Beneficial and Harmful Effects of Reducing Public Suicide Stigma

There is growing evidence that negative attitudes towards persons affected by suicide (i.e. persons who experience suicidality, persons who lost a loved one to suicide), so called public suicide stigma, is harmful for suicide prevention, for example by reducing social support, inhibiting help-seeking for suicidality and increasing distress as well as suicidality among stigmatized persons. Reducing public suicide stigma could therefore be an important factor of successful suicide prevention. However, reducing public suicide stigma could also be harmful, for example by increasing attitudes that suicidal behaviour is a normal and acceptable solution for crisis situations, which could decrease help-seeking for suicidality and encourage suicidal behaviour. This project will (1) develop four interventions (contact-based vs. education based, video vs. text) hypothesized to reduce public suicide stigma, (2) determine the efficacy of the four interventions with regard to reducing public suicide stigma, (3) identify additional harmful (e.g. normalization of suicidal behaviour) and beneficial intervention effects (e.g. improved attitudes to seek help) and (4) investigate pathways explaining intervention effects.

Study Overview

• Status: Completed
• Conditions: Public Suicide Stigma
• Intervention / Treatment: Other: Contact Video; Other: Contact Text; Other: Education Video; Other: Education Text

• Study Type: Interventional
• Enrollment (Actual): 1800
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Germany
  • Ulm, Germany, 89075
    • Ulm University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Participants need to be at least 18 years old, speak German and provide online informed consent.

Exclusion Criteria:

Persons who self-report to have experienced suicidality within three months before baseline will be excluded.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

6

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Contact Video; Participants randomized to this group will watch a video of a person talking about his recovery after attempting suicide.	Other: Contact Video; No additional information necessary.
Experimental: Contact Text; Participants randomized to this group will read a personal story of a person who survived a suicide attempt.	Other: Contact Text; No additional information necessary.
Experimental: Education Video; Participants randomized to this group will watch a video of a psychiatrist presenting facts about suicide and suicide prevention.	Other: Education Video; No additional information necessary.
Experimental: Education Text; Participants randomized to this group will read a text containing facts about suicide and suicide prevention.	Other: Education Text; No additional information necessary.
Placebo Comparator: Control Contact; Participants randomized to this group will read a personal story of a person who survived a heart attack.	Other: Contact Video; No additional information necessary.; Other: Contact Text; No additional information necessary.
Placebo Comparator: Control Education; Participants randomized to this group will read a text containing facts about heart-attacks and their prevention.	Other: Education Video; No additional information necessary.; Other: Education Text; No additional information necessary.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Stigma subscale of the Stigma of Suicide Scale short form (SOSS-SF)	Batterham al. (2013) The Stigma of Suicide Scale. Psychometric properties and correlates of the stigma of suicide. Crisis 34(1):13-21	Immediately after the intervention (t1)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Stigma subscale of the Stigma of Suicide Scale short form (SOSS-SF)	Batterham al. (2013) The Stigma of Suicide Scale. Psychometric properties and correlates of the stigma of suicide. Crisis 34(1):13-21	Two weeks after the intervention (t2)
Literacy of Suicide Scale (LOSS)	Batterham et al. (2013) Correlates of suicide stigma and suicide literacy in the community. Suicide Life Threat Behav 43(4):406-417	Immediately after the intervention (t1); Two weeks after the intervention (t2)
Cognitions Concerning Suicide Scale (CCSS)	Cwik et al. (2017) Measuring attitudes towards suicide: Preliminary evaluation of an attitude towards suicide scale. Compr Psychiatry 72:56-65	Immediately after the intervention (t1); Two weeks after the intervention (t2)
General help-seeking questionnaire suicidal ideation subscale (GHSQ-SI)	Wilson et al. (2005) Measuring help-seeking intentions: Properties of the General Help-Seeking Questionnaire. Canadian Journal of Counselling 39(1):15-28	Immediately after the intervention (t1); Two weeks after the intervention (t2)
Current suicidality	One item adapted from the PHQ-9 (Kroenke et al. 2001; "Do you currently experience thoughts that you would be better off dead or of hurting yourself?" response scale from 1 (not at all) to 7 (very much)	Immediately after the intervention (t1); Two weeks after the intervention (t2)
Positive and Negative Affect Schedule (PANAS), negative affect subscale	Breyer & Bluemke (2016) Deutsche Version der Positive and Negative Affect Schedule PANAS (GESIS Panel). ZIS - GESIS Leibniz Institute for the Social Sciences	Immediately after the intervention (t1); Two weeks after the intervention (t2)
Patient Health Questionnaire (PHQ-2)	Löwe et al. (2005) Detecting and monitoring depression with a two-item questionnaire (PHQ-2). Journal of Psychosomatic Research 58(2):163-171	Two weeks after the intervention (t2)

Collaborators and Investigators

• Sponsor: University of Ulm

Study record dates

Study Major Dates

• Study Start (Actual): February 19, 2021
• Primary Completion (Actual): March 19, 2021
• Study Completion (Actual): March 19, 2021

Study Registration Dates

• First Submitted: February 11, 2021
• First Submitted That Met QC Criteria: February 15, 2021
• First Posted (Actual): February 16, 2021

Study Record Updates

• Last Update Posted (Actual): June 10, 2021
• Last Update Submitted That Met QC Criteria: June 9, 2021
• Last Verified: June 1, 2021

More Information

Terms related to this study

• Keywords: Suicide prevention; Suicide; Stigma; General public
• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior; Suicide
• Other Study ID Numbers: 352/20

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: Anonymized data available upon personal request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No