The Role of Culture in Implicit & Explicit Suicide Ideation

Abstract

This study investigated the role of culture on suicidal thoughts and behaviors by examining (i) differences in explicit reporting of suicidal thoughts and behaviors, (ii) differences in implicit association of suicidal thoughts (iii) correlation of implicit-explicit reporting of suicidal thoughts and behaviors (iv) correlation between religion, religiosity level and reporting of suicidal thoughts between community samples from India and the USA. The study also tested the feasibility of using a measure of cognitive processing (i.e. the Implicit Association Task) as opposed to a self-report measure to identify implicit or hidden associations with suicidal thoughts or behaviors. Given the scarcity of available research on cross-cultural suicidal thoughts and behaviors, this study aims to bridge the current gap and provide evidence on the cultural variability in expression and development of suicidal thoughts and behaviors. The study hypothesized a lower level of explicit reporting of suicidal thoughts and behaviors in the Indian sample (as compared to the USA sample), but equivalent or higher level of implicit association with death/suicide related stimuli. Further, a significant difference in the correlation between religiosity level and suicidal behaviors, moderated by religion, was expected between the two countries. Participants were recruited online using Mechanical Turk to target individuals from India and the USA. A self-report questionnaire format was used to capture information about the participants’ explicit reporting of suicidal thoughts and behaviors, associated risk factors, religious affiliations and country of birth. Implicit cognition towards suicide was measured using an online version of the Death/Suicide IAT. The results showed a significantly lower level of explicit reporting in India as compared to the USA sample but comparable implicit reporting levels. Further, the results also reported a significantly different correlation of religiosity and suicidal thoughts between the two country samples. This study provides initial evidence suggesting a significant role of cultural setting in the reporting and expression of suicidal thoughts and behaviors. This study is also the first to test the feasibility of using the Death/Suicide IAT for measuring implicit suicide related cognition in India.