Construct validity of a proposed new diagnostic entity: Acute Suicidal Affective Disturbance (ASAD)

Raymond P. Tucker, Matt S. Michaels, Megan L. Rogers, La Ricka R. Wingate, Thomas E. Joiner

Research output: Contribution to journalArticlepeer-review

79 Scopus citations


Background The current study presents initial support for the construct validity of Acute Suicidal Affective Disturbance (ASAD), a clinical entity consisting of acute suicide risk and several related features. Methods Participants (N=195) were university students who were recruited for a history of suicide attempt(s), history of suicidal ideation, or no history of suicide attempts or suicidal ideation. Participants completed study measures online. Results Factor analytic results indicated a one factor solution for a lifetime measure of ASAD symptoms. The measure demonstrated strong convergent and divergent validity with common correlates of suicide-related outcomes and incremental predictive validity, as lifetime occurrence of ASAD symptoms predicted number of past suicide attempts above and beyond a host of suicide risk factors. Lifetime ASAD symptoms differed between those with multiple suicide attempts, those with a single attempt, and participants without a history of attempts, as well as between participants with a history of both suicidal ideation and attempts and those with a history of suicidal ideation but not suicide attempts. Limitations The cross-sectional research design limits the ability to infer causation between ASAD symptoms and suicidal behavior. Only past ASAD symptoms (not current symptoms) were measured. Conclusions ASAD appears to be a unified clinical entity that characterizes acute suicide risk which may assist clinicians in determining a client's potential for death by suicide.

Original languageEnglish
Pages (from-to)365-378
Number of pages14
JournalJournal of Affective Disorders
StatePublished - 1 Jan 2016
Externally publishedYes


  • Acute Suicidal Affective Disturbance
  • Acute Suicidal Affective Disturbance Inventory-Lifetime (ASADI-L)
  • Risk factor
  • Suicidal ideation
  • Suicide attempt


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