Initial psychometric properties of the Adaptive Suicide Cognitions Scale

Individuals who have experienced suicidal thoughts or behaviors report experiencing stigma from social contacts as well as treatment providers. Stigma is, in turn, associated with worse outcomes, including increases in suicidal ideation. Although some research has measured experiences of stigma related to suicide, tools measuring destigmatizing or adaptive cognitions related to suicide stigma are limited. This study adapted a resource from NowMattersNow.org that lists 10 things people who had suicidal experiences said they wished they knew when they were suicidal into a pilot measure of adaptive cognitions about suicide. Participants (N = 1,258) completed the 10-item pilot measure, demographic items, and additional convergent/divergent measures. The sample was randomly split 25% (n = 314) / 75% (n = 944) for exploratory and confirmatory analyses. Psychometric analyses (i.e., exploratory factor analysis [EFA], confirmatory factor analysis [CFA], internal consistency estimates, measurement invariance testing, and correlations with other measures) were performed. A two-factor model was identified, with one factor consisting of items related to coping beliefs and one factor related to destigmatizing beliefs. Four items that did not clearly load into the two identified factors were dropped, leaving a total of six items in the final scale (three for each factor). The retained solution obtained good fit in a CFA framework. Scores on the two factors correlated in the expected directions with measures related to stigma, mental health, and experiences with suicide. The resultant measure was also invariant across (binary) gender. However, lower-than-desirable internal consistency estimates were obtained.