Death Attitude (Implicit/Explicit)NCT07020143
Chinese University Students' Death Attitudes and Their Initial Sandplay Characteristics
An observational study of Death Attitude (Implicit/Explicit) and Sandplay Therapy, run by Kai Huang at 1 site in China.
Trial summary
Death attitudes are different emotional reactions, evaluations, and behavioral tendencies of individuals experiencing near-death or death scenes, including positive or negative attitudes toward death such as denial, fear, curiosity, acceptance, avoidance, anxiety, etc. Read more about this study
- Who is it for?
- Ages 18 to 22 yearsHealthy volunteers can take part
- Conditions the study is for
- Death Attitude (Implicit/Explicit), Sandplay Therapy
- How many people
- 100 participants
- Where
- 1 siteChina
- Study dates
- 20 Jun 2025to 20 Aug 2025
- How long will I take part?
- 1 Day
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
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 22 years
- All sexes
- Healthy volunteers accepted
- Adult
Study population: The trial randomly and double-blindly recruited 100 Han Chinese, with no religious beliefs, age range of 20 ± 2 years old, university students to participate in the trial, the subjects had normal vision or corrected vision, none of them had previously participated in similar experiments, and they were familiar with basic computer operation.
Inclusion Criteria Be aged 18-22 years (20 ± 2 years old) Self-identified as Han Chinese ethnicity Currently enrolled as an undergraduate student Normal or corrected-to-normal vision No prior participation in similar psychological experiments (e.g., IAT, sandplay therapy) Proficient in basic computer operations (e.g., keyboard use, mouse navigation) Willing to provide written informed consent Exclusion Criteria Presence of diagnosed psychiatric disorders (e.g., major depressive disorder, PTSD) Regular use of psychotropic medications within the past 6 months Religious affiliation or spiritual practices influencing death-related beliefs History of traumatic bereavement (e.g., loss of immediate family member within 1 year) Physical disabilities affecting sandplay manipulation (e.g., severe hand tremor)
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Death attitudes are different emotional reactions, evaluations, and behavioral tendencies of individuals experiencing near-death or death scenes, including positive or negative attitudes toward death such as denial, fear, curiosity, acceptance, avoidance, anxiety, etc. Wilson proposed a dual-attitude model to differentiate between implicit death attitudes and explicit death attitudes. Subsequently, some scholars have launched a discussion on the measurement and validity of implicit attitudes, Schimmack reviewed the evidence and found that the validity of implicit attitudes was lower than that of explicit instruments in all domains, but could be used as a complementary measure of sensitive attitudes; there are also several studies suggesting that implicit attitudes toward death could play a complementary role in the assessment of suicidal risk, and Wong found that a color image-based implicit association test was superior to a text-based one.
Sandplay therapy was developed by Swiss psychologist Dore M. Kalff in 1954 by combining Jung's analytical psychology and projection techniques with Lowenfeld's "The world technique". It was introduced to Japan by Hayao Kawai, a Japanese clinical psychologist, and introduced to China by Risheng Zhang in 1998. Sandplay therapy as a kind of deep-level expressive art therapy that uses sandboxes and tools to work with the self of individual cases, inherits the theories of Jungian psychotherapy about interpretation and metaphorical symbols, and can help individual cases to present unconscious contents and accomplish certain organization and transformation, which is very helpful to the development of the unconscious. It has a theoretical basis for reflecting the individual's implicit attitude toward death. Sandplay can express deeper emotional contents through metaphors and symbols .
Read more
Initial sandplay is the first one or two sandplays produced by a case. Research on the characteristics of the initial sandplay is helpful for clinicians to better grasp the psychological state and psychological traits of similar groups of people . Risheng Zhang does not advocate for the use of sandplay as a diagnostic tool, but sandplay does have a certain degree of diagnostic function, and by comparing the characteristics with those of the normative group, it can be used as one of the bases for preliminary judgment of the visitor. Renhui Lv suggested that Kalf and subsequent different scholars have combined their own experience in clinical practice to summarize the different methods and concerns of the box court assessment, although subjective assessment is criticized by scholars who hold a scientistic viewpoint, but it has to be admitted that any objectivization means cannot replace the flexibility and wholeness of the subjective assessment. The analytical dimensions of this study were defined in conjunction with the analytical dimensions used by several researchers regarding the study of sandplay characteristics.
This study planned to recruit 100 subjects through double-blind randomization, from which at least 82 subjects were selected from university students who had no religious beliefs, had an age range of 20±2 years old, had normal vision or corrected vision, none of them had participated in similar experiments before, and were familiar with basic computer operations. The study was based on a two-dimensional model of death attitudes, i.e., death attitudes were categorized into exoteric and implicit attitudes, and exoteric death attitudes were measured using the Depiction of Attitudes Toward Death Scale-Revised (DAP-R), and implicit death attitudes were measured using the Single-Category Implicit Association Test (SC-IAT), respectively. The study first explored the correlation between implicit and explicit attitudes toward death by correlating the implicit effect value D of the SC-IAT with the mean of the subdimensions of the DAP-R as pearson product difference. Secondly, based on the DAP-R scores, the university students with external death attitudes were categorized into positive and negative groups; based on the D values of the implicit effects of the SC-IAT, the university students with internal death attitudes were categorized into positive and negative groups, and the significance of the differences was investigated by conducting independent samples t-tests on the box characteristics of the university students of the two groups respectively.
- Keywords
- Chinese university students, implicit and explicit attitudes, death attitudes, the characteristics of initial sandplay
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Chinese university students | The study firstly explored the correlation between the implicit death attitudes and the explicit death attitudes by making pearson product-difference correlation between the implicit effect value D-value of the SC-IAT and the mean value of the sub-dimensions of the DAP-R. Secondly, based on the DAP-R scores, the university students with external death attitudes were categorized into positive and negative groups; based on the D values of the implicit effects of the SC-IAT, the university students with internal death attitudes were categorized into positive and negative groups, and the significance of the differences was investigated by conducting independent sample t-tests on the initial sandplay characteristics of the university students of the two groups respectively. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Sandplay Feature Profile (SFP) via Sandplay Therapy Observation Scale
Quantitative analysis of initial sandplay characteristics using 5 validated dimensions:
Toy Utilization Index: Count of distinct categories used (person/animal/plant/etc.) Sand Manipulation Score: 0-3 scale (0=no manipulation; 3=landform creation) Construction Time: Minutes from first toy selection to completion Self-Representation Coding: 0-2 nominal scale (0=absent; 1=symbolic; 2=literal) Spatial Occupancy Ratio: Calculated as (used area/total sandbox area)×100%
Measured: 1 day
Secondary outcomes (1)
Death Attitude Implicit Association (DA-IA) via SC-IAT
Description: D-value computed using Greenwald's improved algorithm (2003), reflecting response time differences between compatible (death-negative association) and incompatible (death-positive association) trials
Measured: 1 day
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Jun 2025
- Study start20 Jun 2025 (estimated)
- Primary completion20 Aug 2025 (estimated)
- Study completion20 Aug 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Death Attitude (Implicit/Explicit)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Cohort
- Time perspective
- Cross-sectional
- Enrolment
- 100 participants (estimated)
- Target duration
- 1 Day
Sponsor and investigators
- Lead sponsor
- Kai Huang
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Kai Huang, Ocean University of China
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07020143
- Sponsor's protocol ID
- OUCPHECC2025032202
- Status last verified
- Jun 2025
- First submitted
- 15 May 2025
- Last updated
- 13 Jun 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 13 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Chinese University Students' Death Attitudes and Their Initial Sandplay Characteristics
- ClinicalTrials.gov ID
- NCT07020143
- Acronym / sponsor ID
- OUCPHECC2025032202
- Keywords
- Chinese university students, implicit and explicit attitudes, death attitudes, the characteristics of initial sandplay
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 100 participants (estimated)
- Lead sponsor
- Kai HuangUniversity, hospital or other
- Study start
- 20 Jun 2025 (estimated)
- Primary completion
- 20 Aug 2025 (estimated)
- Study completion
- 20 Aug 2025 (estimated)
- First posted
- 13 Jun 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Death attitudes are different emotional reactions, evaluations, and behavioral tendencies of individuals experiencing near-death or death scenes, including positive or negative attitudes toward death such as denial, fear, curiosity, acceptance, avoidance, anxiety, etc. Wilson proposed a dual-attitude model to differentiate between implicit death attitudes and explicit death attitudes. Subsequently, some scholars have launched a discussion on the measurement and validity of implicit attitudes, Schimmack reviewed the evidence and found that the validity of implicit attitudes was lower than that of explicit instruments in all domains, but could be used as a complementary measure of sensitive attitudes; there are also several studies suggesting that implicit attitudes toward death could play a complementary role in the assessment of suicidal risk, and Wong found that a color image-based implicit association test was superior to a text-based one.
Sandplay therapy was developed by Swiss psychologist Dore M. Kalff in 1954 by combining Jung's analytical psychology and projection techniques with Lowenfeld's "The world technique". It was introduced to Japan by Hayao Kawai, a Japanese clinical psychologist, and introduced to China by Risheng Zhang in 1998. Sandplay therapy as a kind of deep-level expressive art therapy that uses sandboxes and tools to work with the self of individual cases, inherits the theories of Jungian psychotherapy about interpretation and metaphorical symbols, and can help individual cases to present unconscious contents and accomplish certain organization and transformation, which is very helpful to the development of the unconscious. It has a theoretical basis for reflecting the individual's implicit attitude toward death. Sandplay can express deeper emotional contents through metaphors and symbols .
Initial sandplay is the first one or two sandplays produced by a case. Research on the characteristics of the initial sandplay is helpful for clinicians to better grasp the psychological state and psychological traits of similar groups of people . Risheng Zhang does not advocate for the use of sandplay as a diagnostic tool, but sandplay does have a certain degree of diagnostic function, and by comparing the characteristics with those of the normative group, it can be used as one of the bases for preliminary judgment of the visitor. Renhui Lv suggested that Kalf and subsequent different scholars have combined their own experience in clinical practice to summarize the different methods and concerns of the box court assessment, although subjective assessment is criticized by scholars who hold a scientistic viewpoint, but it has to be admitted that any objectivization means cannot replace the flexibility and wholeness of the subjective assessment. The analytical dimensions of this study were defined in conjunction with the analytical dimensions used by several researchers regarding the study of sandplay characteristics.
This study planned to recruit 100 subjects through double-blind randomization, from which at least 82 subjects were selected from university students who had no religious beliefs, had an age range of 20±2 years old, had normal vision or corrected vision, none of them had participated in similar experiments before, and were familiar with basic computer operations. The study was based on a two-dimensional model of death attitudes, i.e., death attitudes were categorized into exoteric and implicit attitudes, and exoteric death attitudes were measured using the Depiction of Attitudes Toward Death Scale-Revised (DAP-R), and implicit death attitudes were measured using the Single-Category Implicit Association Test (SC-IAT), respectively. The study first explored the correlation between implicit and explicit attitudes toward death by correlating the implicit effect value D of the SC-IAT with the mean of the subdimensions of the DAP-R as pearson product difference. Secondly, based on the DAP-R scores, the university students with external death attitudes were categorized into positive and negative groups; based on the D values of the implicit effects of the SC-IAT, the university students with internal death attitudes were categorized into positive and negative groups, and the significance of the differences was investigated by conducting independent samples t-tests on the box characteristics of the university students of the two groups respectively.
Study design
- Observational model
- Cohort
- Time perspective
- Cross-sectional
- Target follow-up
- 1 Day
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Chinese university students | – | –The study firstly explored the correlation between the implicit death attitudes and the explicit death attitudes by making pearson product-difference correlation between the implicit effect value D-value of the SC-IAT and the mean value of the sub-dimensions of the DAP-R. Secondly, based on the DAP-R scores, the university students with external death attitudes were categorized into positive and negative groups; based on the D values of the implicit effects of the SC-IAT, the university students with internal death attitudes were categorized into positive and negative groups, and the significance of the differences was investigated by conducting independent sample t-tests on the initial sandplay characteristics of the university students of the two groups respectively. |
Who may qualify
- Ages
- 18 to 22 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
- Study population
- The trial randomly and double-blindly recruited 100 Han Chinese, with no religious beliefs, age range of 20 ± 2 years old, university students to participate in the trial, the subjects had normal vision or corrected vision, none of them had previously participated in similar experiments, and they were familiar with basic computer operation.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Sandplay Feature Profile (SFP) via Sandplay Therapy Observation Scale
Time frame: 1 day
Quantitative analysis of initial sandplay characteristics using 5 validated dimensions: Toy Utilization Index: Count of distinct categories used (person/animal/plant/etc.) Sand Manipulation Score: 0-3 scale (0=no manipulation; 3=landform creation) Construction Time: Minutes from first toy selection to completion Self-Representation Coding: 0-2 nominal scale (0=absent; 1=symbolic; 2=literal) Spatial Occupancy Ratio: Calculated as (used area/total sandbox area)×100%
1 secondary outcome
Death Attitude Implicit Association (DA-IA) via SC-IAT
Time frame: 1 day
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Jun 2025.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Death Attitude (Implicit/Explicit) and Sandplay Therapy, run by Kai Huang at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
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: opening soon, as of the sponsor's last update on 13 Jun 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 China. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact kai huang, master (+8615694456686, huangkai@ouc.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Sandplay Feature Profile (SFP) via Sandplay Therapy Observation Scale (time frame: 1 day). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 13 Jun 2025.