Expansion and Reevaluation of the Implicit Association Test in Suicide Ideators and Suicide Attempters

NCT ID: NCT04585802

Last Updated: 2025-07-18

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 447 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2020-05-27
• Study Completion Date: 2024-11-26

Brief Summary

A new approach to investigate suicidal processes belongs to the broader neurocognitive picture and are so-called implicit associations. In dual process models of information processing a second functioning mode, the automatic processing mode, complements the conscious processing. Suicidal persons tend to have a stronger implicit association with "death" than non-suicidal persons. In this study, implicit associations between different unconscious cognitive constructs are compared among suicidal and non-suicidal patients. Therefore, an adapted version of the computer-based reaction time task (IAT-S) will be used.

Four different versions of IATs are tested in this study. In the first version the implicit association between "self / others" and "death / life" is assessed (1). The second and third version measures the emotional evaluation of "death" (2) and "life" (3). In addition, in the fourth version the implicit association between death / life and internal / external locus of control is assessed (4).

The implicit associations of these four IAT-S versions are compared between three groups: patients with suicidal behavior, patients with suicidal ideation, and a clinical group without previous suicide attempts and without suicidal ideation.

The following hypotheses are made: in all four versions of the IAT-S, patients with previous suicidal behavior will have stronger implicit associations: between "self" and "death" as well as "death" and "internal locus of control" compared to all other groups. With a more "positive" evaluation of "death" and a more "negative" evaluation of "life" than all other participants.

Detailed Description

In this study, four versions of the suicide-specific implicit association tests (IAT-S) are carried out. Previous studies have shown that suicidal persons have stronger associations between the constructs "self" and "death". Furthermore, the strength of these implicit associations increases the risk of suicidal behavior in the follow-up period of six months by a factor of six. In these previous studies, the implicit "self-death association" (the so-called death-identity bias) was investigated. This study will additionally examine an implicit emotional evaluation (death-evaluation-bias). Therefore, two new versions of the IAT-S, which measure how death vs. life are emotionally evaluated, are being tested. In addition, a fourth version of the IAT-S was added and aims to clarify the implicit association between death / life and internal / external locus of control. Previous studies have shown that an internal locus of control is a protective factor and an external locus of control a risk factor for suicide attempts. In the present study, these four IAT-S versions are carried out with different groups of patients: patients with a suicide attempt (1), patients with suicide ideation (2) and patients with neither a suicide attempt nor suicide ideation (3). This cross sectional design allows us to test for group differences in regard to unconscious implicit associations. Hypothesis are described separately for each version of the IAT-S.

Death association: patients in group 1 will have a higher implicit association between self and death than patients in group 2 and that patients in group 2 have a significantly higher implicit association between self and death than patients in group 3.

Death evaluation: patients in group 1 will have more "positive" evaluations of "death" than patients in group 2 and patients in group 2 have a more "positive" evaluations of death than patients in group 3.

Locus of control: patients in group 1 will have a stronger association between internal locus of control and death (a) and external locus of control and life (b) than patients in group 2, and that patients in group 2 have a significantly stronger association between internal locus of control and death (a) and external locus of control and life (b) than patients in group 3.

Conditions

Suicidal Ideation; Suicide Attempt

Study Design

• Observational Model Type: CASE_CONTROL
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

Suicide Attempters (1)

patients with a suicide attempt

No interventions assigned to this group

Suicide Ideators (2)

patients with suicidal ideation

No interventions assigned to this group

Clinical Control Group (3)

patients without suicide attempt and without suicide ideation

No interventions assigned to this group

Healthy Control Group (4)

persons without suicide attempt and without suicide ideation, who do not have a psychiatric disorder

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

• Age 18-65 years
• Ability and willingness to participate in the study
• Ability to give consent

Exclusion Criteria

• Foreign language
• Diagnostic criteria: Psychoses, strong cognitive impairments (e.g. dementia)

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University Hospital of Psychiatry, Department Neuropsychopharmacology and Brain Imaging

OTHER

Sponsor Role: collaborator

University of Bern

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Anja C. Gysin-Maillart, PD

Role: PRINCIPAL_INVESTIGATOR

University of Bern

Locations

University Hospital of Psychiatry and Psychotherapy, University of Bern

Bern, , Switzerland

Countries

Switzerland

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Other Identifiers

2019-01410

Identifier Type: -

Identifier Source: org_study_id