Acquired Capability for Suicide, Pain Tolerance, and Fearlessness of Pain—Validation of the Pain Tolerance Scale of the German Capability for Suicide Questionnaire SARAH WACHTEL, DP, PAULA SIEGMANN, MSC,C € ACILIA OCKLENBURG, MSC, LISA HEBERMEHL, MSC,ULRIKE WILLUTZKI,PHD, AND TOBIAS TEISMANN,PHD The interpersonal theory of suicide (Joiner, 2005) postulates that for a serious suicide attempt, one has to possess the acquired capability to commit suicide. Acquired capability includes higher pain tolerance, which is further assumed to comprise both an elevated physical pain tolerance and fearlessness of pain. Recently, the German Capability for Suicide Questionnaire (GCSQ) was validated. The aim of this study is further validation of the GCSQ’s Pain Tolerance scale by investigating the scale’s association with objective pain tolerance and fearlessness of pain in two undergraduate samples (N = 81; N = 76). Both associations were found indicating a strong criterion validity of the Pain Tolerance scale. Suicide is the tenth leading cause of death in the United States regardless of age and sex; 12.3 suicidal deaths per 100,000 population are reported (Hoyert & Xu, 2012). Data for Germany are similar: 12.1 deaths of suicide per 100,000 population occurred in 2012 (Federal Statistical Office, 2013). The number of suicide attempts is estimated to be up to 20 times higher than the number of actual deaths (World Health Organization, 2014). Risk fac- tors for suicidal thoughts and behaviors include mental illness, past suicide attempts, male gender, older age, social isolation, sex- ual abuse, physical illness, and chronic pain (Cavanagh, Carson, Sharpe, & Lawrie, 2003; Joiner, 2005; Kanzler, Bryan, McGeary, & Morrow, 2012; Van Orden et al., 2010). The central question is, who of those at risk or con- templating suicide actually attempt or die by suicide? Furthermore, it is of interest to exam- ine which intra- and interpersonal processes play a role in suicidal behaviors. Joiner (2005) proposed the interper- sonal theory of suicide (IPTS) stating that for serious suicidal acts, one has to have the wish to die and possess the ability to overcome one’s fear of death and to tolerate the pain that accompanies a suicide attempt. Conse- quently, two conditions, a death wish and the acquired capability to commit suicide, jointly lead to a suicide attempt. According to Joiner, the joint presence of both perceived burden- someness and thwarted belongingness results in a wish to die and leads to suicidal thoughts. Various studies have verified that perceived burdensomeness, thwarted belongingness, SARAH WACHTEL,PAULA SIEGMANN,C € ACILIA OCKLENBURG,LISA HEBERMEHL and TOBIAS TEIS- MANN, Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr- Universit€at Bochum, Bochum, Germany; ULRIKE WILLUTZKI, Department of Psychology and Psy- chotherapy, Universita¨t Witten/Herdecke, Wit- ten, Germany. Address correspondence to Sarah Wachtel, Department of Clinical Psychology and Psycho- therapy, Faculty of Psychology, Ruhr-Universit€at Bochum, Massenbergstr. 9-13, 44787 Bochum, Germany; E-mail: sarah.wachtel@rub.de Suicide and Life-Threatening Behavior 45 (5) October 2015 541 © 2014 The American Association of Suicidology DOI: 10.1111/sltb.12149