Introduction. There is a dearth of valid and reliable psychometric scales to measure Acquired Capability for Suicide in adolescents, who are among the most vulnerable group for suicide attempts in Mexico. Objective. To obtain the reliability and structural, convergent, and predictive validity, as well as a sensitivity and specificity test of the adapted version of the ACSS in Mexican adolescents. Additionally, we tested whether the adapted structure of the scale is consistent for both clinical and non-clinical adolescent populations. Method. A Confirmatory Factor Analysis, invariance test and reliability analyses were obtained from a sample of 429 Mexican adolescents (73% non-clinical and 27% clinical participants). Then, a refined version of ACSS (ACSS-AP) was applied to a different sample of 345 adolescents diagnosed with psychiatric disorders, to determine its convergent validity with related constructs, and its predictive validity through a simple linear regression to predict lifetime suicide attempts. The sensitivity and specificity of the instrument were evaluated using the occurrence of lifetime suicide attempts, analyzed through a binomial logistic regression model. Results. A factor structure is proposed for each sub-sample; the Fearlessness about death factor is stable across both clinical and non-clinical populations, while the Pain tolerance factor in the clinical sample is assessed through more severe pain exposure events. The fit indices for both scales were excellent. The reliability for non-clinical adolescents (α = .67 -ɷ = .71-) was lower compared to clinical adolescents (α = .87 -ɷ = .87-). The scale correlated positively with a moderate strength with its nomological network and predicted lifetime suicide attempts explaining 16.4% of the variance. The overall classification accuracy of the model was 80.3%. Discussion and conclusion. ACSS-AP showed validity and reliability in clinical populations. Acquired capability manifests differently in clinical and non-clinical adolescent populations.
Gutiérrez-García et al. (Sun,) studied this question.