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ITALIAN VALIDATION OF THE ACSS-FAD IN A SAMPLE OF UNIVERSITY STUDENTS
Francesca Dolenz 1, Sara Magliocca 1, Alice Silva 1, Fabio Madeddu 1, Raffaella Calati 1, 2
1 Department of Psychology, University of Milan-Bicocca, Milan, Italy; 2 Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France
Introduction: Suicide is one of the leading
causes of death, the second in the 15-29 age
group.
Interpersonal Theory of Suicide (Figure 1)
postulated that the simultaneous presence of
three constructs, Thwarted Belongingness (TB),
Perceived Burdensomeness (PB) and Capability
for Suicide, can lead to lethal or near lethal
suicide attempts [1].
versus students without it, and students with
lifetime suicidal risk versus students without it.
We tested factor structure,internal consistency
and criterion,convergent/divergent validity of
the ACSS-FAD. Data were analyzed with
Statistical Package for the Social Sciences (SPSS),
version 26.We applied Bonferroni correction,
accepting p value ≥.001.
Results: Students with current SI and students
with lifetime suicidal risk showed higher levels
of depression (BDI-II), anxiety (STAI), physical
and psychological pain (Psychache, MPQ, VAS),
loneliness (UCLA) and lower levels of self-
esteem (Rosenberg), social support (MSPSS)
and reasons for living (RFL) compared to
students without SI and students without
suicidal risk.
One-factor structure was confirmed and the
scale showed good internal consistency
(Cronbach’s α=0.84).
ACSS-FAD correlated with current SI (r=0.21,
p<.001) and lifetime suicidal risk (r=0.21,
p<.001) and there was a tendency towards
significance (t (456)=-2.06,p=0.04), considering
its capacity to discriminate between those who
had a history of suicide attempts and those
who did not. This result did not survive to
Bonferroni and we hypothesized this could be
explained by the low number of subjects who
attempted suicide in our sample (4,1%).
According to previous literature [2], ACSS-FAD
Living
Objective: This study aimed at the Italian
validation of the Acquired Capability for Suicide
Scale –Fearlessness About Death (ACSS-FAD),
assessing fearlessness about death, one of the
facets of the Capability for Suicide.
Methods: This cross-sectional research was
conducted on a sample of university students
(n=458), aged 18-29. They were assessed with a
battery including ACSS-FAD.We distinguished
students with current suicidal ideation (SI)
versus
negatively correlated with the RFL subscale fear
of suicide and with both dimensions of Pain
Vigilance and Awareness Questionnaire (PVAQ).
However, no correlation between ACSS-FAD and
other pain measures was found.
In addition to our hypothesis, ACSS-FAD
negatively correlated with two other RFL
subscales (survival coping beliefs and moral
objections).
As expected [2], ACSS-FAD showed no
correlation with either Interpersonal Needs
que
Questionnaire (INQ)or its subscales (PB and
TB) and there was no correlation between
ACSS-FAD and depression.
We found an interesting result: apparently,
ACSS-FAD showed no relations with the
majority of the investigated constructs
[anxiety,self-awareness (SAQ), loneliness,
social support and self-esteem]. This may
support IPTS purpose to be a theory that
explains the greatest variability in suicidal
behavior beyond main risk factors of suicide.
Conclusions:As far as we know, this is the
first Italian validation of the ACSS-FAD in
literature.
Surely, some aspects need further
investigation: first, the relation between
ACSS-FAD and SI,to test their truly
independence, as postulated by IPTS.
Second, the relation between ACSS-FAD and
pain, which is a multidimensional construct,
and it is possible that some aspects are more
related to SI, hence to PB and TB [i.e.
Psychache scale and Mental Pain
Questionnaire (MPQ)] and others to suicide
attempts, hence to AC (i.e. PVAQ).
Summarizing, ACSS-FAD seems to be a
reliable and valid measure of fearlessness
about death, especially in young adults, and
it could be important to improve suicide risk
assessment.
1. Van Orden, K. A. (2010). The interpersonal theory of suicide. A useful theory? Advancing the Science of Suicidal Behavior: Understanding and Intervention, 117 (2), 41-52.
2. Ribeiro, J. D., Witte, T. K., Van Orden, K. A., Selby, E. A., Gordon, K. H., Bender, T. W., & Joiner, T. E. (2014). Fearlessness about death: The psychometric properties and construct validity of the
revision to the acquired capability for suicide scale. Psychological Assessment, 26 (1), 115-126.
Figure 1: Interpersonal Theory of Suicide (IPTS)
Table 1: Correlations between ACSS-FAD and other scales
Copyright © 2021 –Raffaella Calati (raffaella.calati@unimib.it)
** p = .001
*** p < .001
ACSS-FAD
STAI (now)-0.12
STAI (usually) -0.09
BDI-II -0.02
PVAQ (passive awareness) -0.16**
PVAQ (active vigilance) -0.17 ***
SAQ -0.08
Psychache -0.01
MPQ 0.07
VAS 0.02
INQ (PB) 0.09
INQ (TB) 0.44
UCLA -0.01
MSPSS (significant others) -0.08
MSPSS (family) -0.14
MSPSS (friends) 0.05
Rosenberg 0.02
RFL (survival and coping beliefs) -0.16**
RFL (family) -0.09
RFL (children) -0.12
RFL (fear of suicide) -0.36***
RFL (fear of social disapproval) -0.01
RFL (moral objections) -0.23***