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Suicidal IdeationIAT-SNCT04585802

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

An observational study of Suicidal Ideation and Suicide Attempt, run by University of Bern at 1 site in Switzerland.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial 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. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Suicidal Ideation, Suicide Attempt
How many people
447 participants
Where
1 siteSwitzerland
Study dates
27 May 2020to 26 Nov 2024
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • Adult, Older adult

Study population: Patients from the University Hospital of Psychiatry

Who may be able to join

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

Who cannot join

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

Trial locations and contacts

1 site in 1 country.

Switzerland1 site
  • University Hospital of Psychiatry and Psychotherapy, University of Bern

    Bern, 3008

Other trials in Switzerland

About this study

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).

Read more

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.

Read the 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.

Keywords
Implicit Association Test
Medical subject headings
Suicidal Ideation, Suicide, Attempted

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT04585802
Study groupRoleWhat they receive
Suicide Attempters (1)patients with a suicide attempt
Suicide Ideators (2)patients with suicidal ideation
Clinical Control Group (3)patients without suicide attempt and without suicide ideation
Healthy Control Group (4)persons without suicide attempt and without suicide ideation, who do not have a psychiatric disorder

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Implicit Association Test (IAT)

    The German version of the Suicide Implicit Association Test (Rath et al., 2018) is administered using a computer paradigm and is designed to measure implicit associations with death using D-values. D is an individual effect size assessment that reflects the comparative difficulty of performing the two response conditions of the IAT, with a value of 0 indicating that the tasks had equivalent performance (Greenwald et al., 2003). D has a theoretical minimum of -2 and maximum of +2 when blocks of the same size are compared (Nosek \& Sriram, 2007). The more positive the D-values, the stronger the association between the "self" and "death" than between the "self" and "life".

    Measured: One assessment at baseline after study information and informed consent was given

Secondary outcomes (7)
  1. Suicide Behaviors Questionnaire - Revised

    The Suicide Behaviors Questionnaire measures suicidal behavior in the past and consists of four items. Item scores range from 3 to 18 with higher scores indicating more suicidal behavior (Osman et al., 2001).

    Measured: One assessment at baseline after study information and informed consent was given

  2. Beck Scale for Suicide Ideation (BSS)

    The Beck-Scale for Suicide Ideation measures suicidal thinking and consists of 21 items. Item scores range from 0 to 42 with higher scores indicating more suicidal ideation (Beck \& Steer, 1993; Kliem \& Brähler, 2016).

    Measured: One assessment at baseline after study information and informed consent was given

  3. Beck Depression Inventory (BDI-II)

    The Beck Depression Inventory measures the severity of depression and consists of 21 items. Item scores range from 0 to 63 with higher scores indicating a higher intensity of depression (Beck, Steer \& Brown, 1996).

    Measured: One assessment at baseline after study information and informed consent was given

  4. Mee-Bunney Psychological Pain Assessment Scale (MBPPAS)

    The Mee-Bunney Psychological Pain Assessment Scale measures psychological pain and consists of 10 items. Item scores range from 10 to 50 with higher scores indicating more psychological pain (Mee et al., 2011).

    Measured: One assessment at baseline after study information and informed consent was given

  5. Positive Mental Health Scale (PMH-scale)

    Positive Mental Health Scale measures positive mental health ans consists of 9 items. Item scores range from 9 to 36 with higher scores indicating more positive mental health (Lukat, Margraf, Lutz, van der Veld \& Becker, 2016).

    Measured: One assessment at baseline after study information and informed consent was given

  6. Internal External Locus of Control-4 (IE-4)

    The IE-4 is a Scale for the Assessment of Locus of Control and consists of two subscales with two items each. For each subscale, the mean value of the two items is calculated, which can range from 1 to 5 with higher scores indication more internal/external locus of control (Kemper, Beierlein, Kovaleva, \& Rammstedt, 2012).

    Measured: One assessment at baseline after study information and informed consent was given

  7. Mini-International Neuropsychiatric Interview (M.I.N.I.)

    The Mini-International Neuropsychiatric Interview is a brief structured diagnostic interview to assess the most common psychiatric disorders (Sheehan et al., 1998).

    Measured: One assessment at baseline after study information and informed consent was given

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Oct 2020
  2. Study start27 May 2020
  3. Primary completion26 Nov 2024
  4. Study completion26 Nov 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Cross-sectional
Enrolment
447 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04585802
Sponsor's protocol ID
2019-01410
Other IDs
2019
Acronym
IAT-S
Status last verified
Jul 2025
First submitted
23 Sep 2020
Last updated
18 Jul 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Nock MK, Park JM, Finn CT, Deliberto TL, Dour HJ, Banaji MR. Measuring the suicidal mind: implicit cognition predicts suicidal behavior. Psychol Sci. 2010 Apr;21(4):511-7. doi: 10.1177/0956797610364762. Epub 2010 Mar 9.

    PubMed 20424092
  • Pearce CM, Martin G. Locus of control as an indicator of risk for suicidal behaviour among adolescents. Acta Psychiatr Scand. 1993 Dec;88(6):409-14. doi: 10.1111/j.1600-0447.1993.tb03482.x.

    PubMed 8310847
  • Rath D, Hallensleben N, Glaesmer H, Spangenberg L, Strauss M, Kersting A, Teismann T, Forkmann T. [Implicit Associations with Death: First Validation of the German Version of the Suicide Implicit Association Test (Suicide IAT)]. Psychother Psychosom Med Psychol. 2018 Mar;68(3-4):109-117. doi: 10.1055/s-0043-105070. Epub 2017 Jun 29. German.

    PubMed 28718868
  • Everall, RD, Altrows, KJ, Paulson, BL. Creating a Future: A Study of Resilience in Suicidal Female Adolescents. Journal of Counseling & Development. 2006; 84(4): 461-470.

  • Osman A, Bagge CL, Gutierrez PM, Konick LC, Kopper BA, Barrios FX. The Suicidal Behaviors Questionnaire-Revised (SBQ-R): validation with clinical and nonclinical samples. Assessment. 2001 Dec;8(4):443-54. doi: 10.1177/107319110100800409.

    PubMed 11785588
  • Beck AT, Steer RA, Ball R, Ranieri W. Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. J Pers Assess. 1996 Dec;67(3):588-97. doi: 10.1207/s15327752jpa6703_13.

    PubMed 8991972
  • Beck AT, Steer RA. BSI, Beck Scale for Suicide Ideation. Psychological Corporation. 1993.

  • Kliem S, Brähler E. Beck-Hoffnungslosigkeits-Skala. Deutsche Fassung. Göttingen:Hogrefe. 2016.

  • Mee S, Bunney BG, Bunney WE, Hetrick W, Potkin SG, Reist C. Assessment of psychological pain in major depressive episodes. J Psychiatr Res. 2011 Nov;45(11):1504-10. doi: 10.1016/j.jpsychires.2011.06.011. Epub 2011 Aug 9.

    PubMed 21831397
  • Lukat J, Margraf J, Lutz R, van der Veld WM, Becker ES. Psychometric properties of the Positive Mental Health Scale (PMH-scale). BMC Psychol. 2016 Feb 10;4:8. doi: 10.1186/s40359-016-0111-x.

    PubMed 26865173
  • Kemper CJ, Beierlein C, Kovaleva A, Rammstedt B. Eine Kurzskala zur Messung von Kontrollüberzeugung: Die Skala lnternale-Externale Kontrollüberzeugung-4 (IE-4). GESIS Working Papers.2012; 2(19).

  • Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57.

    PubMed 9881538
  • Nosek BA, Sriram N. Faulty assumptions: A comment on Blanton, Jaccard, Gonzales, and Christie (2006). J Exp Soc Psychol. 2007 May;43(3):393-398. doi: 10.1016/j.jesp.2006.10.018.

    PubMed 18438456
  • Greenwald AG, Nosek BA, Banaji MR. Understanding and using the implicit association test: I. An improved scoring algorithm. J Pers Soc Psychol. 2003 Aug;85(2):197-216. doi: 10.1037/0022-3514.85.2.197.

    PubMed 12916565

Questions about this trial

What is this clinical trial studying?

An observational study of Suicidal Ideation and Suicide Attempt, run by University of Bern at 1 site in Switzerland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Implicit Association Test (IAT) (time frame: One assessment at baseline after study information and informed consent was given). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04585802, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Jul 2025.

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