Orexin Antagonism for Suicide Risk: A Proof-of-Concept Clinical Trial

Implicit Association Tests (IATs)

Implicit Association Tests ( IATs) use reaction time (RT) to capture automatic, implicit processes to gauge implicit self-identification with a construct of interest. Participants classify stimuli presented in the center of the screen into categories. The category labels are located on the left and right of the screen and participants classify stimuli by selecting keys corresponding to the left or right. RTs are measured as participants complete this task thereby gauging implicit mental associations. This study uses two variations of the IAT, a suicide-related IAT and a Escape-Me IAT to determine the extent to which participants associate suicide-related and escape-related constructs with the self.

Buss-Perry Aggression Questionnaire

The Buss-Perry Aggression Questionnaire is a 20-item self-report questionnaire assessing four dimensions of aggression: physical aggression, verbal aggression, anger, and hostility. Participants indicate how well each item describes them on a 5-point scale ranging from 1 (Not at all like me) to 5 (Very much like me).

Overt Aggression Scale Modified

The Overt Aggression Scale Modified (OAS-M) is a clinician-administered interview of aggressive behavior. Participants are asked about "outbursts of anger" (reactive aggression) in the past week. The OAS-M is strongly related to measures of anger and differentiates between participants with and without intermittent explosive disorder, supporting its validity as a measure of reactive aggression.

Point Subtraction Aggression Paradigm

The Point Subtraction Aggression Paradigm (PSAP) is a laboratory-based assessment of reactive aggression in which participants play a competitive computer game against a fictional opponent to obtain points that coincide with a monetary reward. The PSAP can be administered virtually through Inquisit Web, a software designed to facilitate virtual research experiments.

Barratt Impulsiveness Scale

The Barratt Impulsiveness Scale (BIS-11) is a 30-item self-report questionnaire assessing the personality/behavioral construct of impulsiveness. It includes six first-order factors (attention, motor, self-control, cognitive complexity, perseverance, and cognitive instability impulsiveness) and three second-order factors (attentional, motor, and non-planning impulsiveness). Participants rate each item on a 4-point scale ranging from 1 (Rarely/Never) to 4 (Almost Always/Always). Total scores can range from 30 to 120.

Hamilton Depression Scale

The Hamilton Depression Scale (HAM-D) is a clinician-administered 17-item questionnaire assessing the severity of depressive symptoms. Each item measures a depressive symptom (e.g., feelings of guilt, anxiety somatic). Items are rated on a 5-point (0 to 4) or 3-point (0 to 2) scale.

Generalized Anxiety Disorder-7

The Generalized Anxiety Disorder-7 (GAD-7) assesses anxiety symptom severity over the past two weeks with seven items rated from 0 (not at all) to 3 (nearly every day). An additional item assesses how difficult these symptoms have made functioning, which is rated from "not difficult at all" to "extremely difficult." Total scores use items 1-7 and range from 0 to 21. A score of 10 or greater represents a cut point for identifying cases of GAD, and cut points of 5, 10, and 15 could be interpreted as representing mild, moderate, and severe levels of anxiety.

Pittsburgh Sleep Quality Index

The Pittsburgh Sleep Quality Index (PSQI) is a 19-item self-report questionnaire assessing sleep quality in clinical populations. It has seven subcategories: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The PSQI has both Likert-type and open-ended questions. Scores for the ordinal questions range from 0 to 3, with higher scores indicating more acute sleep disturbances.

Patient-rated Inventory of Side-Effects

The Patient-rated Inventory of Side Effects (PRISE) is a 32-item self-report questionnaire assessing the presence and severity of side effects experienced by patients from a medication. Each item is rated on a 4-point scale (0 to 3). Items are summed for total scores, and higher scores indicate greater severity and impact of side effects.