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Exploring Implicit Emotional Associations With Death in Patients With Current Suicidal Ideation : Results From Novel Attitude Implicit Association Tests for Suicide

Aschenbrenner, L. M. ; Frei, A. ; Knapp, D. ; Forkmann, T. ; Schreiber, D. ; Glaesmer, H. ; Brüdern, J. ; Stein, M. ; Walther, S. and Gysin-Maillart, A. LU (2025) In Suicide and Life-Threatening Behavior 55(5).
Abstract

Introduction: Assessing suicide risk in clinical settings is challenging, as conventional self-report scales have limited predictive validity. The Death Implicit Association Test (D-IAT) was developed to explore implicit associations related to death and the self-concept. However, it omits the emotional association with death that may be crucial in suicide risk assessment. This cross-sectional study on individuals with current suicidal ideation integrates the implicit emotional association with death into the conventional D-IAT. Methods: We aimed to explore whether patients with current suicidal ideation exhibit more positive implicit emotional associations with death compared to a clinical control group without current suicidal... (More)

Introduction: Assessing suicide risk in clinical settings is challenging, as conventional self-report scales have limited predictive validity. The Death Implicit Association Test (D-IAT) was developed to explore implicit associations related to death and the self-concept. However, it omits the emotional association with death that may be crucial in suicide risk assessment. This cross-sectional study on individuals with current suicidal ideation integrates the implicit emotional association with death into the conventional D-IAT. Methods: We aimed to explore whether patients with current suicidal ideation exhibit more positive implicit emotional associations with death compared to a clinical control group without current suicidal ideation and lifetime suicidal behavior (total N = 182). We employed the standard identity D-IAT (D-IATme/not me) and two novel attitude D-IAT versions (D-IATI like/I don’t like, D-IATpleasant/unpleasant). Furthermore, we compared all versions regarding their predictive and discriminative validity and analyzed correlations between implicit associations and self-reported suicidal ideation. Results: In the D-IATme/not me and D-IATI like/I don’t like version, patients with current suicidal ideation exhibited weaker negative associations with death compared to clinical controls. The D-IATpleasant/unpleasant did not yield a group difference. The D-IATme/not me showed superior performance in predictive validity and a similar performance in discriminative validity as the D-IATI like/I don’t like. These two versions correlated positively with self-reported current suicidal ideation. In the D-IATpleasant/unpleasant, no such correlation was found. Discussion: Our findings substantiate the validity and reliability of the identity D-IAT and suggest the D-IATI like/I don’t like as a potential complementary attitude variant with personalized categories. Incorporating implicit emotional associations when working with suicidal patients could enhance the evaluation and treatment of individuals at risk of suicide. Further investigation is warranted to gain a more comprehensive understanding of these relationships.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
implicit cognitive processes, suicidal behavior, suicidal ideation, suicidal mode, suicide risk assessment
in
Suicide and Life-Threatening Behavior
volume
55
issue
5
article number
e70047
publisher
Wiley-Blackwell
external identifiers
  • scopus:105015845802
  • pmid:40916391
ISSN
0363-0234
DOI
10.1111/sltb.70047
language
English
LU publication?
yes
id
7cbe451e-5f0f-4d5b-8857-a7155095276e
date added to LUP
2025-10-10 11:24:07
date last changed
2025-10-14 13:09:50
@article{7cbe451e-5f0f-4d5b-8857-a7155095276e,
  abstract     = {{<p>Introduction: Assessing suicide risk in clinical settings is challenging, as conventional self-report scales have limited predictive validity. The Death Implicit Association Test (D-IAT) was developed to explore implicit associations related to death and the self-concept. However, it omits the emotional association with death that may be crucial in suicide risk assessment. This cross-sectional study on individuals with current suicidal ideation integrates the implicit emotional association with death into the conventional D-IAT. Methods: We aimed to explore whether patients with current suicidal ideation exhibit more positive implicit emotional associations with death compared to a clinical control group without current suicidal ideation and lifetime suicidal behavior (total N = 182). We employed the standard identity D-IAT (D-IAT<sub>me/not me</sub>) and two novel attitude D-IAT versions (D-IAT<sub>I like/I don’t like</sub>, D-IAT<sub>pleasant/unpleasant</sub>). Furthermore, we compared all versions regarding their predictive and discriminative validity and analyzed correlations between implicit associations and self-reported suicidal ideation. Results: In the D-IAT<sub>me/not me</sub> and D-IAT<sub>I like/I don’t like</sub> version, patients with current suicidal ideation exhibited weaker negative associations with death compared to clinical controls. The D-IAT<sub>pleasant/unpleasant</sub> did not yield a group difference. The D-IAT<sub>me/not me</sub> showed superior performance in predictive validity and a similar performance in discriminative validity as the D-IAT<sub>I like/I don’t like</sub>. These two versions correlated positively with self-reported current suicidal ideation. In the D-IAT<sub>pleasant/unpleasant</sub>, no such correlation was found. Discussion: Our findings substantiate the validity and reliability of the identity D-IAT and suggest the D-IAT<sub>I like/I don’t like</sub> as a potential complementary attitude variant with personalized categories. Incorporating implicit emotional associations when working with suicidal patients could enhance the evaluation and treatment of individuals at risk of suicide. Further investigation is warranted to gain a more comprehensive understanding of these relationships.</p>}},
  author       = {{Aschenbrenner, L. M. and Frei, A. and Knapp, D. and Forkmann, T. and Schreiber, D. and Glaesmer, H. and Brüdern, J. and Stein, M. and Walther, S. and Gysin-Maillart, A.}},
  issn         = {{0363-0234}},
  keywords     = {{implicit cognitive processes; suicidal behavior; suicidal ideation; suicidal mode; suicide risk assessment}},
  language     = {{eng}},
  number       = {{5}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Suicide and Life-Threatening Behavior}},
  title        = {{Exploring Implicit Emotional Associations With Death in Patients With Current Suicidal Ideation : Results From Novel Attitude Implicit Association Tests for Suicide}},
  url          = {{http://dx.doi.org/10.1111/sltb.70047}},
  doi          = {{10.1111/sltb.70047}},
  volume       = {{55}},
  year         = {{2025}},
}