Couple-Based Crisis Safety Planning

Higher scores indicate greater acceptability of the present intervention. The minimum score is 4 and the maximum possible score is 20.

Higher scores indicate greater feasibility of the present intervention. The minimum score is 4 and the maximum possible score is 20.

Higher scores indicate greater appropriateness of the present intervention. The minimum possible score is 4 and the maximum possible score is 20.

Suicide crisis symptoms will be assessed using a short form version of the Suicide Crisis Inventory - 2 (SCI-2) during eligibility screener. The SCI-2-SF is a 9-item self-report measure that assesses crisis symptoms over the past several days across five subscales: 1) Entrapment; 2) Affective Disturbance; 3) Loss of Cognitive Control; 4) Hyperarousal; and 5) Social Withdrawal, with selected items recorded such that higher scores are indicative of more severe SCS symptoms. The full 61-item measure will be utilized in later stages of data collection (i.e. baseline assessment and 3-month follow-up assessment). The maximum total score for the short form version is 36. The maximum total score for the standard 61-item version of the measure is 244. Minimum possible scores for both versions of the scale are 0.

Once the desired participant quota (50 couples) is met, the study team will analyze the means by which participants were recruited. This study utilizes two different advertisements that describe the same study, but with different language. The study team will assess which type of advertisement yielded more engagement, once all participants are enrolled.

Relationship quality will be assessed using the Couples Satisfaction Index. The CSI is a widely-used and well-validated 32-item self-report measure that assesses relationship quality, and has been used for psychosocial interventions for military couples. Higher scores indicate greater satisfaction with one's relationship. The maximum total score for this scale is 161. The minimum possible score is 0.

Emotion regulation will be assessed using the Difficulties in Emotion Regulation Scale. The DERS is a widely-used 36-item self-report measure that assesses emotion dysregulation and six subfactors: 1) Awareness; 2) Clarity; 3) Goals; 4) Impulse; 5) Non-Acceptance; and 6) Strategies. The measure is well-validated and has been used extensively in Veteran and military samples. Higher scores suggest greater problems with emotion regulation. The maximum possible total score is 180. The minimum possible total score is 36.

Cognitive flexibility will be assessed using the Cognitive Flexibility Inventory. The CFI is a well-validated 20-item self-report measure that measures three aspects of cognitive flexibility: 1) Controllability Perception; 2) Alternative Explanation Awareness; and 3) Alternative Solution Generation. The maximum possible score on this scale is 140, and the minimum possible score is 20, with higher scores indicating greater cognitive flexibility.

Behavioral intention will be assessed using a Theory of Planned Behavior Questionnaire (TPBQ). The TPBQ is a 9-item version of the scale that was developed using the guidelines set forth by Ajzen (2006) and measures: 1) Attitude Toward Behavior; 2) Injunctive and Descriptive Norms; 3) Perceived Behavioral Control; 4) Intention; and 5) Past Behaviors. The scale was modified to fit the scope of the intervention that takes place in the study (i.e. Crisis Response Planning) This scale is scored in 5 different dimensions with a maximum total score of 63 and a minimum possible total score of 9.

A self-report depression scale for research in the general population. Scores range from 0-60. A score equal to or above 16 indicates a person at risk for clinical depression.

The Diagnostic Interview for Anxiety, Mood, and ObsessiveCompulsive and Related Neuropsychiatric Disorders will be used to assess current and lifetime histories of mental disorders to characterize the sample. This is necessary to understand the clinical severity of our sample in relation to previous CRP studies to guide interpretations for generalizability. The DIAMOND is a well-validated and widely-used semi-structured interview designed to assess for DSM-5 diagnoses. Screener questions and follow-up modules will be administered for the following disorders: Social Anxiety Disorder, Panic Disorder, Agoraphobia, Generalized Anxiety Disorder, Persistent Depressive Disorder, Major Depressive Disorder, Bipolar I & II Disorders, Obsessive-Compulsive Disorders, Acute Stress Disorder, Post-traumatic Stress Disorder, Adjustment Disorder, Substance Use Disorder, and Attention Deficit/Hyperactivity Disorder.

This protocol includes two subscales from the Screening version of the Columbia-Suicide Severity Rating Scale © (C-SSRS): Severity of Suicidal Ideation and Suicidal Behavior. Both subscales provide definitions of suicidal ideation and behavior and corresponding probes. The severity of ideation subscale is rated on a 5-point ordinal scale: 1 = wish to be dead, 2 = nonspecific active suicidal thoughts, 3 = suicidal thoughts with methods, 4 = suicidal intent, and 5 = suicidal intent with plan. The suicidal behavior subscale is rated on a nominal scale that includes actual, aborted, and interrupted attempts; preparatory behavior; and nonsuicidal, self-injurious behavior.

The Current version of the C-SSRS assesses suicidality during a two time periods-ideation in the past month and suicidal behavior in the past 3 months.

Depressive symptoms will be measured by the Patient Health Questionnaire-9. The PHQ-9 is a widely used 9- item self-report measure that assesses depressive symptoms over the past two weeks. The maximum possible score is 27 and the minimum possible total score is 0, with higher scores indicating greater severity of depressive symptoms.

Anxiety symptoms will be measured by the Generalized Anxiety Disorder - 7. The GAD-7 is a widely used 7-item self-report measure that asses anxious symptoms over the previous two weeks. The maximum possible score is 21 and the minimum possible total score is 0, with higher scores indicating greater severity of anxiety symptoms

The investigators will use the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) to assess health and disability. The WHODAS 2.0 is a 12-question self-report measure that covers six domains: 1) Cognition; 2) Mobility; 3) Self-care; 4) Getting Along; 5) Life Activities; and 6) Participation. The maximum possible converted summary score is 100 and the minimum score is 0, with higher scores indicating a greater level of disability.

Assesses mental health domains across several psychiatric diagnoses. This measure consists of 23 questions and assesses 13 psychiatric domains, including depression, anger, mania, anxiety, somatic symptoms, suicidal ideation, psychosis, sleep problems, memory, repetitive thoughts and behaviors, dissociation, personality functioning, and substance use. Items ask individuals to rate how often they are bothered by symptoms in the last two weeks. A rating of mild (i.e., 2) or greater on any item within a domain (except for substance use, suicidal ideation, and psychosis) may serve as a guide for additional inquiry and follow up to determine if a more detailed assessment for that domain is necessary. For substance use, suicidal ideation, and psychosis, a rating of slight (i.e., 1) or greater on any item within the domain may serve as a guide for additional inquiry and follow-up to determine if a more detailed assessment is needed.

Suicide crisis symptoms will be measured using an abbreviated version of the SCS-2. Two to three items exhibiting the largest factor loadings for each of the five subfactors were extracted, resulting in 17 items. These items were then edited to be in the present tense ("Please indicate how you are feeling on the following items") and replaced with a visual analogue scale (0-100), which is similar to past EMA studies assessing suicide risk and associated variables. Higher scores indicate greater severity of crisis symptoms.

Suicide risk will be assessed using the Depressive Symptom Index - Suicide Subscale (DSI-SS). This is a 4-item self-report measure that assesses current risk. Higher scores indicate greater levels of risk. The maximum possible total score for this scale is 12 and the minimum possible total score is 0

Crisis response planning engagement will be assessed using nine binary ("Yes/No") self-report items to understand if participants did any of the following since their last survey: 1) Identify warning signs; 2) Internal coping strategies; 3) Activity based distractions; 4) Social distractions; 5) Location change; 6) Discuss thoughts with partner or others; 7) Contacted professionals; 8) Hospitalization; and 9) Lethal means safety. Higher scores indicate greater level of engagement with the current intervention