Magazine article Clinical Psychiatry News

MacArthur Fellow's Focus: Suicide Prevention

Magazine article Clinical Psychiatry News

MacArthur Fellow's Focus: Suicide Prevention

Article excerpt

At the beginning of his career, Matthew K. Nock, Ph.D., a clinical psychologist, wanted to focus on research that could prevent suicide, but not enough was known about what motivated people to harm themselves for him to start testing ways to intervene.

In the last several years, Dr. Nock, along with his research team at Harvard University in Cambridge, Mass., has been chipping away at some of those unanswered questions, finding links between anxiety and suicidal behavior, and developing a predictive tool that could someday help clinicians identify people with suicidal thoughts.

Last year, Dr. Nock, who at age 38 is a professor of psychology at Harvard, was named as one of 22 fellows by the John D. and Catherine T. MacArthur Foundation. The prestigious award was given to a range of people from across the fields of sports, science, and the arts who were selected for their "creativity, originality, and potential to make important contributions in the future."

The award also comes with a $500,000 "no-strings-attached" grant for the next 5 years. Dr. Nock said he plans to put that money right back into his Harvard lab, where he will seed some pilot projects aimed at attaining a better understanding of suicidal behavior.

He said he is also continuing work on the suicide implicit association test, a brief, computer-based test that he and his research team developed. It uses a person's reaction time to measure the extent to which they identify with the concepts of death and suicide. The predictive test has had success in the laboratory and in early tests in the emergency department at Massachusetts General Hospital in Boston (Psychol. Sci. 2010; 21:511-7).

The researchers found that the test could distinguish between people with psychiatric distress and those who had made a suicide attempt. It also improved the prediction of future suicide attempts better than with clinician prediction, patient prediction, or chart diagnosis. Dr. Nock said he and his colleagues are now trying to replicate the early results and are assessing different versions of the test: "I think we have promising early findings, and now we really want to first try to improve on our predictive accuracy."

The next step will be to determine whether the test can be useful in clinical decision making. "We're hesitant as a research team to make it widely available and get it out into the hands of clinicians until we know we have the best possible tool," Dr. Nock said.

His research also has uncovered new linkages between suicidal behavior and anxiety that could help clinicians identify people who are more likely to act on suicidal thoughts. …

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