Neuropsychological Patterns of Suicide Ideators and Suicide Attempters

Recruiting

• Conditions: Inhibitory Control; Locus of Control; Self Efficacy; Suicide, Attempted; Suicidal Ideation; Attention
• Interventions: Other: (Neuro-)psychological assessment

• Registration Number: NCT06248268
• Lead Sponsor: University of Bern

Brief Summary

The present study consists of 3 projects in total and aims to investigate the (neuro-) psychological patterns from suicidal ideation to suicidal behavior as well as the effects and feasibility of ASSIP Home Treatment.

The overall aim of project 1 is to determine (neuro-) psychological differences between suicide attempters, suicide ideators, a clinical control group, and healthy controls. Study participants in project 1 will participate in a one-time (neuro-) psychological assessment.

Project 1 of this study is an observational cross-sectional study with four groups that will be conducted at the University Hospital of Psychiatry and Psychotherapy Bern (Switzerland): Patients with at least one suicide attempt in their past (SUAT), patients with suicidal ideation (SUID), patients from the same clinical cohort, without neither suicidal behavior or ideation (CLIN) and the healthy group (HLTH). The cohorts to be examined (SUAT \& SUID) will be compared to the two control groups (CLIN \& HLTH). Only people who have signed the informed consent and meet the eligibility criteria can participate in this study.

Detailed Description

Purpose and aims:

The present study consists of 3 projects in total and aims to investigate the (neuro-) psychological patterns from suicidal ideation to suicidal behavior as well as the effects and feasibility of ASSIP Home Treatment.

The aim of this project is to distinguish the (neuro-) psychological patterns of suicide ideators from suicide attempters by investigating four experimental groups. For this purpose, neuropsychological functioning, as well as psychological process factors, are analyzed. Patients with at least one prior suicide attempt are compared to patients with suicidal ideation, to a clinical control group, as well as to healthy controls. For this project, patients who are being treated at the University Hospital of Psychiatry and Psychotherapy Bern (Switzerland) at the time of the project will be requested. Afterwards, participants with a suicide attempt in their history will also be asked to participate in the longitudinal part of the study, which is Project 2.

Background:

In Switzerland, approximately three people die by suicide every day, and suicide attempts exceed this number by far. As a previous suicide attempt is one of the strongest predictors of a completed suicide, it is of utmost importance to identify the people at risk. However, research has shown that traditional risk factors (e.g., depression, psychiatric disorder, etc.) reliably predict suicidal ideation but poorly predict suicidal behavior. Furthermore, while effective suicide-specific interventions exist, up to 50% of the suicide attempters reject the recommended treatment, and around 60% discontinue treatment after one session. Hence, a different approach is required. In this study, three projects will be conducted. In Project 1, (neuro-) psychological patterns of suicide attempters will be identified by comparing the following four different groups:

1. patients with a prior suicide attempt (SUAT),

2. patients with no prior suicide attempt but suicidal ideation (SUID),

3. a general patient group (CLIN), and

4. a healthy control group (HLTH).

Project 2 will investigate how these patterns are modulated by the efficacious brief therapy ASSIP. In Project 3, the feasibility, effects and cost-effectiveness of the ASSIP Home Treatment will be investigated.

Study design of Project 1:

Project 1 of this study is a quantitative cross-sectional and observational study with four groups that will be conducted at the University Hospital of Psychiatry and Psychotherapy Bern (Switzerland): Patients with at least one suicide attempt in their past (SUAT), patients with suicidal ideation (SUID), patients from the same clinical cohort without suicidal behavior or ideation (CLIN), and the healthy group (HLTH). The cohorts to be examined (SUAT \& SUID) will be compared to two control groups (CLIN \& HLTH). Study participants in Project 1 will participate in a one-time (neuro-) psychological assessment. To account for the heterogeneity in suicide attempters, suicide ideators, generally clinical patients and healthy controls, the samples will be balanced for age, gender and treatment setting by group matching.

Study Timeline

• Study First Submitted: 2023-03-13
• Study First Submitted QC: 2024-01-30
• Study First Posted: 2024-02-08
• Status Verified: 2024-03
• Study Start: 2024-03-20
• Last Update Submitted: 2024-03-20
• Last Update Posted: 2024-03-22
• Primary Completion: 2026-12
• Study Completion: 2026-12

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 180

Inclusion Criteria

Subjects fulfilling the following inclusion criteria are eligible for the study:

• Informed consent as documented by signature
• Age ≥ 18 years

Additional inclusion criteria for the SUAT group:

• At least one previous suicide attempt
• Willingness to attend the ASSIP brief therapy

For the SUID, CLIN, and HLTH groups, no further inclusion criteria are formulated.

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Exclusion Criteria

The presence of any one of the following exclusion criteria will lead to exclusion of the subject:

• Serious cognitive impairment
• Any psychotic disorder
• Any current medication, which substantially impairs the attention span, reaction, rate or any other relevant cognitive functions
• Inability to follow the procedures of the study (e.g., insufficient mastery of the German language, previous enrolment into the current study)

Additional exclusion criterion for the SUID, CLIN and HLTH group:

• Previous suicidal behavior

Additional exclusion criteria for the CLIN and HLTH groups:

• Suicidal ideation

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Suicide attempters	(Neuro-)psychological assessment	Patients with at least one previous suicide attempt
Suicide ideators	(Neuro-)psychological assessment	Patients with suicidal thoughts, but no previous suicide attempt
Clinical control group	(Neuro-)psychological assessment	Patients without suicidal behavior and thoughts
Healthy controls	(Neuro-)psychological assessment	Healthy persons without suicidal behavior and thoughts

Primary Outcome Measures

Name	Time	Method
Differences in Inhibitory Control	The assessment takes place 1 day to 1 week after informed consent.	The Go/No-Go task is a cognitive task to assess an individual's ability to inhibit a prepotent response. It is used to measure impulse control and response inhibition. The task requires participants to respond ("Go" response) to one type of stimulus and to withhold or inhibit their response ("No-Go" response) to another type of stimulus. The Go/No-Go task yields measures such as reaction time, accuracy, and the ability to inhibit responses. Reaction times can vary widely, and accuracy is often expressed as a percentage of correct responses. Lower reaction times and higher accuracy in withholding responses (No-Go trials) indicate better inhibitory control and cognitive performance.

Secondary Outcome Measures

Name	Time	Method
Selective Attention and Interference Control	The assessment takes place 1 day to 1 week after informed consent.	The Stroop task is a cognitive psychology test that evaluates an individual's ability to selectively attend to information while inhibiting interference from irrelevant stimuli. The Stroop task measures the time taken to complete tasks and the accuracy of responses. The primary measures are the time taken to complete the task and the number of errors. Lower completion times and fewer errors indicate better cognitive control and attentional focus. Lower scores (faster completion times and fewer errors) are associated with better outcomes, reflecting more efficient cognitive processing and interference control. Higher scores, if used to quantify errors or time taken, are associated with a worse outcome, indicating greater interference and potentially reduced cognitive control.

Trial Locations

Locations (1)

University Hospital of Psychiatry and Psychotherapy, University of Bern; 🇨🇭 Bern, Switzerland