Psychological Closeness to Suicide Methods Scale (PCSMS)

Abstract

The Psychological Closeness to Suicide Methods Scale (PCSMS), developed by Rogers, Murley, and Clary (2025), is a novel, psychometric self-report instrument. It is specifically designed to evaluate an individual’s psychological closeness to their preferred means of suicide. The scale’s primary theoretical role is to quantify a critical risk factor that is hypothesized to influence the dangerous transition from passive suicidal ideation to active suicidal action.

The development of the 15-item final version of the PCSMS involved rigorous qualitative work, drawing content from interviews with suicide researchers, specialized clinicians, and individuals possessing lived experience of suicide (Clary et al., 2024). The scale’s psychometric properties were established using two distinct samples: university students (Sample 1) and community-based adults (Sample 2). Both cohorts included individuals reporting current suicidal ideation and/or a history of suicide attempts, allowing for robust assessment of factor structure, reliability, and validity measures, including Item Response Theory.

Keywords

Familiarity, Fixation, Incremental Validity, Psychological Closeness, Regulation, Risk Factors, Sentiment, Suicide Methods, Psychodynamics, Suicidal Ideation, Suicidality, Suicide Risk Assessment.

Authors

Rogers, Megan L., Murley, William D., Clary, Kelly L.

Purpose

The fundamental purpose of the PCSMS is to provide a multidimensional, self-report assessment for quantifying an individual’s psychological attachment, preoccupation, or perceived capability regarding specific suicide methods. This measurement aims to refine clinical and research understanding of acute suicide risk.

By focusing on psychological closeness, the scale intends to capture a mechanism that differentiates individuals who harbor suicidal thoughts from those who proceed to plan or attempt suicide, thereby offering a more nuanced tool for predicting and intervening in suicidal trajectories than traditional measures of general suicidal ideation alone.

Construct

The core construct measured by the PCSMS is **Psychological Closeness to Suicide Methods**. This construct is conceptualized as the degree of cognitive preoccupation, emotional investment, behavioral familiarity, and regulatory dependence an individual experiences regarding a specific method of suicide.

The scale encompasses several facets of this closeness, including fixation on the method, emotional comfort derived from its presence, and perceived mastery or understanding of its use. It is theorized that a higher degree of psychological closeness lowers the threshold for acting on suicidal intent, positioning the construct as a key mediator in the progression toward an attempt.

Validity

The validity of the PCSMS was established through comprehensive psychometric evaluation across multiple dimensions.

• Item Response Theory (IRT): IRT analysis indicated that the scale items were highly discriminant, effectively distinguishing between individuals with differing levels of the latent trait. Furthermore, the items spanned varying levels of difficulty, ensuring comprehensive measurement across the continuum of psychological closeness.

• Convergent and Discriminant Validity: Correlations generally supported the theoretical positioning of the construct. Facets of psychological closeness showed small positive associations with symptoms of general psychopathology. As expected, these facets demonstrated slightly larger correlations with suicide-specific constructs, such as rumination and capability for suicide. Importantly, nonsignificant associations were found with unrelated factors like sleep disturbances and impulsivity, confirming strong discriminant validity.

• Incremental Validity: Linear regression models confirmed that the PCSMS provided significant predictive power above standard covariates. When predicting suicidal ideation, the covariates alone accounted for 45.3% of the variance (Step 1). The inclusion of the PCSMS total score (Step 2) increased the explained variance to 47.7%, and the inclusion of its subscales further increased it to 50.6%. This demonstrated that the PCSMS total score is positively and significantly associated with suicidal ideation, providing unique insight beyond existing risk factors.

Reliability

The reliability of the PCSMS was assessed primarily through measures of internal consistency across the two development samples.

• Internal Consistency: The total score exhibited high internal consistency in both samples (αs = .90 and .93). The four underlying subscales also demonstrated good internal reliability, with alpha coefficients consistently strong: Subscale 1 (αs = .89 and .85), Subscale 2 (αs = .84 and .75), Subscale 3 (αs = .83 and .87), and Subscale 4 (αs = .84 and .82).

Factor Analysis

Factor Analysis was utilized to determine the latent structure of the PCSMS and establish measurement invariance.

• Confirmatory Factor Analysis (CFA): The final version of the PCSMS, following item refinement, demonstrated a strong model fit for a four-factor structure across both Sample 1 (χ²(84) = 208.63, CFI = 1.00, TLI = 0.99, RMSEA = .06) and Sample 2 (χ²(84) = 114.38, CFI = 1.00, TLI = 1.00, RMSEA = .04). While a higher-order factor model provided a poorer fit than the four-factor structure (Δχ²(2) = 7.11, p = .029), the bifactor model showed superior fit (Δχ²(8) = 101.15, p < .001), supporting the presence of a strong general factor alongside specific factors related to psychological closeness.

• Measurement Invariance: The psychometric properties of the scale were found to be consistent across key demographic and clinical groups. Measurement invariance was successfully established across suicide attempt history, gender, and race/ethnicity, confirming its broad applicability.

Instrument

Test Type: Original Instrument.

Format: Participants rate each of the 15 items (final version) on a 5-point scale ranging from 0 (not at all true for me) to 4 (very true for me).

Language Available: English.

Population Group: Human; Male; Female.

Age Group: Adulthood (18 years & older).

Population Details: The scale was evaluated on university students and community adults in the United States, all with current suicidal ideation and/or a history of suicide attempts.

Test Methodology: Test Validity; Convergent Validity; Discriminant Validity; Test Reliability; Internal Consistency; Factor Analysis; Confirmatory Factor Analysis; Item Response Theory; Measurement Invariance.

Keywords

Familiarity, Fixation, Psychological Closeness, Suicide Risk Assessment, Suicidality, Suicidal Ideation, Suicide Methods, Psychodynamics, Psychometrics, Internal Consistency.

Authors

Author ORCID Identifier: Rogers, Megan L.: http://orcid.org/0000-0002-4969-7035

Affiliation Email addresses: Rogers, Megan L.: [email protected]

Correspondence Address: Rogers, Megan L., Texas State University, Department of Psychology, 601 University Drive, San Marcos, Texas, United States, 78666.

Permissions & Fee and Test Year

Permissions: May use for Research/Teaching

Fee: No

Test Year: 2025

Reference’s

• Rogers, M. L., Murley, W. D., & Clary, K. L. (2025). Development and psychometric evaluation of the Psychological Closeness to Suicide Methods Scale. Psychological Assessment, 37(3), 71–84. doi.org/10.1037/pas0001360

Items of the Psychological Closeness to Suicide Methods Scale (PCSMS)

Note. Items are rated from 0 (not at all true for me) to 4 (very true for me).

1. I think about this method a lot.

2. I am fixated on this method.

3. I do not want to associate with this method. (R)

4. I am anxious when I am far away from this method.

5. I am obsessed with this method.

6. This method is scary to me. (R)

7. I am attached to this method.

8. I often engage with this method in a non-suicidal manner.

9. I feel a special connection with this method.

10. I experience calmness when I think about this method.

11. This method reduces my feelings of emotional pain.

12. I feel better when I have access to this method.

13. If I don’t have access to this method, my heart begins to race.

14. I am dependent on this method for emotional stability.

15. If I don’t have access to this method, I feel unsafe.

16. This method is socially accepted within my culture/community.

17. I am emotionally invested in this method.

18. My community/culture views this method as dishonorable. (R)

19. I understand how to properly administer this method (whether for suicide or another purpose).

20. I try to mentally separate myself from this method. (R)

21. This method is significant to me.

22. I have a strong bond with this method.

23. I do not want to be close to this method. (R)

24. I do not know how to use this method (whether for suicide or another purpose). (R)

25. I have a lot of history with this method.

26. This method is a safety blanket.

27. This method makes me feel secure.

28. I am psychologically close to this method.

29. I have a hard time not thinking about this method.

30. I have positive memories of this method.

31. I am confident in my ability to correctly use this method (whether for suicide or another purpose).

32. I have special memories that are connected to this method.

33. I am emotionally close to this method.

34. If I don’t have access to this method, I feel anxious.

35. I am anxious when I am close to this method. (R)

36. I am intensely connected to this method.

37. I feel comfort when I have access to this method.

38. I am relaxed or at ease when I think about this method.

39. I feel disgusted when I think about this method. (R)

40. I am disconnected from this method. (R)

41. I have a negative reaction when I think about this method. (R)

42. I experience relief when I think about this method.

43. I am comfortable with being near this method.

44. This method has sentimental value to me.

45. This method is meaningful to me.

46. I avoid thinking about this method. (R)

47. I feel safer when I am close to this method.

48. My identity is strongly connected with this method.

49. I have built a mental barrier between myself and this method. (R)

50. This method is always on my mind.

51. If I don’t have access to this method, I feel hopeless.

52. I am very familiar with this method.

53. I feel better when I think about this method.

Note. Items that were retained in the final version of the Psychological Closeness to Suicide Methods Scale are indicated in bold.