazlett, E. A., Blair, N. J., Fernandez, N., Mascitelli, K., Perez‐Rodriguez, M. M., New, A. S., Goetz, R. R., & Goodman, M. (2016) · Psychophysiology · doi:10.1111/psyp.12698 · Cited by 20 · see citing works
Lieberman, L., Petrey, K., Shankman, S. A., Phan, K. L., & Gorka, S. M. (2020) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2020.06.003 · Cited by 20 · see citing works
Lamontagne, S. J., Zabala, P. K., Zarate, C. A., & Ballard, E. D. (2023) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105361 · Cited by 12 · see citing works
Cwik, J. C., Forkmann, T., Glaesmer, H., Paashaus, L., Schönfelder, A., Rath, D., Prinz, S., Juckel, G., & Teismann, T. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02812-9 · Cited by 5 · see citing works
- Authors
- Smith, P. N., Cukrowicz, K. C., Poindexter, E. K., Hobson, V., & Cohen, L. M.
- Affiliations
- University of Rochester Medicine (US)
- Texas Tech University (US)
- Corresponding author
- Cukrowicz, Kelly C.
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2010-08-30
- Volume
- 27
- Issue
- 9
- Pages
- 871-877
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC5022783
- OpenAlex
- W2129146534
- Cited by
- 202
- References
- 25
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 11 · 2023: 14 · 2022: 6 · 2021: 10 · 2020: 18 · 2019: 13 · 2018: 12 · 2017: 17 · 2016: 26 · 2015: 17 · 2014: 16 · 2013: 9 · 2012: 6
- FWCI
- 5.96
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5t32mh020061-25)
- National Institute of Mental Health (T32-MH020061)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- acquired capability for suicide, suicide attempters, suicidal ideation, fearlessness, pain insensitivity, interpersonal theory of suicide, depression, self-perception
- MeSH terms
- Adult, Attitude to Death, Depressive Disorder, Electromyography, Fear, Female, Humans, Life Change Events, Male, Middle Aged, Models, Psychological, Pain, Psychiatric Status Rating Scales, Psychological Theory, Self Concept, Socioeconomic Factors, Suicide, Attempted, Case-Control Studies, Young Adult, Self Report, Suicidal Ideation
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