The fearlessness about death scale’s efficacy for differentiating suicide attempts from non-suicidal self-injury, a meta-analysis

Abstract

We used multivariate meta-analysis modeling variances and covariances of suicidal ideation, suicide attempts, and non-suicidal self-injury to investigate if the Fearlessness About Death scale differentiated between suicide attempts and non-suicidal self-injury. The systematic search yielded 27 studies that fulfilled the inclusion criteria. The association of suicidal ideation with suicide attempts was comparable to the association of suicidal ideation with non-suicidal self-injury. The Fearlessness About Death scale weakened both associations to a comparative degree. These results cast doubt on the clinical utility of the Fearlessness About Death scale, as well as the self-assessment of suicidal ideation, suicide attempts and non-suicidal self-injury.

Authors contributors

JS conceived the presented idea and developed the research protocol under supervision of NK. ACP and JS contributed to the title/abstract screening and full text screening. JS performed the statistical analysis. CAE and JS established the risk of bias estimations. JS drafted the initial manuscript with the help of all coauthors. JS, CAE and CZ revised the paper. CAE, CZ and NK provided expert input. All authors discussed results and contributed intellectually to the final manuscript.

Disclosure statement

No conflict of interest.

Role of funding sources

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

Data availability

All data needed for reproduction of this publication are available publicly.

See Supplementary material for studies included in the meta-analysis.

Ethical statement

Meta-analyses do not require an ethics statement according to Austrian law because it uses no identifiable patient data.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.