Anxiety Sensitivity Index-3 Suicidal Cognition Concerns: A New Measure Examining Negative Reactions to Suicidal Ideation

Abstract

Objective

Anxiety sensitivity cognitive concerns (ASCC), the fear of the consequences of mental dyscontrol, has been established as a risk factor for suicidal ideation (SI). Treatments targeted at reducing ASCC have been shown to reduce suicide risk. In this study, a new self-report measure, the Anxiety Sensitivity Index-3 Suicidal Cognition Concerns (ASI-3-SCC), was developed to assess sensitivity specifically to thoughts of suicide and wanting to die.

Method

Participants completed the new measure as well as measures of anxiety sensitivity, depressive symptoms, SI, and worst point SI. We hypothesized that the ASI-3-SCC would be associated with SI and worst point SI. Additionally, we hypothesized that the ASI-3-SCC would moderate the relationship between ASCC and SI.

Results

As predicted, the ASI-3-SCC was significantly associated with SI in the past two weeks and lifetime worst point SI after accounting for ASCC and depression. The ASI-3-SCC also moderated the relationship between ASCC and SI such that ASCC was related to SI at high levels of ASI-3-SCC.

Conclusions

We suggest that the interpretation of SI and feelings of wanting to die as dangerous may lead to more attention to those thoughts when they occur and increased psychological distress associated with those thoughts. This measure will allow researchers to measure a novel construct in the literature and further examine the impact of catastrophic interpretations of suicidal thoughts.

Highlights

• Created a new measure for sensitivity to thoughts of suicide and wanting to die.

• Suicidal cognition concerns associated with suicidal ideation in the past two weeks.

• Suicidal cognition concerns associated with lifetime worst point suicidal ideation.

• Suicidal cognition concerns moderated AS cognitive concerns and ideation relation.

Keywords:

• Anxiety sensitivity cognitive concerns
• suicide
• worst-point ideation

ACKNOWLEDGEMENTS

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

Notes

1 The pattern of significance was the same for transformed and non-transformed variables in the regression analyses. The non-transformed ASI-3-SCC and interaction term did not reach statistical significance in the moderation analysis.

2 The pattern of significance for the overall model was the same with and without DASS-21 included in step one of the regression models. ASCC was a significant predictor of both current ideation and worst-point ideation in step one when DASS-21 was not included (p < 0.01) and was a significant predictor of current ideation (p = 0.03) but not worst-point ideation (p = 0.48) in the second step.

3 When the moderator and independent variable were interchanged, the model was not significant, b = 0.05, t(167) = 1.84, p = 0.07, 95% CI = –0.003 to 0.095.

4 When the moderator and independent variable were interchanged, the model was not significant, b = <0.01, t(167) = –0.58, p = 0.56, 95% CI = –0.013 to 0.007.

Additional information

Notes on contributors

Nicole S. Smith

Nicole S. Smith: Nicole is broadly interested in studying cognition in anxiety disorders. Specifically, she is interested in cognitive biases such as anxiety sensitivity as it applies to anxiety disorders and suicide prevention. She is also interested in applying principles from basic educational research to learning-based treatments for anxiety disorders. Most recently, Nicole has studied the phenomenon of nocturnal panic attacks, especially the differences between those who experience panic attacks only while awake and those who experience panic attacks both while asleep and while awake.

Brian W. Bauer

Brian W. Bauer: Brian is interested in suicide prevention research. He has investigated brief dialectical behavioral therapy interventions for suicide prevention, associations between ADHD and suicide, and suicide in veteran populations. Most recently, his work has focused on understanding how behavioral economic strategies and principles can be integrated into suicide prevention work.

Rachel L. Martin

Rachel L. Martin: Rachel’s research focus is on military deployment trauma and how deployment related experiences interact with individuals’ aggression to cause interpersonal distress. Specifically, she is interested in aspects of trauma such as moral injury and post-battle experiences.

Raymond P. Tucker

Raymond P. Tucker: Dr. Tucker’s research interest is broadly in the area of suicide prevention. He is particularly interested in novel etiological and maintaining factors of suicidal ideation and suicide attempts; the study of which enhances theoretical models of suicide as well as the clinical assessment and management of suicide risk. Projects in this area included behavioral markers of suicide risk (e.g., implicit associations to suicide stimuli and attentional bias toward pain-related stimuli), the Acute Suicidal Affective Disturbance (ASAD) proposed clinical entity, and drivers of suicide. A parallel area of research investigates historical and current cultural factors that influence suicide risk and resilience in underrepresented populations. Much of this work has focused on ethnic and racial minority factors such as historical trauma in Indigenous communities and racial microaggressions in people of color. Current work also includes the impact of minority stressors and gender affirmation medical intervention on the maintenance of suicidal ideation in transgender veterans.

Daniel W. Capron

Daniel W. Capron: Dr. Capron’s research utilizes technology and cross-cutting translational research to better the understanding and treatment of anxiety, trauma, and suicide-related psychopathology. His current projects involve using computerized interpretation bias modification to reduce anxiety sensitivity, increasing treatment seeking behaviors in the Mississippi National Guard using behavioral economic techniques, and utilizing a brief mobile phone intervention to reduce suicide risk.