Implicit Measure of Life/Death Orientation Predicts Response of Suicidal Ideation to Treatment in Psychiatric Inpatients

Abstract

In this study, we set out to extend empirical research on the Life-Death Implicit Association Test (IAT) by administering the measure to an adult psychiatric inpatient population with suicidal ideation. We sought to examine its association with other suicide-relevant measures and to determine whether it adds predictive utility beyond that offered by other measures of suicide risk. The IAT was administered (N = 124) at biweekly intervals as part of an assessment battery at an inpatient facility for complex, treatment resistant psychiatric disorders (average length of stay: approximately 6 weeks). Multiple regression procedures were utilized to examine relationships among the measures and their predictive utility with respect to suicidal ideation at discharge. Consistent with prior research with other populations, significant associations were found between IAT performance and explicit (self-report and interview) measures of suicide risk. Moreover, the IAT was found to predict suicidal ideation at discharge above and beyond number of prior suicide attempts and admission scores on measures of depression, suicidal ideation, and hopelessness. Change in IAT performance over the course of treatment was observed. The IAT shows promise as an addition to explicit measures conventionally used to estimate suicide risk in psychiatric patients. These findings are consistent with a cognitive vulnerability model of suicide risk.

Keywords:

• cognition
• Implicit Association Test
• psychiatric inpatients
• suicide risk assessment

Additional information

Notes on contributors

Thomas E. Ellis

Thomas E. Ellis and Katrina A. Rufino, The Menninger Clinic and Baylor College of Medicine, Houston, Texas, USA.

Katrina A. Rufino

Thomas E. Ellis and Katrina A. Rufino, The Menninger Clinic and Baylor College of Medicine, Houston, Texas, USA.

Kelly L. Green

Kelly L. Green, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.