First-person stimuli: Improving the validity of stimuli in studies of suicide and related behaviors

Researchers are increasingly using objective methods to study constructs related to suicidal thoughts and behavior (STB; e.g., self-identification with suicide), such as via behavioral tasks and brain imaging. Although promising, such approaches often are limited by the use of overly general stimuli (e.g., images, words) to represent constructs under study (e.g., suicide attempt). Overly general stimuli are problematic because they inadequately represent constructs, contributing to measurement error and thereby decreasing the internal and external validity of findings. To address this issue in suicide research specifically, we developed a set of first-person (FP) perspective suicide images depicting suicide attempt, evaluated its psychometric properties in one study, and examined whether people with recent suicidal thoughts rated FP-suicide images differently than people with no history of STB in a second study. Study 1 (N = 221) results suggest FP-suicide images have good construct validity (rs =.66-.87 with other suicide images) and internal consistency (Cronbach =s =.80) across three subjective rating dimensions (i.e., valence, arousal, threat). Study 2 (N = 73) results suggest that people with recent suicidal thoughts display substantially lower aversion toward FP-suicide images (i.e., lower negative valence [d = 1.22, p <.001], lower arousal [d =.61, p <.05] and lower threat ratings [d = 1.27, p <.001]) than people with no STB history. FP-suicide images provide researchers using behavioral tasks/brain imaging paradigms with more self-relevant stimuli that may increase the internal and external validity of findings. First-person stimuli may improve both our understanding and prediction of STB as well as provide novel targets (e.g., lower aversion to suicide) for clinical intervention. This study provides evidence of the validity and reliability of a newly developed set of first-person perspective suicide images designed for use in computerized behavioral tasks investigating suiciderelated constructs. These findings suggest that using such stimuli may contribute to improved prediction and prevention of suicide thoughts/behavior as well as help uncover novel targets for clinical intervention.