Raising doubt about the anticipated consequences of suicidal behavior: Evidence for a new approach from laboratory and real-world experiments

Abstract Objective Converging evidence from basic science and experimental suicide research suggest that the anticipated consequences of suicide may have direct causal effects on suicidal behavior and accordingly represent a promising intervention target. Raising doubt about individuals’ desirable anticipated consequences of suicide may be one means of disrupting this target. We tested this possibility across two complementary experimental studies. Method Study 1 tested the effects of raising doubt about desirable anticipated consequences on virtual reality (VR) suicide in the lab, randomizing 413 participants across four conditions. In Study 2, 226 suicidal adults were randomized to an anticipated consequence manipulation or control condition then re-assessed at 2- and 8-weeks post-baseline. Results In Study 1, anticipating that engaging in VR suicide would guarantee a desirable outcome significantly increased the VR suicide rate; conversely, raising doubt about the desirable anticipated consequences significantly reduced the VR suicide rate. In Study 2, raising doubt about the anticipated consequences of attempting suicide by firearm significantly reduced the perceived lethality of firearms as well as self-predicted likelihood of future suicide attempts, with effects sustained at 2-week follow-up. Conclusions Findings suggest that raising doubt about desirable anticipated consequences of suicide merits further research as one potential approach to inhibit suicidal behavior.