Implicit measures of suicide vulnerability: Investigating suicide-related information-processing biases and a deficit in behavioral impulse control in a high-risk sample and healthy controls

• Published in: Behaviour research and therapy 2024-09, Vol.180, p.104601, Article 104601
• Main Authors: Brüdern, Juliane, Spangenberg, Lena, Stein, Maria, Forkmann, Thomas, Schreiber, Dajana, Stengler, Katarina, Gold, Helena, Glaesmer, Heide
• Format: Article
• Language: English
• Subjects: Attentional bias; Behavioral impulsivity; Behavioral measures; Implicit associations with death; Suicidal behavior; Suicide
• ISSN: 0005-7967; 1873-622X; 1873-622X
• DOI: 10.1016/j.brat.2024.104601

Relevant implicit markers of suicidal thoughts and behaviors (STBs) have only been studied in isolation with mixed evidence. This is the first study that investigated a suicide attentional bias, a death-identity bias and a deficit in behavioral impulsivity in a high-risk sample and healthy controls. We administered the Death Implicit Association Test, the Modified Suicide Stroop Task, and a Go/No-Go Task to inpatient suicide ideators (n = 42), suicide attempters (n = 40), and community controls (n = 61). Suicide ideators and attempters showed a suicide attentional bias and a death-identity bias compared to healthy controls. Ideators and attempters did not differ in these implicit information-processing biases. Notably, only attempters were more behaviorally impulsive compared to controls; however, ideators and attempters did not significantly differ in behavioral impulsivity. Moreover, implicit scores were positively intercorrelated in the total sample. In line with the Cognitive Model of Suicide, ideators and attempters display suicide-related information processing biases, which can be considered as implicit cognitive markers of suicide vulnerability. Furthermore, attempters have elevated levels of behavioral impulsiveness. These results are highly relevant in the context of crisis intervention strategies and warrant further research. •Recent suicide ideators and attempters show a suicide attentional bias and death-identity bias compared to healthy controls.•Attempters are more behaviorally impulsive compared to healthy controls.•Ideators and attempters do not differ in a suicide attentional bias, death-identity bias and behavioral impulsivity.•Suicide-related implicit markers were intercorrelated in ideators, suggesting an implicit suicidal mode.•Results are highly relevant in the context of commonly recommended crisis intervention strategies.