Initial psychometric properties of the Adaptive Suicide Cognitions Scale

Individuals who have experienced suicidal thoughts or behaviors report experiencing stigma from social contacts and treatment providers. Although research has measured experiences of stigma related to suicide, tools measuring destigmatizing or adaptive cognitions related to suicide are limited. This study adapted a resource from NowMattersNow.org listing 10 things people with lived experience of suicide said they wished they knew when they were suicidal. These 10 things were modified into pilot items for the development of a measure of adaptive cognitions about suicide. Participants (N = 1,258) completed the pilot items, demographic items, and convergent/divergent measures. The sample was randomly split 25% (n = 314) / 75% (n = 944) for exploratory and confirmatory analyses. Exploratory factor analysis, confirmatory factor analysis, internal consistency estimates, measurement invariance testing, and correlations with other measures were performed. A two-factor model was identified, with one factor 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 six items in the final scale (three for each factor). This 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 measure was invariant across gender. However, lower-than-desirable internal consistency estimates were obtained. The resultant measure, the Adaptive Suicide Cognitions Scale, assesses two constructs that may be useful to examine further, with the goal of reducing the severity and impacts of suicide-related stigma.