title: Suicide and self-injury-related implicit cognition: A large-scale examination and replication.
abstract: Suicide and self-injury are difficult to predict because at-risk individuals are often unable or unwilling to report their intentions. Therefore, tools to reliably assess risk without reliance on self-report are critically needed. Prior research suggests that people who engage in suicidal and nonsuicidal self-injury (NSSI) often implicitly (i.e., outside conscious control) associate themselves with self-harm and death, indicating that self-harm-related implicit cognition may serve as a useful behavioral marker for suicide risk. However, earlier studies left several critical questions about the robustness, sensitivity, and specificity of self-harm-related implicit associations unaddressed. We recruited a large sample of participants (N = 7,015) via a public web-based platform called Project Implicit Mental Health (PIMH) to test several hypotheses about self-harm-related implicit associations using the Implicit Association Test (IAT). Participants were randomly assigned to complete 1 of 3 self-harm IATs (Self + Cutting using picture stimuli, Self + Suicide using word stimuli, Self + Death using word stimuli). Results replicated prior studies demonstrating that self-harm-related implicit associations were stronger among individuals with (vs. without) a history of suicide attempt and NSSI. Results also suggested that self-harm-related implicit associations are robust (based on internal replication), are sensitive to recency and severity of self-harm history (e.g., stronger associations for more recent and more lethal prior suicide attempts), and correlate with specific types of self-harm behaviors. These findings clarify the nature of self-harm-related implicit cognition and highlight the IAT's potential to track current risk for specific types of self-harm in ways that more fixed risk factors cannot. (PsycINFO Database Record
authors.affiliation: Department of Psychology, University of Virginia.
authors.forename: Jeffrey J
authors.identifier: 0000-0003-0845-3963
authors.initials: JJ
authors.lastname: Glenn
authors.affiliation: Department of Psychology, University of Virginia.
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Werntz
authors.affiliation: Department of Psychology, University of California.
authors.forename: S J Katarina
authors.initials: SJ
authors.lastname: Slama
authors.affiliation: Department of Psychology, West Virginia University.
authors.forename: Shari A
authors.initials: SA
authors.lastname: Steinman
authors.affiliation: Department of Psychology, University of Virginia.
authors.forename: Bethany A
authors.initials: BA
authors.lastname: Teachman
authors.affiliation: Department of Psychology, Harvard University.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Nock
mesh_terms: D000328:Adult; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D011930:Reaction Time; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000523:psychology*; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D055815:Young Adult