Aschenbrenner Lara Marie, Frei Adriana, Forkmann Thomas, Schreiber Dajana, Glaesmer Heide, Brüdern Juliane, Stein Maria, Sedlinská Marie-Anna, Adorjan Kristina, Walther Sebastian, Gysin-Maillart Anja
Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; Graduate School for Health Sciences, Faculty of Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland.
Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Universitätsstraße 2, 45141 Essen, Germany.
Compr Psychiatry. 2025 Oct;142:152621. doi: 10.1016/j.comppsych.2025.152621. Epub 2025 Jul 7.
This study examined two Death-Implicit Association Test versions targeting associations between the self-concept (standard identity D-IAT; iD-IAT) and internal versus external control (adapted control D-IAT; cD-IAT) and death among suicide attempters. Additionally, correlations with explicit psychological variables and psychometrics were explored.
116 psychiatric inpatients (58.1 % female; age M = 33.6, SD = 12.4) were classified as single versus multiple and recent versus lifetime suicide attempters. Implicit associations were measured using the iD-IAT and cD-IAT. Self-report measures included constructs relevant to suicidal behaviour.
Recent attempters showed weaker self-life (t(114) = 2.18, p = .016) and internal control-life (t(114) = 2.26, p = .013) associations than lifetime attempters. Multiple attempters exhibited weaker internal control-life associations than single attempters (t(114) = 2.25, p = .007). The iD-IAT correlated with suicidal ideation (r(114) = 0.20, p = .032), depression (r(114) = 0.20, p = .033) and external control (r(114) = 0.21, p = .021), the cD-IAT with suicidal ideation (r(114) = 0.25, p = .006) and depression (r(114) = 0.26, p = .006). The cD-IAT predicted multiple attempts (χ(1116) = 3.88, p = .049), showed higher internal consistency (r =. 31, p = .001) and predictive validity in detecting multiple (AUC = 0.64; p = .013) and recent (AUC = 0.62; p = .028) attempters than the iD-IAT.
The cD-IAT shows preliminary potential to differentiate suicidal behaviour based on recency and frequency, offering a tentative step toward understanding cognitive vulnerabilities of at-risk subgroups, warranting further refinement, validation and prospective analyses.
本研究考察了两种死亡内隐联想测验版本，目标是探究自杀未遂者的自我概念（标准身份死亡内隐联想测验；iD - IAT）与内控和外控（改编后的控制死亡内隐联想测验；cD - IAT）之间的关联以及与死亡的关系。此外，还探讨了与显性心理变量和心理测量指标的相关性。
116名精神科住院患者（58.1%为女性；年龄M = 33.6，标准差SD = 12.4）被分为单次与多次自杀未遂者以及近期与终生自杀未遂者。使用iD - IAT和cD - IAT测量内隐联想。自我报告测量包括与自杀行为相关的构念。
与终生自杀未遂者相比，近期自杀未遂者的自我 - 生命关联（t(114) = 2.18，p = 0.016）和内控 - 生命关联（t(114) = 2.26，p = 0.013）较弱。多次自杀未遂者的内控 - 生命关联比单次自杀未遂者弱（t(114) = 2.25，p = 0.007）。iD - IAT与自杀意念（r(114) = 0.20，p = 0.032）、抑郁（r(114) = 0.20，p = 0.033）和外控（r(114) = 0.21，p = 0.021）相关，cD - IAT与自杀意念（r(114) = 0.25，p = 0.006）和抑郁（r(114) = 0.26，p = 0.006）相关。cD - IAT可预测多次自杀未遂（χ(1116) = 3.88，p = 0.049），在检测多次（AUC = 0.64；p = 0.013）和近期（AUC = 0.62；p = 0.028）自杀未遂者方面，其内部一致性更高（r = 0.31，p = 0.001）且预测效度高于iD - IAT。
cD - IAT在基于近期性和频率区分自杀行为方面显示出初步潜力，为理解高危亚组的认知脆弱性迈出了试探性的一步，值得进一步完善、验证和进行前瞻性分析。
