# Chronic accessibility of suicide-related constructs in suicidal behavior

Armand Chatard, Alexia Delbreil, Ghina Harika-Germaneau, Marc Besnier, Leila Selimbegovic, Nemat Jaafari

► To cite this version:

Armand Chatard, Alexia Delbreil, Ghina Harika-Germaneau, Marc Besnier, Leila Selimbegovic, et al. Chronic accessibility of suicide-related constructs in suicidal behavior. Psychiatry Research Communications, 2026, 6 (1), pp.100243. 10.1016/j.psycom.2025.100243. hal-05442150

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# Chronic accessibility of suicide-related constructs in suicidal behavior

Armand Chatard<sup>a,b,*</sup>, Alexia Delbreil<sup>a,b,c</sup>, Ghina Harika-Germaneau<sup>a,b</sup>, Marc Besnier<sup>a,b ID</sup>, Leila Selimbegovic<sup>a</sup>, Nemat Jaafari<sup>a,b</sup>

## ARTICLE INFO

Handling Editor: Dr. Leonardo Fontenelle

**Keywords:**

Suicide-related construct accessibility

Suicide ideation

Suicidal behavior

## ABSTRACT

**Objective:** This study examined whether chronic accessibility of suicide-related constructs differs across individuals with a history of suicidal ideation, planning, or attempts. Although situational increases in suicide-related accessibility have been documented experimentally, its chronic elevation among individuals with suicidal histories remains understudied.

**Method:** A large purposive sample of young adults (N = 952) with moderate-to-high depressive symptoms completed a word-completion task assessing chronic cognitive accessibility of suicide- and sadness-related constructs. Participants were classified into four groups based on lifetime history: no suicidal behavior, ideation, planning, and attempts.

**Results:** Suicide-related constructs were more chronically accessible among individuals with a history of suicide planning or attempts, but not among those reporting suicidal ideation alone, compared with individuals with no suicidal history. No comparable pattern was observed for sadness-related constructs.

**Discussion:** These findings suggest that chronic accessibility of suicide-related cognitions may be a content-specific cognitive marker associated with more severe suicidal behavior. Further research is required to clarify its temporal dynamics and potential implications for suicide risk assessment.

## 1. Introduction

"Suicide is the result of an interior dialogue. The mind scans its options; the topic of suicide comes up, the mind rejects it, scans again; there is suicide, it is rejected again, and then finally the mind accepts suicide as a solution, then plans it, and fixes it as the only answer." (Shneidman, 1996) p. 15.

Suicide remains a major public health concern with profound individual and societal consequences. Although theoretical and empirical advances have substantially improved our understanding of suicidal behavior, the cognitive mechanisms that contribute to the emergence and maintenance of suicidal thoughts remain insufficiently understood (O'Connor and Nock, 2014). One candidate mechanism highlighted early by Shneidman (1996) is the cognitive accessibility of suicide-related constructs, that is, the ease with which suicide-related thoughts or representations spontaneously come to mind (Chatard and Selimbegović, 2011; Chatard et al., 2017; Selimbegović and Chatard, 2025). Despite its theoretical relevance, this process has received

relatively limited empirical attention.

The present study addresses this gap by examining whether individuals with different histories of suicidal behavior—ideation, planning, and attempts—exhibit heightened chronic accessibility of suicide-related constructs.

### 1.1. Suicide-related construct accessibility

Construct accessibility, broadly defined as the readiness with which a mental representation becomes activated (Higgins et al., 1982; Bargh and Pratto, 1986), plays a key role in shaping attention, interpretation, and behavior. Repeated activation strengthens accessibility, such that certain thoughts may eventually arise spontaneously across contexts (Higgins and Brendl, 1995). Applied to suicide, several authors have suggested that suicide-related thoughts may become increasingly automatic and intrusive as they recur, eventually contributing to suicidal behavior (Shneidman, 1996; Cornette et al., 2000; Williams and Pollock, 2001).

<footnote><sup>a</sup> Université de Poitiers, CNRS 7295, Centre de Recherches Cognition et Apprentissage, France</footnote>

<footnote><sup>b</sup> Unité de Recherche Clinique, Centre Hospitalier Laborit, Poitiers, France</footnote>

<footnote><sup>c</sup> Centre Hospitalier Universitaire de Poitiers, Service de Médecine Légale, Poitiers, France</footnote>

<footnote>* Corresponding author. Université de Poitiers, CNRS 7295, 5, rue Théodore Lefebvre, TSA, Poitiers Cedex 9, 21113, France.
E-mail address: armand.chatard@univ-poitiers.fr (A. Chatard).</footnote>
Contemporary models converge on this idea. In particular, escape theory (Baumeister, 1990) posits that experiences of failure, self-discrepancy, or major disillusionment trigger aversive self-awareness and a desire to escape, thereby making suicide-related cognitions more salient. Cognitive models of suicidal behavior (Wenzel and Beck, 2008) propose that maladaptive schemas become automatically activated under such conditions, shaping how individuals process emotionally threatening information.

Experimental findings support these theoretical perspectives. In particular, failure feedback has been shown to reliably increase the accessibility of sadness-related constructs among individuals characterized by heightened self-discrepancies (Higgins et al., 1986), as well as individuals' own perceived weaknesses among those with low self-esteem (Doddson and Wood, 1998). More recently, failure feedback has also been shown to enhance the accessibility of suicide-related words in vulnerable individuals, as measured through word-completion and lexical decision tasks (Chatard and Selimbegović, 2011; Chatard et al., 2017). Importantly, this specific effect on self-destructive thought processing has been replicated across cultural contexts (Tang et al., 2013; Breines and Ayduk, 2013) and consistently linked to escape motivation (see Selimbegović and Chatard, 2025 for a review).

While most of this work has examined situational accessibility, triggered by acute stressors, an open question is whether repeated suicidal thinking leads to chronic, context-independent accessibility of suicide-related constructs—particularly among individuals with a history of more severe suicidal behavior.

## 1.2. Indirect cognitive measures and suicide

Research on suicide-related construct accessibility can be situated within the broader framework of dual-process models, which emphasize the dynamic interplay between automatic and controlled cognitiveecedents of suicidal thoughts and behaviors (Selimbegović and Chatard, 2025; Olson et al., 2022; Brüdern et al., 2022). From this perspective, indirect cognitive measures provide a privileged tool for investigating automatic processes involved in suicidality. In this framework, several empirical paradigms point to the role of automatic cognitive processes in suicidal vulnerability. Attentional-bias studies indicate that suicide attempters have greater difficulty disengaging from suicide-related stimuli (Cha et al., 2010; Richard-Devantoy et al., 2016). Studies using the Implicit Association Test (Greenwald et al., 1998) further show that stronger automatic associations between “death/suicide” and the self predict future suicide attempts (Tello et al., 2020; Nock et al., 2010; Sohn et al., 2021).

Other indirect cognitive approaches to suicidal thoughts and behaviors include verbal implicit paradigms. Using a suicide-focused Word Sentence Association Paradigm (Rogers et al., 2024), this work showed that suicide-relevant interpretation biases were associated with a lifetime history of suicide attempt, while showing no reliable association with suicidal ideation and no prospective predictive validity. Although this task assesses interpretation biases rather than construct accessibility, it nonetheless highlights the contribution of automatic, early-stage cognitive processes to suicidal vulnerability.

With direct reference to construct accessibility, one study has examined whether individuals with suicidal ideation exhibit heightened construct accessibility (Rosario-Williams et al., 2023). This work used a word-completion task in a sample of young adults reporting moderate-to-high depressive symptoms and found no evidence for increased accessibility among individuals with suicidal ideation. The small sample size (N = 115) substantially limited statistical power, and the study did not include participants with suicide plans or attempts, leaving open whether construct accessibility may differentiate more severe forms of suicidal behavior.

Together, these findings underscore the need to investigate suicide-related construct accessibility across a broader and more severe

spectrum of suicidal behaviors.

## 1.3. Study overview

The present study examined whether a history of suicidal ideation, planning, or attempts is associated with strengthened chronic accessibility of suicide-related constructs, even in neutral, non-threatening contexts, that is, in the absence of situational stressors such as failure feedback.

To address this question, we compared chronic accessibility across four groups defined by lifetime suicidal history: individuals with no suicidal behavior, suicidal ideation only, suicide planning, and suicide attempts. To ensure sufficient representation of individuals with more severe suicidal histories—typically underrepresented in general population samples—we recruited a large sample of young adults screened for moderate-to-high depressive symptoms, following prior work (Rosario-Williams et al., 2023). This sampling strategy increased the likelihood of including participants with a history of suicide plans and attempts and ensured adequate statistical power to detect effects of modest size.

We hypothesized a graded pattern of chronic accessibility, with the highest levels among individuals with a history of suicide planning or attempts, intermediate levels among those reporting ideation only, and the lowest levels among individuals without any suicidal history.

# 2. Method

## 2.1. Participants

Participants were drawn from a larger mental health survey conducted at the University of Poitiers, which included more than 5000 observations collected between 2023 and 2024. The parent study aimed to examine mood, cognitive processes, and mental health indicators in the general young adult population. From this dataset, we selected a purposive subsample of individuals who scored in the top 20 % of the CES-D distribution, ensuring adequate representation of participants with a history of suicidal ideation, planning, and attempts.

The final sample included 952 participants (87.9 % female; M age = 26.0, SD = 10.8). With this sample size, the study had adequate statistical power (≥0.80) to detect small effect sizes in group comparisons (e² ≈ 0.01–0.02) at α = .05.

Participants were initially recruited through announcements made in university classes, and they were encouraged to share the survey link with friends and relatives to broaden recruitment beyond students. Participation was voluntary and anonymous.

The study employed a cross-sectional design, and all data were collected at a single time point through an online survey.

## 2.2. Procedure

This study obtained approval from the local ethics committee and was conducted in accordance with the ethical guidelines of the French Psychological Society and the Declaration of Helsinki. Participants completed an online survey hosted on the Pavlovia platform (http://pavlovia.org/) and provided electronic informed consent before beginning the study. Upon completing the survey, participants were thanked and debriefed online. No monetary or material compensation was offered for their participation.

## 2.3. Measures

*Construct accessibility.* Participants first completed a word completion task to assess the accessibility of concepts related to sadness and suicide (Chatard and Selimbegović, 2011; Chatard et al., 2017). They were presented with 24 word-fragments, each appearing successively on the screen, and were asked to complete each fragment with the first word
that came to mind, without concern for selecting a specific word. If they could not think of a word, they were allowed to move on to the next trial. Among these, four fragments could be completed either as neutral or sadness-related words (target words: failure [échec], depression [déprime], sad [triste], and grief [chagrin]), and four could be completed as neutral or suicide-related words (target words: suicide [suicide], to hang [pendre], rope [corde], and wrist [veine]). The words “rope,” “to hang,” and “wrist” were chosen because they refer to common methods of suicide in Europe (Nock et al., 2007). The list of word fragment is presented in Table 1. As in previous research (Chatard and Selimbegović, 2011; Chatard et al., 2017), the percentages of suicide- and sadness-related completions were used as measures of accessibility. These percentages correspond to the proportion of suicide- and sadness-related words among all completed word fragments.

**Depressive Symptoms.** Depressive symptoms were assessed using the CES-D scale (Center for Epidemiologic Studies-Depression; (Radloff, 1977); French version by (Fuhrer and Rouillon, 1989)). The CES-D is a 20-item self-report scale designed to measure the frequency of depressive symptoms experienced over the past week. Participants rate each item on a 4-point scale, ranging from 0 (rarely or none of the time) to 3 (most or all of the time), with higher scores indicating more severe depressive symptoms. The scale covers a range of symptoms, including mood, somatic complaints, and interpersonal difficulties. Total scores range from 0 to 60, with higher scores reflecting greater levels of depressive symptomatology. In the present study, only participants with scores of 32 or above were selected, indicating moderate to high levels of depressive symptoms.

**Suicidal Behavior.** Suicidal ideation, planning, and attempts were assessed using three items: “Have you ever thought about committing suicide in the past?” (yes or no response), “Have you ever planned to commit suicide in the past?” and “Have you ever attempted suicide in the past?” Each item was answered with a “yes” or “no” response. These items were taken from the Self-Injurious Thoughts and Behaviors Interview (Nock et al., 2007); French version by (Tello et al., 2020).

**Demographics.** Participants reported on their age, sex, diploma, and socioeconomic status.

## 2.4. Statistical analysis

All analyses were conducted using non-parametric tests due to deviations from normality typically observed in suicide research. Group differences (no suicidal behavior, ideation, plan, attempt) were tested using Kruskal-Wallis ANOVAs, followed by Dwass-Steel-Critchlow-Fligner pairwise comparisons. We also conducted logistic regressions on the two diagnostic fragments (“suicide” and “triste”) to test specific group differences. Effect sizes ($\epsilon^2$) and 95 % confidence intervals are reported where appropriate.

## 2.5. Transparency and data availability

This study was not preregistered. All information on sample selection, exclusions, measures, and analyses is reported transparently. The dataset (.csv) and R code used in this study are publicly available on the OSF (DOI: 10.17605/OSF.IO/5PMQJ).

# 3. Results

## 3.1. Sample characteristics

Sociodemographic characteristics for the four suicidal-behavior groups are presented in Table 2. As shown, the sample was predominantly female and relatively young, with no notable sociodemographic differences between groups. A Kruskal-Wallis test revealed significant differences in depressive symptoms across groups, $\chi^2(3) = 56.50, p < .001, \epsilon^2 = 0.0591$. Pairwise comparisons indicated that participants without a history of suicidal behavior reported significantly lower depressive symptoms than participants with suicidal ideation, suicide plans, or suicide attempts. Participants with suicidal ideation also reported lower depressive symptoms than those with suicide plans or suicide attempts. No difference emerged between the plan and attempt groups.

## 3.2. Suicide-related word accessibility

Mean proportions and 95 % confidence intervals for suicide-related

<table><caption>**Table 1**
Neutral, suicide- and sadness-related word fragments in French and English.</caption><thead><tr><th>Word fragment</th><th>Neutral Word</th><th>Suicide- and sadness-related word (French)</th><th>Suicide- and sadness-related word (English)</th></tr></thead><tbody><tr><td>AC_</td><td>ACCES</td><td>ACCES</td><td>ACCESS</td></tr><tr><td>BAL_</td><td>BALON</td><td>BALON</td><td>BALLOON</td></tr><tr><td>BON_IR</td><td>BONSOIR</td><td>BONSOIR</td><td>GOOD EVENING</td></tr><tr><td>CHAT_</td><td>CHATONS</td><td>CHATONS</td><td>KITTENS</td></tr><tr><td>CH_G_IN</td><td>CHIGNON</td><td>CHAGRIN</td><td>GRIEF</td></tr><tr><td>CI_RE</td><td>CIGARE</td><td>CIGARE</td><td>CIGAR</td></tr><tr><td>COR_E</td><td>CORSE</td><td>CORDE</td><td>ROPE</td></tr><tr><td>DEP_</td><td>DEPENSE</td><td>DEPRIME</td><td>DEPRESSION</td></tr><tr><td>E_</td><td>EFFET</td><td>ECHEC</td><td>FAILURE</td></tr><tr><td>H_</td><td>HAIE</td><td>HAIE</td><td>HEDGE</td></tr><tr><td>JO_R</td><td>JOUR</td><td>JOUR</td><td>DAY</td></tr><tr><td>LIV_</td><td>LIVRE</td><td>LIVRE</td><td>BOOK</td></tr><tr><td>PE_U</td><td>PEAU</td><td>PEAU</td><td>SKIN</td></tr><tr><td>PEN_</td><td>PENSEE</td><td>PENDRE</td><td>TO HANG</td></tr><tr><td>PO_H_</td><td>POCHE</td><td>POCHE</td><td>POCKET</td></tr><tr><td>RI_N</td><td>RIEN</td><td>RIEN</td><td>NOTHING</td></tr><tr><td>S_V_N_</td><td>SOUVENT</td><td>SOUVENT</td><td>OFTEN</td></tr><tr><td>SU_I_</td><td>SUBLIME</td><td>SUICIDE</td><td>SUICIDE</td></tr><tr><td>TRA_N</td><td>TRAIN</td><td>TRAIN</td><td>TRAIN</td></tr><tr><td>TRI_</td><td>TRIPLE</td><td>TRISTE</td><td>SAD</td></tr><tr><td>TRO_</td><td>TROUVE</td><td>TROUVE</td><td>FOUND</td></tr><tr><td>VE_T</td><td>VENT</td><td>VENT</td><td>WIND</td></tr><tr><td>VE_N_</td><td>VERNI</td><td>VEINE</td><td>WRIST</td></tr><tr><td>VI_</td><td>VIOLET</td><td>VIOLET</td><td>VIOLET</td></tr></tbody></table>

Note: Each word fragment was presented in a random order, displayed successively on the screen. The fragment remained visible until the participant provided a response or chose to proceed to the next trial. Participants were instructed to complete each fragment with the first word that came to mind, without concern for selection.
<table><caption>**Table 2**
Sociodemographic characteristics of the sample.</caption><thead><tr><th rowspan="2"></th><th colspan="4">Lifetime Suicidal Behavior</th></tr><tr><th>No SB</th><th>SI</th><th>SP</th><th>SA</th></tr></thead><tbody><tr><td><strong>Sex (n)</strong></td><td></td><td></td><td></td><td></td></tr><tr><td>Female</td><td>239</td><td>314</td><td>119</td><td>169</td></tr><tr><td>Male</td><td>29</td><td>46</td><td>20</td><td>20</td></tr><tr><td><strong>Age (M, SD)</strong></td><td>27.7 (12.0)</td><td>25.8 (10.3)</td><td>23.7 (9.38)</td><td>25.7 (10.5)</td></tr><tr><td><strong>Nationality (n)</strong></td><td></td><td></td><td></td><td></td></tr><tr><td>French</td><td>247</td><td>326</td><td>133</td><td>183</td></tr><tr><td>Other</td><td>21</td><td>34</td><td>6</td><td>6</td></tr><tr><td><strong>Occupation (n)</strong></td><td></td><td></td><td></td><td></td></tr><tr><td>Student</td><td>151</td><td>211</td><td>92</td><td>101</td></tr><tr><td>Other</td><td>117</td><td>149</td><td>47</td><td>88</td></tr><tr><td><strong>Socioeconomic status (M, SD)</strong></td><td>4.85 (1.64)</td><td>4.88 (1.76)</td><td>5.06 (1.65)</td><td>4.48 (1.91)</td></tr><tr><td><strong>Depressive Symptoms (M, SD)</strong></td><td>37 (4.66)</td><td>38.1 (5.11)</td><td>39.7 (5.70)</td><td>41.1 (6.72)</td></tr></tbody></table>

Note: No SB = No Suicidal Behavior, SI = Suicide Ideation, SP = Suicide Plan, SA = Suicide Attempt. Socioeconomic status is measured using a ladder scale ranging from 0 to 10. Depressive symptoms are represented as continuous scores.

completions are presented in Table 3. A Kruskal-Wallis test indicated significant group differences in the proportion of suicide-related completions, $\chi^2(3) = 12.50$, $p = .006$, $\epsilon^2 = 0.0131$. Pairwise comparisons showed that participants with a history of suicide attempts produced significantly more suicide-related completions than those with no suicidal history and those with suicidal ideation. No other contrasts were significant. These results suggest that chronic accessibility of suicide-related constructs is the most elevated among individuals with the most severe suicidal histories.

### 3.3. Sadness-related word accessibility

Means and confidence intervals for sadness-related completions are presented in Table 4. Although a Kruskal-Wallis test indicated overall group differences, $\chi^2(3) = 9.32$, $p = .025$, $\epsilon^2 = 0.00976$, post-hoc tests showed that this effect was driven exclusively by lower sadness-related completions among individuals with suicidal ideation compared to those with no suicidal history. No significant differences emerged among the remaining groups. Thus, unlike the results for suicide-related completions, sadness-related accessibility did not increase as suicidal severity increased.

### 3.4. Complementary analyses

To examine whether effects were stronger for fragments most directly linked to the target constructs, logistic regressions were conducted on the “suicide” and “sad” fragments (see Tables 5 and 6, respectively). For the suicide-related fragment, participants with a history of suicide planning or suicide attempts showed approximately twice the odds of completing the fragment with “suicide” relative to participants with no suicidal history. No such difference was observed for participants reporting suicidal ideation only. For the sadness-related fragment, none of the groups differed from the no-suicidal-behavior group. These findings confirm that the observed pattern is specific to suicide-related content and does not extend to negative-affect-related words more generally.

<table><caption>**Table 3**
Means (with 95 % CI) of the proportion of suicide-related completions.</caption><thead><tr><th rowspan="2">Group</th><th rowspan="2">n</th><th rowspan="2">Mean</th><th rowspan="2">SD</th><th colspan="2">95 % Confidence Interval</th></tr><tr><th>Lower</th><th>Upper</th></tr></thead><tbody><tr><td>No SB</td><td>268</td><td>6.81</td><td>5.52</td><td>6.16</td><td>7.47</td></tr><tr><td>SI</td><td>360</td><td>7.11</td><td>5.50</td><td>6.55</td><td>7.68</td></tr><tr><td>SP</td><td>139</td><td>7.96</td><td>5.49</td><td>7.05</td><td>8.87</td></tr><tr><td>SA</td><td>189</td><td>8.40</td><td>5.28</td><td>7.62</td><td>9.18</td></tr></tbody></table>

Note: No SB = No Suicidal Behavior, SI = Suicide Ideation, SP = Suicide Plan, SA = Suicide Attempt.

## 4. Discussion

### 4.1. Summary of findings

The present study examined whether chronic accessibility of suicide-related constructs differs across individuals reporting distinct histories of suicidal behavior. Using a large purposive sample of young adults with moderate-to-high depressive symptoms, we found that suicide-related constructs were more accessible among individuals with a history of suicide planning and, more markedly, suicide attempts. No such increase was observed among individuals reporting suicidal ideation only. By contrast, accessibility of sadness-related constructs did not show a similar pattern and did not increase with the severity of suicidal history. Together, these findings suggest that chronic accessibility of suicide-related cognitions may represent a cognitive marker specific to more severe forms of suicidal behavior.

### 4.2. Theoretical implications

These findings extend prior work on situational suicide-related accessibility by showing that accessibility differences persist beyond acute stress contexts. Previous experimental studies demonstrated that failure feedback transiently increases the accessibility of suicide-related thoughts in vulnerable individuals (Chatard and Selimbegović, 2011; Chatard et al., 2017). The present results suggest that such accessibility may become chronically heightened among individuals with a history of suicide planning or attempts, even in neutral contexts where no situational trigger is present. This pattern is consistent with theoretical models positing that repeated activation strengthens the chronic accessibility of cognitive representations (Higgins and Brendl, 1995).

Rather than reflecting a mere intensification of affective distress, the selective elevation of suicide-related accessibility among individuals with a history of planning or attempts suggests a qualitative shift in the cognitive processing of suicide-related information. Consistent with dual-process models of suicidality (Selimbegović and Chatard, 2025; Olson et al., 2022; Brüdern et al., 2022), suicide-related constructs may

<table><caption>**Table 4**
Means (with 95 % CI) of the proportion of sadness-related completions.</caption><thead><tr><th rowspan="2">Group</th><th rowspan="2">n</th><th rowspan="2">Mean</th><th rowspan="2">SD</th><th colspan="2">95 % Confidence Interval</th></tr><tr><th>Lower</th><th>Upper</th></tr></thead><tbody><tr><td>No SB</td><td>268</td><td>5.01</td><td>4.58</td><td>4.44</td><td>5.59</td></tr><tr><td>SI</td><td>360</td><td>4.31</td><td>4.77</td><td>3.82</td><td>4.81</td></tr><tr><td>SP</td><td>139</td><td>4.82</td><td>5.49</td><td>4.03</td><td>5.62</td></tr><tr><td>SA</td><td>189</td><td>5.19</td><td>5.28</td><td>4.51</td><td>5.88</td></tr></tbody></table>

Note: No SB = No Suicidal Behavior, SI = Suicide Ideation, SP = Suicide Plan, SA = Suicide Attempt.
<table><caption>**Table 5**
Logistic regression analysis showing the odds of completing the suicide-related fragment with the word "suicide."</caption><thead><tr><th rowspan="2">Predictor</th><th rowspan="2">Estimate</th><th rowspan="2">SE</th><th rowspan="2">Z</th><th rowspan="2">p</th><th rowspan="2">Odds ratio</th><th colspan="2">95 % Confidence Interval</th></tr><tr><th>Lower</th><th>Upper</th></tr></thead><tbody><tr><td>Intercept</td><td>-1.4481</td><td>0.156</td><td>-9.305</td><td>&lt;0.001</td><td>0.235</td><td>0.173</td><td>0.319</td></tr><tr><td>Category:</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>SI – No SB</td><td>0.0790</td><td>0.203</td><td>0.389</td><td>0.698</td><td>1.082</td><td>0.726</td><td>1.613</td></tr><tr><td>SP – No SB</td><td>0.6449</td><td>0.241</td><td>2.680</td><td>0.007</td><td>1.906</td><td>1.189</td><td>3.054</td></tr><tr><td>SA – No SB</td><td>0.7069</td><td>0.220</td><td>3.213</td><td>0.001</td><td>2.028</td><td>1.317</td><td>3.121</td></tr></tbody></table>

Note. No SB = No Suicidal Behavior, SI = Suicide Ideation, SP = Suicide Plan, SA = Suicide Attempt. Estimates represent the log odds of "Suicide = 1" vs. "Suicide = 0".

<table><caption>**Table 6**
Logistic regression analysis showing the odds of completing the sadness-related fragment with the word "sadness."</caption><thead><tr><th rowspan="2">Predictor</th><th rowspan="2">Estimate</th><th rowspan="2">SE</th><th rowspan="2">Z</th><th rowspan="2">p</th><th rowspan="2">Odds ratio</th><th colspan="2">95 % Confidence Interval</th></tr><tr><th>Lower</th><th>Upper</th></tr></thead><tbody><tr><td>Intercept</td><td>-1.6275</td><td>0.165</td><td>-9.869</td><td>&lt;0.001</td><td>0.196</td><td>0.142</td><td>0.271</td></tr><tr><td>Category:</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>SI – No SB</td><td>-0.642</td><td>0.220</td><td>-0.292</td><td>0.770</td><td>0.938</td><td>0.609</td><td>1.443</td></tr><tr><td>SP – No SB</td><td>-0.2156</td><td>0.297</td><td>-0.726</td><td>0.468</td><td>0.806</td><td>0.450</td><td>1.442</td></tr><tr><td>SA – No SB</td><td>0.0369</td><td>0.255</td><td>0.145</td><td>0.885</td><td>1.038</td><td>0.630</td><td>1.709</td></tr></tbody></table>

Note. No SB = No Suicidal Behavior, SI = Suicide Ideation, SP = Suicide Plan, SA = Suicide Attempt. Estimates represent the log odds of "Suicide = 1" vs. "Suicide = 0".

become increasingly embedded within automatic associative networks as individuals move from ideation toward more severe behavioral engagement. This shift from predominantly controlled to more automatic processing provides a cognitive account of the transition from thinking about suicide to acting on such thoughts. This interpretation is further consistent with findings from a large-scale cross-sectional study showing that increases in the accessibility of implicit suicidal cognition tend to follow, rather than precede, peaks in explicit suicidal ideation (Freichel and O'Shea, 2023).

Our results further converge with recent findings from verbal implicit paradigms showing that suicide-related interpretation biases are associated with a lifetime history of suicide attempts, but not with suicidal ideation (Rogers et al., 2024). Importantly, they are also consistent with prior work reporting no association between suicidal ideation and suicide-related construct accessibility (Rosario-Williams et al., 2023). Together, these findings suggest that automatic cognitive signatures of suicide may be more closely linked to behavioral engagement in suicide (planning and attempts) than to ideation alone. One plausible explanation is that individuals who report suicidal ideation only may experience such thoughts more sporadically, whereas those who engage in planning or attempts are likely exposed to more frequent and sustained suicide-related cognitions, which may in turn strengthen their chronic accessibility.

### 4.3. Specificity relative to negative affectivity

An important contribution of the present study is the demonstration that the observed effects are not explained by a broader increase in the accessibility of negatively valenced or dysphoric content. Individuals with a history of suicide attempts did not show elevated accessibility for sadness-related constructs, and the only significant sadness-related difference was a modest decrease among individuals with suicidal ideation relative to controls. This dissociation between suicide-related and sadness-related accessibility strongly suggests that the observed effect is content-specific rather than a reflection of generalized negative affectivity, ruminative tendencies, or depressive symptom severity.

The absence of increased sadness accessibility among individuals with a history of suicide attempts may appear counterintuitive at first glance. One speculative interpretation, however, is that repeated engagement with suicidal behavior may be accompanied by a form of emotional numbing or "mental narrowing," as described in escape-based models of suicide (Baumeister, 1990). Such a mechanism could account

for the coexistence of heightened suicide-related accessibility and blunted sadness accessibility among individuals with a history of attempts.

By contrast, the reduced accessibility of sadness-related constructs observed among individuals reporting suicidal ideation only may reflect a different psychological process. One possibility is that, at earlier stages of the suicidal process, individuals may actively attempt to regulate or suppress distressing affective states and thoughts. From this perspective, lower sadness accessibility could reflect an effortful form of cognitive or emotional avoidance rather than emotional blunting per se. Such regulatory attempts may temporarily reduce the spontaneous activation of sadness-related content, while not yet giving rise to the chronic automaticity observed for suicide-related constructs at more advanced stages of suicidal behavior.

Importantly, these interpretations remain speculative and should be tested directly in future research using designs that allow for the simultaneous assessment of emotional reactivity, regulation strategies, and implicit cognitive accessibility across different stages of suicidal behavior.

### 4.4. Clinical implications and limitations

The present findings may have implications for clinical assessment. Chronic accessibility of suicide-related constructs, assessed via brief and non-reactive tasks such as word completion, could represent a complementary indicator of vulnerability, particularly among individuals with a history of suicidal planning or attempts. Because suicidal thoughts are often underreported due to stigma, fear of hospitalization, or ambivalence (Selimbegović and Chatard, 2025; Nock et al., 2010), indirect cognitive measures may help identify at-risk individuals who do not disclose such thoughts explicitly.

However, several important limitations must be acknowledged when interpreting these clinical implications. First, the effect sizes observed in the present study, although statistically significant, were modest, which limits their immediate clinical utility for individual-level prediction. Second, the practical implementation of implicit tasks in routine clinical settings remains constrained by time demands, lack of standardization, and uncertainty regarding how to integrate such measures within existing risk assessment frameworks. At present, these tools are therefore better suited for research purposes, mechanistic modeling, and multimodal approaches that combine self-report, behavioral performance, ecological assessments, and biological indicators.
Additional methodological limitations warrant consideration. The cross-sectional design precludes any inference about temporal ordering or transitions between suicidal ideation, planning, and attempts. Suicidal ideation, planning, and attempts were assessed using single dichotomous items, which limits the granularity of these constructs and reduces sensitivity to within-category heterogeneity. Finally, although the sample was large, it was recruited primarily in a university context and may not fully generalize to clinical or high-risk populations. Moreover, the word-completion task captures only a narrow component of the broader construct of suicide-related cognition and should not be interpreted as an exhaustive measure of automatic suicidal processing.

## 4.5. Conclusion

Despite these limitations, the present study provides novel evidence that chronic accessibility of suicide-related constructs is elevated among individuals with a history of suicide planning or suicide attempts, but not among those reporting suicidal ideation alone. These findings advance our understanding of the cognitive processes associated with suicidal behavior and highlight the potential relevance of automatic cognitive activation as a marker of more severe forms of suicidal vulnerability.

### CRediT authorship contribution statement

**Armand Chatard:** Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Software, Resources, Project administration, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization.
**Alexia Delbreil:** Writing – review & editing.
**Ghina Harika-Germaneau:** Writing – review & editing.
**Marc Besnier:** Writing – review & editing.
**Leila Selimbegovic:** Writing – review & editing.
**Nemat Jaafari:** Writing – review & editing.

### Transparency and data availability

This study was not preregistered. We have reported all details regarding our sample size determination, data exclusions, manipulations, and measures. The .csv dataset and R code supporting the findings are openly available on the Open Science Framework (OSF) at https://osf.io/5pmqj/, under the reference DOI: 10.17605/OSF.IO/5PMQJ.

### Ethical statement

This study obtained approval from the institutional ethics committee (CER-TP, 2024-11-15) and was conducted in accordance with the ethical guidelines of the French Psychological Society and the Declaration of Helsinki.

### Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

### Acknowledgements

This research was supported by the CNRS Programme de prématuration (grant 2025–29) awarded to Armand Chatard.

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