Evaluating Potential Iatrogenic Effects of a Suicide-Focused Research Protocol

Crisis. 2022 Dec;43(6):508-515. doi: 10.1027/0227-5910/a000823. Epub 2021 Sep 22.

Abstract

Background: Concerns regarding the potential iatrogenic effects of suicide assessment have long impeded suicide research. Aims: We sought to examine the effects of an intensive, suicide-focused assessment protocol on mood, suicidality, and urges to harm oneself or others. Method: Participants were adults admitted to a psychiatric inpatient unit for recent suicidal ideation or behavior, or reasons unrelated to suicide. Our study protocol included clinical interviews evaluating suicide history and laboratory tasks with suicide-related stimuli. We modified an existing measure to create a brief, 6-item interview, the Assessment Session Check-In, which was administered before and after research procedures. Results: These indicated overall reductions in distress, suicidal intent, and urges to harm oneself or others from preassessment to postassessment. Postassessment reductions in stress predicted lower likelihood of a suicide attempt at follow-up. Limitations: Although beneficial to examine a high-risk sample, it is possible that an intensive suicide-focused protocol could prove more problematic for those with lower baseline levels of negative affect and suicidal thoughts. Conclusions: Results challenge the belief that assessing suicide elevates distress or suicidality, even among a high-risk sample of adults admitted to a psychiatric inpatient unit.

Keywords: assessment; psychiatric inpatients; screening; stress; suicide.

MeSH terms

  • Adult
  • Affect
  • Humans
  • Iatrogenic Disease
  • Inpatients
  • Suicidal Ideation*
  • Suicide, Attempted* / psychology