Examining potential iatrogenic effects of viewing suicide and self-injury stimuli.

Christine, B.; Glenn, Jeffrey J.; Deming, Charlene A.; D’Angelo, Eugene J.; Hooley, Jill M.; Teachman, Bethany A.; Nock, Matthew K.

doi:10.1037/pas0000280

Cited by 43 publications

(46 citation statements)

References 21 publications

(26 reference statements)

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“…In our analysis, D-scores were not significantly correlated with levels of depression, impulsivity, or inhibition, although there was a trend with state-level anxiety that aligns with the literature on the relationship between suicide attempts and anxiety (Sareen et al, 2005). Lastly, and similar to previous analyses, completion of the S-IAT was not associated with increased levels of sadness or anger or with decreased levels of happiness (Cha et al, 2016). Although the task was associated with decreased anxiety, it is important to note that the S-IAT was conducted at the end of the scanning session, which might have affected these results.…”

supporting

confidence: 88%

Functional Imaging of the Implicit Association of the Self With Life and Death

Ballard

Reed

Szczepanik

et al. 2019

Suicide & Life Threat Behav

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Objective A critical need exists to identify objective markers of suicide ideation. One potential suicide risk marker is the Suicide Implicit Association Task (S‐IAT), a behavioral task that uses differential reaction times to compare the implicit association between the self and death to the implicit association between the self and life. Individuals with a stronger association between the self and death on the S‐IAT are more likely to attempt suicide in the future. To better understand the neural underpinnings of the implicit association between self and either life or death, a functional magnetic resonance imaging (fMRI) version of the S‐IAT was adapted and piloted in healthy volunteers. Method An fMRI version of the S‐IAT was administered to 28 healthy volunteers (ages 18–65, 14F/14M). Results Behavioral results were comparable to those seen in non‐scanner versions of the task. The task was associated with patterns of neural activation in areas relevant to emotional processing, specifically the insula and right ventrolateral prefrontal cortex. Conclusions Performance on the S‐IAT fMRI task may reflect scores obtained outside of the scanner. In future evaluations, this task could help assess whether individuals at increased risk of suicide display a different pattern of neural activation in response to self/death and self/life stimuli.

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supporting

confidence: 88%

Functional Imaging of the Implicit Association of the Self With Life and Death

Ballard

Reed

Szczepanik

et al. 2019

Suicide & Life Threat Behav

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“…Across three intensive suicide research studies, results indicated that participants did not endorse significant increases in suicide risk at postassessment or report adverse events. Collectively, the results add to a body of research demonstrating the feasibility of conducting intensive, nontreatment suicide‐specific research without doing harm to participants (e.g., Cha et al., ; Smith et al., ).…”

Section: Discussionmentioning

confidence: 65%

“…Previous research with civilians suggests that participating in non‐treatment‐related suicide research does not produce significant iatrogenic effects (e.g., Cha et al., ; Gould et al., ). For example, Smith, Poindexter, and Cukrowicz () conducted a study investigating psychiatric and suicide‐specific symptoms and physiological reactivity when exposed to an affectively modulated startle reflex task.…”

mentioning

confidence: 99%

Veteran Participation in Intensive Suicide Research Protocols: No Evidence of Iatrogenic Effects

Poindexter

Nazem

Barnes

et al. 2018

Suicide & Life Threat Behav

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Suicide research remains fraught with ethical and methodological issues, including researchers' reservations about conducting intensive suicide research protocols due to potential iatrogenic effects and liability concerns. Such issues significantly impede scientific inquiry related to suicide. To date, no research has explored potential iatrogenic effects of intensive, nontreatment suicide research among Veterans. This study aimed to fill this gap. It was hypothesized that participation in suicide-specific protocols would not significantly increase risk among Veterans. Veterans completed self-reports, structured interviews, and rigorous suicide-specific tasks (Study A, N = 34; Study B, N = 18; Study C, N = 119). Findings indicated there were no significant differences in pre- and postassessment suicide risk variables (all ps > .05). Estimated mean change for "urge to harm self" was -0.24 (95% confidence interval [CI]: -0.60, 0.13), -0.28 (CI: -0.56, 0.01), and -0.01 (CI: -0.09, 0.07) and "intent to harm self" was -0.18 (95% CI: -0.45, 0.10), 0 (CI: -0.17, 0.17), and 0.01 (CI: -0.04, 0.06) for Studies A, B, and C, respectively. Results indicated the respective protocols did not produce iatrogenic effects. The current findings are discussed with attention to safety-monitoring techniques that may reduce iatrogenic effects and considerations for future researchers.

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“…Using standard IAT scoring procedures (Greenwald, Nosek, & Banaji, ), associations between ‘death’ and ‘me’ are measured by calculating a difference ( D ) score for each participant; positive D scores indicate a stronger association between death and the self (i.e., faster response latencies on death & me paired trials than on life & me paired trials), whereas negative D scores represent a stronger association between life and the self (see Nock et al., for scoring details). Importantly, iatrogenic effects of self‐injury IATs (i.e., Self‐Injury IAT, Death IAT, Suicide IAT) have been examined in adults, undergraduate students, and adolescent psychiatric inpatients: minimal change in desire for death or self‐injury and only a slight mood decline has been observed from pre‐ to post‐IAT administration (Cha, Glenn et al., ). Therefore, self‐injury IATs, such as the Death IAT, are considered appropriate to use with adolescent clinical populations.…”

Section: Methodsmentioning

confidence: 99%

“…Cha, Glenn et al. () examined iatrogenic effects of a series of IATs (including the Self‐Injury, Suicide, and Death IATs) among adolescent psychiatric inpatients, but did not report specifically on IAT performance. Cha, Augenstein et al.…”

mentioning

confidence: 99%

Implicit identification with death predicts change in suicide ideation during psychiatric treatment in adolescents

Glenn

Kleiman

Coppersmith

et al. 2017

Child Psychology Psychiatry

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Background Suicidal thoughts and behaviors are major public health concerns in youth. Unfortunately, knowledge of reliable predictors of suicide risk in adolescents is limited. Promising research using a death stimuli version of the Implicit Association Test (Death IAT) indicates that stronger identification with death differs between adults with and without a history of suicidal thoughts and behaviors and uniquely predicts suicide ideation and behavior. However, research in adolescents is lacking and existing findings have been mixed. The current study extends previous research by testing whether implicit identification with death predicts changes in suicide ideation during psychiatric treatment in adolescents. Methods Participants included 276 adolescents, ages 13–19, admitted to a short-term residential treatment program. At hospital admission and discharge, adolescents completed the Death IAT and measures of recent suicidal thoughts. Results At admission, implicit identification with death was associated with recent suicide ideation, but did not differ between those who engaged in prior suicidal behavior and those who did not. Prospectively, adolescents’ implicit identification with death at admission significantly predicted their suicide ideation severity at discharge, above and beyond explicit suicide ideation. However, this effect only was significant for adolescents with longer treatment stays (i.e., more than 13 days). Conclusions Implicit identification with death predicts suicidal thinking among adolescents in psychiatric treatment. Findings clarify over what period of time implicit cognition about death may predict suicide risk in adolescents.

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Examining potential iatrogenic effects of viewing suicide and self-injury stimuli.

Cited by 43 publications

References 21 publications

Functional Imaging of the Implicit Association of the Self With Life and Death

Functional Imaging of the Implicit Association of the Self With Life and Death

Veteran Participation in Intensive Suicide Research Protocols: No Evidence of Iatrogenic Effects

Implicit identification with death predicts change in suicide ideation during psychiatric treatment in adolescents

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