The Revised Attentional Fixation on Suicide Experiences Questionnaire (AFSEQ-R) and its Relationship with Suicidal Ideation and Behavior
Introduction: Attentional fixation is a cognitive process characterized by a preoccupation with a certain topic. The Attentional Fixation on Suicide Experiences Questionnaire (AFSEQ) was developed to measure fixation on suicide. The current study aimed to investigate a revised version of this measure (AFSEQ-R) and examine differences between recent suicide attempters and those with suicidal ideation (SI) only. Method: Participants were 57 inpatients who attempted suicide within 14 days of study participation and 57 inpatients who presented with SI but no suicidal behavior within the past year. Analyses included an exploratory factor analysis (EFA) of the AFSEQ-R, bivariate correlations between AFSEQ-R total score (and its factors) with related constructs, and logistic regression of attentional fixation as a moderator of the association between SI and attempt status. Results: EFA revealed a two-factor structure for the AFSEQ-R: Cognitive Stuckness (and AFSEQ-R total score) correlated with SI, anxiety, impulsivity, and specific problem-solving deficits, while Cognitive Dysfunction acted as a moderator of the association between Stuckness and SI. AFSEQ-R scores did not moderate the relationship between current SI and attempt status. Conclusion: Attentional fixation on suicide may contribute to the distress associated with SI. Interventions aimed at reducing attentional fixation may reduce suffering.