Table_1_Psychometric properties of the modified Suicide Stroop Task (M-SST) in patients with suicide risk and healthy controls.DOCX

The Cognitive Model of Suicide proposes a suicide attentional bias in individuals with suicidal thoughts and behavior (STBs). The Suicide Stroop Task (SST) was developed as a behavioral measure to assess this attentional bias. However, prior studies demonstrated poor psychometric properties of the SST.MethodsWe developed a modified Suicide Stroop Task (M-SST) and tested its psychometric properties in a sample of healthy controls (n = 30) and inpatients with STBs (n = 24). Participants (50% female, aged 18 to 61 years) completed the M-SST with neutral, positive, negative, suicide-related positive and suicide-related negative words. Interference scores were calculated by subtracting the mean reaction time (mean RT) of the neutral words from the mean RT of the suicide-related positive words (mean RTSuicide-Positive–mean RTNeutral) and suicide-related negative words (mean RTSuicide-Negative–mean RTNeutral), resulting in two suicide-specific interference scores. Similarly, interference scores were calculated for the positive and negative words by subtracting the mean RT of neutral words from the mean RT of positive and negative words.ResultsWhen analyzed separately, patients with STBs showed greater interferences for suicide-related positive words (p = 0.039), and for suicide-related negative words (p = 0.016), however, we found no group differences in interference scores for positive and negative words, suggesting a suicide attentional bias in patients with STBs. Controlling for the repeated measure design, a repeated measure ANOVA failed to detect a significant group × interference interaction effect (p = 0.176), which limits the generalizability of the findings. However, the interference score of suicide-related negative words showed an adequate classification accuracy (AUC = 0.72, 95% CI [0.58–0.86], p = 0.006) for differentiating between healthy controls and patients with STBs. Moreover, the interference scores showed acceptable internal reliability for the total sample and only suicide-related interference scores were correlated with clinical characteristics, thus demonstrating convergent validity.ConclusionThe results provide preliminary evidence for a suicide attentional bias in individuals with STBs compared to healthy controls. The M-SST represents a promising tool for assessing a suicide attentional bias by revealing adequate psychometric properties. Future studies with larger samples are needed to confirm these preliminary findings.

自杀认知模型提出了自杀意念和行为个体（STBs）的自杀注意力偏差。自杀斯特鲁普任务（SST）作为一种行为测量方法，旨在评估这种注意力偏差。然而，先前的研究表明，SST的心理学测量特性较差。研究方法：本研究开发了改良的自杀斯特鲁普任务（M-SST），并在30名健康对照者和24名STBs住院患者中测试了其心理学测量特性。参与者（女性占50%，年龄在18至61岁之间）完成了M-SST，其中包含中性、积极、消极、与自杀相关的积极和消极词汇。通过从与自杀相关的积极词汇的平均反应时间（平均RT）和消极词汇的平均反应时间（平均RTSuicide-Negative）中减去中性词汇的平均反应时间（mean RTSuicide-Positive–mean RTNeutral；mean RTSuicide-Negative–mean RTNeutral），计算出两个针对自杀的特定干扰分数。类似地，通过从积极词汇和消极词汇的平均反应时间中减去中性词汇的平均反应时间，计算了积极和消极词汇的干扰分数。研究结果：当单独分析时，STBs患者在与自杀相关的积极词汇（p=0.039）和消极词汇（p=0.016）上表现出更大的干扰，但我们在积极和消极词汇的干扰分数上未发现组间差异，这表明STBs患者存在自杀注意力偏差。在控制重复测量设计的情况下，重复测量方差分析未能检测到显著的小组×干扰交互效应（p=0.176），这限制了研究结果的可推广性。然而，与自杀相关的消极词汇的干扰分数显示出足够的分类准确性（AUC=0.72，95% CI [0.58–0.86]，p=0.006），能够区分健康对照者和STBs患者。此外，干扰分数在总体样本中显示出可接受的内部一致性，并且只有与自杀相关的干扰分数与临床特征相关，从而证明了收敛效度。结论：研究结果为STBs个体与健康对照者相比存在自杀注意力偏差提供了初步证据。M-SST作为一种有前景的工具，通过揭示其充分的心理学测量特性，可用于评估自杀注意力偏差。需要更大样本量的未来研究来证实这些初步发现。