Love and suicide: the structure of the Affective Intensity Rating Scale (AIRS) and its relation to suicidal behavior.

Esperanza Morales,Zimri S Yaseen,Karin Fisher,Igor I Galynker

doi:10.1371/journal.pone.0044069

Abstract

BackgroundSuicide has been linked to intense negative affect. However, little is known about the range of affects experienced by suicidal persons, or the separate effects of affect valence and intensity. We examine a novel self-report scale, the 17-item Affective Intensity Rating Scale (AIRS), and its relation to suicidality in a high-risk sample.Methodology/Principal FindingsPatients presenting with suicidality were recruited from the Emergency Department in a large urban hospital, and completed a battery of assessments there. Structure of the AIRS was assessed using Maximum Likelihood Factor Analysis with Oblimin rotation. Convergent and divergent validity were assessed by regressing AIRS subscales against Brief Symptom Inventory subscales. Relation to suicidality was assessed by regression of suicide attempt status against scale and subscale scores, and individual items and two-way item interactions, along with significant clinical and demographic factors. 176 subjects were included in analyses. Three reliable subscales were identified within the AIRS measure: positive feelings towards self, negative feelings towards self, and negative feelings towards other. Only individual AIRS items associated significantly with suicide attempt status; strong ‘feelings of love’ associated positively with actual suicide attempt, while ‘feelings of calm’ and ‘positive feelings towards self’ associated negatively. Interaction analyses suggest ‘calm’ moderates the association of ‘love’ with suicide attempt.Conclusions/SignificanceFactor analysis of the AIRS is consistent with a circumplex model of affect. Affective dimensions did not predict suicidal behavior, but intense feelings of love, particularly in the absence of protective feelings of calm or positive self-view associated with current attempt.

Highlights

Suicide is a leading cause of mortality for in the United States more than 36,000 die by suicide annually, and nearly twenty times as many present to emergency rooms with suicide attempts [1,2]
While self-report scales such as the Emotional Intensity Scale (EIS) [11] and the Affective Intensity Measure (AIM) [12,13,14], have been developed to measure trait affective intensity, to date no study has examined the distinct contributions of state affective intensity and valence to suicidal behavior
To begin to answer these questions, we examined the structure of a novel scale, the 17-item Affective Intensity Rating Scale (AIRS), and its relation to suicidality in a psychiatric emergency room setting

Summary

Introduction

Suicide is a leading cause of mortality for in the United States more than 36,000 die by suicide annually, and nearly twenty times as many present to emergency rooms with suicide attempts [1,2]. Recent research has begun to focus on acute states which may be markers of a ‘‘suicide-crisis.’’ [4] Suicide has been linked to states of high intensity negative affect [5], and prior to suicide death, patients experienced multiple intense negative affects in association with depression [6]. Affects such as hopelessness, rage, guilt, abandonment, loneliness, severe anxiety, humiliation, and self-hatred have shown to play an important role in suicidality [4]. We examine a novel self-report scale, the 17-item Affective Intensity Rating Scale (AIRS), and its relation to suicidality in a high-risk sample

Methods

Results

Discussion

Conclusion