Exploring suicidal behaviour through implicit identity and control biases: Findings from the Death-Implicit Association Test and its novel control-adaptation

Compr Psychiatry. 2025 Jul 7;142:152621. doi: 10.1016/j.comppsych.2025.152621. Online ahead of print.

ABSTRACT

OBJECTIVE: 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.

METHOD: 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.

RESULTS: 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_s(114) = 0.20, p = .032), depression (r_s(114) = 0.20, p = .033) and external control (r_s(114) = 0.21, p = .021), the cD-IAT with suicidal ideation (r_s(114) = 0.25, p = .006) and depression (r_s(114) = 0.26, p = .006). The cD-IAT predicted multiple attempts (χ²(1116) = 3.88, p = .049), showed higher internal consistency (r_sb =. 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.

CONCLUSIONS: 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.

PMID:40639101 | DOI:10.1016/j.comppsych.2025.152621