Alexander J. Millner

Introduction The inclusion of suicide gestures in modern nomenclatures for self‐injurious thoughts and behaviors (SITB) is contentious due to their history of pejorative connotations and inconsistent operationalization and measurement. Here we sought to investigate the extent to which participants who endorse this behavior on a standardized SITB measure: (1) describe their behavior in a way that is consistent with contemporary definitions for suicide gestures; (2) accurately classify their behavior when presented with multiple SITB response options; and (3) consistently report their level of intent to die across survey items. Methods Participants were 83 adults from a community‐based sample who endorsed lifetime suicide gesture(s) in an online survey containing self‐report measures assessing their prior SITB engagement, followed by open‐ended questions eliciting narrative descriptions of their behaviors. Results Approximately 13% of participants who endorsed lifetime suicide gestures provided narrative descriptions that met criteria for the behavior, and around one‐third consistently reported zero intent to die in their explicit ratings. Additionally, some participants reported non‐zero intent to die from behaviors without direct potential for physical injury. Conclusions Overall, this study highlights substantial issues with the validity of current approaches to measuring suicide gestures. Implications for the classification of suicide gestures in clinical and research settings are discussed.

Objective The purpose of this study was to examine implicit affect toward suicide (i.e., how good/bad suicide is perceived). Some people might be more likely to think about/choose suicide because they perceive it as a good option (to gain relief) relative to available alternatives. Method Implicit affect toward suicide among adults ( N = 72) and adolescents ( N = 174) with and without suicidal thoughts was examined using first‐person (FP) perspective suicide pictures in the affect misattribution procedure (AMP). Results Suicidal adults’ implicit positive affect toward suicide was associated with STB variables, such as explicit valence ( r = 0.34) and arousal ( r = 0.44) ratings of suicide pictures, and implicit affect differentiated groups above and beyond explicit valence ratings. Contrary to our hypothesis, suicidal participants did not display higher implicit positive affect toward suicide than nonsuicidal participants. However, suicidal participants displayed consistent implicit affect toward different suicide pictures, whereas nonsuicidal participants evaluated some pictures as more pleasant than others (ORs = 1.92–2.27). Conclusions Implicit affect toward suicide may relate to STB, but stimuli characteristics (e.g., color) likely influence the accuracy of assessment with the AMP and should be a focus of future research involving this and other implicit measures.