Implicit affective responses to suicide-related stimuli: Differences as a function of suicide attempt history and concurrent substance use.

Introduction: Individuals who are depressed, have suicide attempts, and a substance use disorder (SUD) may have different patterns of suicidal thoughts and behaviors and respond differently to cues associated with suicide and death.

Method: Implicit affective reactions to visual cues suggestive of suicide and death (as well as to pleasant, unpleasant, and neutral cues), were compared among three groups of hospitalized adults: (a) depressed patients without the histories of suicidal behavior (depression only), (b) depressed patients with suicide attempts, but no current substance abuse disorder (SA), and (c) depressed patients with both suicide attempts and substance use disorder (SA + SUD).

Results: The SA group demonstrated higher positive evaluations of visual cues associated with suicide and death when compared to the SA + SUD group. The SA + SUD group demonstrated the lowest positive evaluation of suicide-related stimuli as well as less positive evaluation of visual cues of generally unpleasant stimuli.

Conclusion: Differences observed between SA and SA + SUD participants underscore differences in responses to cues related to suicide, which may reflect differences in mechanisms of risk.