Exploring dissociation as a facilitator of suicide risk: A translational investigation using virtual reality

Caulfield, Nicole M.; Karnick, Aleksandr T.; Capron, Daniel W.

doi:10.1016/j.jad.2021.10.097

Cited by 10 publications

(4 citation statements)

References 27 publications

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“…It was proposed that NSSI could act as an “anti-dissociative” ( 80 ), while other researchers suggested the presence of a dissociative subtype of NSSI in which self-harm could have a “pro-dissociative function”, as physical pain could facilitate emotional and mental distress anaesthesia ( 81 ). Interestingly, the latter has been associated with a shorter shift towards SA ( 82 ) and dissociation was suggested as SA facilitator, as it could favour numbness to physical pain and disconnection from one’s body ( 83 ), a theory that has been also explored by a study using virtual reality ( 84 ). Our findings described significant higher DES-II scores in NSSInotSA and SAonly groups compared to the control group, whereas the NSSIplusSA group showed lower scores, hence suggesting a potential ‘protective’ role of dissociation regarding the presentation of SA among NSSI individuals exclusively.…”

Section: Discussionmentioning

confidence: 99%

The role of Theory of Mind in the transition towards suicidal attempts in youth NSSI: an exploratory pilot study

Orsolini,

Corona,

Cervelli

et al. 2024

Front. Psychiatry

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Non-suicidal self-injury (NSSI) can both precede and co-occur with suicidal attempts (SA). Underlying mechanisms/factors leading to the transition to SA in NSSI youths have been proposed (including the role of social cognition), despite they should be yet confirmed. Therefore, the study aims at exploring the role of the Theory of Mind in the differentiation of a sample of NSSI youngsters (aged 15-24) according to the presence of SA. We divided the sample into 4 groups using the Deliberate Self Harm Inventory (DSHI) and Columbia Suicide Severity Rating Scale (C-SSRS): control group (notNSSInotSA), NSSI without SA (NSSInotSA), NSSI with SA (NSSIplusSA), and SA without NSSI (SAonly). NSSIplusSA patients displayed higher Reading the Mind in the Eyes Test (RMET) scores (indicative of ToM abilities) than both the NSSInotSA (p=0.0016) and SAonly groups (p=0.0198), while SAonly patients showed lower RMET scores compared to the control group (p=0.0214). Multiple regression models used to differentiate NSSInotSA and NSSIplusSA found a significant association between RMET and LOSCS-CSC (Level Of Self-Criticism Scale-Comparative Self-Criticism) (pC=0.0802, pD=0.0016, pG=0.0053). Our findings supported the hypothesis that a hypertrophic affective ToM may possibly be associated with the occurrence of SA in youth NSSI. Further larger and longitudinal studies should confirm these preliminary findings, by exploring all social cognition dimensions.

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Section: Discussionmentioning

confidence: 99%

The role of Theory of Mind in the transition towards suicidal attempts in youth NSSI: an exploratory pilot study

Orsolini,

Corona,

Cervelli

et al. 2024

Front. Psychiatry

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“…The dissociation induction tasks were counterbalanced to ensure there are no order effects for these two tasks. For the purpose of this study, additional VR paradigms used were not described but can be reviewed in Caulfield (2020). Acute dissociation questionnaires were given after each challenge listed below.…”

Section: Methodsmentioning

confidence: 99%

“…The unique considerations of working with suicidal individuals are likely an important reason for the field's lack of progress. Augmented reality (AR) technologies using virtual reality (VR) platforms are a valuable approach for studying potential causes of STBs in a safe and controlled manner that does not put participants at greater risk for suicide (Caulfield et al, 2022; Franklin et al, 2019; Huang et al, 2021). It is particularly crucial to examine the use of technology for suicide because technology‐based approaches, such as AR, may be a cost‐effective approach to the assessment and treatment of suicide risk and may increase the likelihood that those in need will be able to access affordable, quality mental health care (CDC, 2017).…”

Section: Introductionmentioning

confidence: 99%

Exploring the indirect effects of acute dissociation on capability and suicide risk: A multi‐method investigation with augmented reality

Caulfield

Karnick

Fergerson

et al. 2022

Suicide & Life Threat Behav

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Introduction:The current study aimed to explicate the role of dissociation in the capability and suicide relationship by examining how lifetime and state-based acute dissociation contributes to capability for suicide using a multi-method approach of self-report and augmented reality (AR) laboratory tasks.Method: Participants (N = 145) were students recruited for course credit at a southern university. Participants completed self-report and laboratory AR dissociative induction tasks. Correlations and mediation analyses were conducted to test hypotheses using SPSS v. 26 and PROCESS Macro.Results: There was a significant indirect effect on capability and suicidal ideation via acute dissociation (β = 0.035, SE = 0.02, 95% CI = 0.001, 0.095). Additionally, there was a significant indirect effect on capability and suicide attempt(s) via dissociation (β = 0.19, SE = 0.10, 95% CI = 0.044, 0.449). Conclusions:As prior theories suggest, dissociation may augment feeling disconnected from the body and may temporarily impact capability to render a suicidal act as more probable. The presence of dissociation after a painful and provocative attempt may increase capability and pain tolerance. Implications of these findings include the consideration of dissociation as a pertinent factor in the assessment and treatment of suicide and the role of AR in aiding the exploration of suicide correlates.

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“…Head-mounted immersive virtual reality technology (IVR) shows promise to be an effective tool for a variety of interventions and applications. For promoting psychological health, for example, IVR has the potential to be an effective tool for delivering exposure therapy (Carl et al, 2019), psychosocial treatment in individuals with psychosis (Schroeder et al, 2022), and for assessing and treating suicide risk (Caulfield et al, 2022), while also promoting accessibility to said interventions (Freeman et al, 2017). For pain and anxiety reduction in hospital settings among younger populations, IVR has shown promise in being a safe and engaging medium (Iannicelli et al, 2019;Malloy & Milling, 2010;Pourmand et al, 2018;Ridout et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Examining the Role of Visual Attention in Determining Presence: A Novel Application of Feature Integration Theory to Immersive Virtual Reality

Dilanchian,

Boot

2023

Preprint

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Immersive virtual reality (IVR) has the potential to be an effective and easily disseminable method for deploying a variety of interventions to promote health, wellbeing, and physical and everyday functioning. The psychological construct of presence, often described as the “sense of being there,” is considered a core aspect of the technology, and consequently a major facilitator of successful IVR experiences and interventions. While prior research has explored how individual difference factors and technology characteristics impact presence, relatively less is known about the effect of the cognitive demands of the virtual experience itself. Based on previous empirical studies and theories, attention may play an important role in establishing IVR presence. To directly test this idea, we manipulated attention to the virtual environment, with manipulations inspired by classic conceptualizations of visual attention and search derived from feature integration theory. Participants engaged in IVR foraging tasks in which they navigated the environment to “catch” different animals. These tasks varied in the degree to which attention was necessary to detect and locate the target animal. Despite initial pilot data and concurrent behavioral evidence that the two scenarios varied substantially and significantly in attentional demands, no effect of presence was observed. Results suggest that different levels of visual attention to elements of the virtual environment may not be an important determinant of IVR presence.

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Exploring dissociation as a facilitator of suicide risk: A translational investigation using virtual reality

Cited by 10 publications

References 27 publications

The role of Theory of Mind in the transition towards suicidal attempts in youth NSSI: an exploratory pilot study

The role of Theory of Mind in the transition towards suicidal attempts in youth NSSI: an exploratory pilot study

Exploring the indirect effects of acute dissociation on capability and suicide risk: A multi‐method investigation with augmented reality

Examining the Role of Visual Attention in Determining Presence: A Novel Application of Feature Integration Theory to Immersive Virtual Reality

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