Refining measurement of suicide ideation to improve testability of suicide theories

Modern ideation-to-action suicide theories distinguish risk factors for suicide ideation (SI) from factors that move a person from SI to suicidal behavior. Effectively testing these theories requires valid measures of SI, which must be distinct from those measuring suicidal behavior itself or non-SI risk factors for suicidal behavior. Unfortunately, most SI measures fall short of these expectations. Prominent tools characterized as measures of SI often assess a wide range of experiences relevant to suicidal thoughts and behaviors, aggregated into a total score. These composite measures introduce noise into suicide-focused research, which hampers efforts to understand and predict suicidal thoughts and behaviors as distinct phenomena. Assessing non-SI risk factors for suicidal behavior within measures that purport to capture SI may yield improved prediction of suicidal behavior, but at the expense of construct validity and the necessary specificity to test modern suicide theories. Our recommendations focus on development, testing, and use of independent measures of SI, suicidal behaviors, and other risk factors for these experiences. We encourage researchers to be explicit regarding constructs captured in measurement of SI and related phenomena to ensure that suicide science is robust, replicable, and informative to both the testing of suicide theories and the implementation of suicide prevention efforts in clinical practice. (PsycInfo Database Record (c) 2025 APA, all rights reserved).