Clinical trial NCT04585802: Expansion and Reevaluation of the Implicit Association Test in Suicide Ideators and Suicide Attempters
Official title: Expansion and Reevaluation of the Implicit Association Test in Suicide Ideators and Suicide Attempters
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Suicidal Ideation
Suicide Attempt
Keywords: Implicit Association Test
Lead sponsor: University of Bern
Sponsor class: OTHER
Collaborators: name: University Hospital of Psychiatry, Department Neuropsychopharmacology and Brain Imaging
First posted: 2020-10-14
Enrollment: 280
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Observational model: CASE_CONTROL
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: Patients from the University Hospital of Psychiatry

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.

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)

Primary outcomes:
measure: Implicit Association Test (IAT)
timeFrame: One assessment at baseline after study information and informed consent was given
Secondary outcomes:
measure: Suicide Behaviors Questionnaire - Revised
timeFrame: One assessment at baseline after study information and informed consent was given
measure: Beck Scale for Suicide Ideation (BSS)
timeFrame: One assessment at baseline after study information and informed consent was given
measure: Beck Depression Inventory (BDI-II)
timeFrame: One assessment at baseline after study information and informed consent was given
measure: Mee-Bunney Psychological Pain Assessment Scale (MBPPAS)
timeFrame: One assessment at baseline after study information and informed consent was given
measure: Positive Mental Health Scale (PMH-scale)
timeFrame: One assessment at baseline after study information and informed consent was given
measure: Internal External Locus of Control-4 (IE-4)
timeFrame: One assessment at baseline after study information and informed consent was given
measure: Mini-International Neuropsychiatric Interview (M.I.N.I.)
timeFrame: One assessment at baseline after study information and informed consent was given
Other outcomes:
Locations:
city: Bern
country: Switzerland
facility: University Hospital of Psychiatry and Psychotherapy, University of Bern
Study officials:
affiliation: University of Bern
name: Anja C. Gysin-Maillart, PD
role: PRINCIPAL_INVESTIGATOR
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