Implicit cognition tests for the prediction of suicide risk of non-suicidal self-injury in individuals: A systematic review

BACKGROUND Suicide risk assessment in individuals with non-suicidal self-injury (NSSI) is clinically challenging; implicit cognition tests may address limitations of explicit measures but lack systematic synthesis. AIM To synthesize evidence on the validity of implicit cognition tests for suicide risk assessment in individuals with NSSI. METHODS A systematic search of 6 databases (PsycINFO, PubMed, MEDLINE, EMBASE, CNKI, Wanfang Data) up to January 20, 2023, was conducted. Eligible studies were quantitative; effect sizes [odds ratio (OR), Cohen’s d] with 95% confidence intervals were reported. The risk of bias was evaluated by the Newcastle-Ottawa Scale (EMBASE, CNKI, Wanfang Data) up to January 20, 2023, was conducted. Eligible studies were quantitative; effect sizes (OR, Cohen’s d) with 95% confidence intervals were reported. The risk of bias was evaluated by the Newcastle-Ottawa Scale. RESULTS Nine studies were included. Implicit tests showed robust retrospective validity (Cohen’s d = 0.71, OR = 1.87) but time-dependent prospective validity (effective ≤ 3 months, inconsistent ≥ 6 months). They complemented but did not replace explicit measures. CONCLUSION Implicit cognition tests are valuable adjuncts for short-term suicide risk assessment in adolescents with NSSI.