It is not widely known whether and how heuristics influence suicide risk assessment, despite a body of research in other domains focusing on human judgement (Hadlaczky, 2016; Yager et al., 2021). This paper aims to highlight cognitive biases potentially affecting suicide risk assessment and presents findings from an experiment addressing cognitive rigidity and trait anxiety as possible confounders of the effect of heuristics. We investigated how an environment fostering utilization of heuristics impacts the perception of suicide risk among primary care physicians’ (PCP), who play a crucial role in identifying suicidal tendencies.
The participants (N=76) with the mean age of 43.9 years (SD=13.7) assessed two fictional cases representing patients with moderate and high suicide risk, previously confirmed by competent judges and Sad Persons (MSPS) scores. The experimental group (EG) was randomly assigned to a situation inducing heuristic reasoning by being asked to assess two cases in the following sequence – severe case and moderate case. The control group (CG) assessed only the moderate case and was expected to give more adequate suicide risk evaluations than the EG. The participants' trait anxiety (STAI, Spielberger et al.) and cognitive rigidity (The Need for Closure Scale [NFCS], Webster, Kruglanski) were assessed to determine whether these variables contribute to suicide risk assessment.
It was confirmed, with limitations, that introducing conditions conducive to cognitive biases resulted in differences between EG and CG in the assessment of patient B’s (moderate case) suicide risk (p=.01, Cramer's V=.35). No relationship was found between PCPs’ anxiety level and the degree of perceived suicide risk for the patient. It was partially confirmed that the degree of perceived suicide risk is related to cognitive rigidity (p<.05).
The results may suggest the need for physicians to pay attention to the value of reflective practice, which may help in reducing diagnostic biases. Increasing awareness of common cognitive biases may contribute to improving skills of recognizing and controlling them. Further replications are necessary to explore the problem more thoroughly.