Matthew K Nock

Matthew K Nock
Harvard University | Harvard · Department of Psychology

Ph.D.

About

380
Publications
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41,655
Citations

Publications

Publications (380)
Article
Full-text available
Clinical risk prediction models powered by electronic health records (EHRs) are becoming increasingly widespread in clinical practice. With suicide-related mortality rates rising in recent years, it is becoming increasingly urgent to understand, predict, and prevent suicidal behavior. Here, we compare the predictive value of structured and unstruct...
Preprint
Little is known about how female adolescent ballet dancers—a group at high-risk for the development of body dissatisfaction and eating disorders—construct body ideals, and how their social identities interact with body ideals to confer risk for disordered eating. Using a novel body figure behavioral task, this study investigated (1) whether degree...
Article
Objective: Suicide is a major public health concern in the United States, but few effective and scalable interventions exist to help those with suicidal thoughts. We hypothesized that reading first-person narratives about working through suicidal thoughts would reduce the desire to die among adults and that this effect would be mediated by increas...
Chapter
Psychology is a popular subject to study, with thousands entering graduate school each year, but unlike med or pre-law, there is limited information available to help students learn about the field, how to successfully apply, and how to thrive while completing doctoral work. The Portable Mentor is a useful, must-have resource for all students inter...
Article
The suicide rate (currently 14 per 100,000) has barely changed in the United States over the past 100 years. There is a need for new ways of preventing suicide. Further, research has revealed that suicidal thoughts and behaviors and the factors that drive them are dynamic, heterogeneous, and interactive. Most existing interventions for suicidal tho...
Article
Full-text available
The first year of college may carry especially high risk for onset of alcohol use disorders. We assessed the one-year incidence of alcohol use disorders (AUD) among incoming first-year students, predictors of AUD-incidence, prediction accuracy and population impact. A prospective cohort study of first-year college students (baseline: N = 5843; resp...
Article
Cross-sectional studies and prospective studies with long follow-up periods (e.g., years) have shown that lower levels of social support are associated with nonsuicidal self-injury (NSSI) among adolescents. This study examined how short-term changes in social support may contribute to NSSI behavior and whether different sources of support (e.g., fr...
Article
Despite significant advances in early-intervention services for psychosis, delays in identifying patients continue to impede the delivery of prompt and effective treatments. We sought to develop and preliminarily validate a self-administered psychosis implicit association task (P-IAT) as a screening and diagnostic support tool for identifying indiv...
Article
Background Depression and anxiety are both prevalent among university students. They frequently co-occur and share risk factors. Yet few studies have focused on identifying students at highest risk of first-onset and persistence of either of these conditions. Methods Multicenter cohort study among Spanish first-year university students. At baselin...
Article
Full-text available
Significance Using language to “distance” ourselves from distressing situations (i.e., by talking less about ourselves and the present moment) can help us manage emotions. Here, we translate this basic research to discover that such “linguistic distancing” is a replicable measure of mental health in a large set of therapy transcripts ( N = 6,229)....
Article
Background Interest in developing machine learning models that use electronic health record data to predict patients’ risk of suicidal behavior has recently proliferated. However, whether and how such models might be implemented and useful in clinical practice remain unknown. To ultimately make automated suicide risk–prediction models useful in pra...
Article
Prior research has struggled to differentiate cortisol stress response patterns reflective of well-regulated versus dysregulated hypothalamic–pituitary–adrenal (HPA) axis function among adolescents. Here, we show how exploring profiles of joint HPA– inflammatory stress responsivity, and linking those profiles to pubertal development and peer stress...
Article
Full-text available
Background: Medically ill youth are at increased suicide risk, necessitating early detection. This study aimed to assess the feasibility of administering the Death Implicit Association Test (Death IAT) to pediatric medical inpatients. Methods: Participants completed measures including the Ask Suicide-Screening Questions (ASQ) and the Death IAT. Res...
Article
Objective: The purpose of this study was to examine implicit affect toward suicide (i.e., how good/bad suicide is perceived). Some people might be more likely to think about/choose suicide because they perceive it as a good option (to gain relief) relative to available alternatives. Method: Implicit affect toward suicide among adults (N = 72) an...
Article
Importance: Half of the people who die by suicide make a health care visit within 1 month of their death. However, clinicians lack the tools to identify these patients. Objective: To predict suicide attempts within 1 and 6 months of presentation at an emergency department (ED) for psychiatric problems. Design, setting, and participants: This p...
Article
Inleiding: Er is weinig bekend over epidemiologische aspecten (prevalentie, comorbiditeit, impact en zorggebruik) van de depressieve stoornis bij universiteitsstudenten. In een descriptief-epidemiologisch onderzoek naar de depressieve stoornis (volgens DSM-IV) bij eerstejaarsstudenten aan de KU Leuven, België, werden de 12-maanden prevalentie, de p...
Article
Bckground Theories of suicide suggest that suicidal ideation (SI) results in part from difficulty imagining the future, which itself relies on the ability to remember the past. The present study examines multiple components of episodic future thinking and memory including event richness, which is commonly measured within the cognitive literature bu...
Chapter
Full-text available
This chapter describes the role of machine learning in youth suicide prevention. Following a brief history of suicide prediction, research is reviewed demonstrating that machine learning can enhance suicide prediction beyond traditional clinical and statistical approaches. Strategies for internal and external model evaluation, methods for integrati...
Article
Full-text available
There has been growing interest in using wearable physiological monitors to passively detect the signals of distress (i.e., increases in autonomic arousal measured through increased electrodermal activity [EDA]) that may be imminently associated with suicidal thoughts. Before using these monitors in advanced applications such as creating suicide ri...
Article
Full-text available
Background Stressful life events are a common antecedent of suicidal thoughts. However, not all stressful events lead to increased suicidal thinking, even among those who frequently have suicidal thoughts. In this study, we examined whether the ways that individuals regulate their emotions moderates the association between stressful events and suic...
Article
Background and objectives Individuals with disordered eating display heightened attentional biases towards food- and body-related stimuli. However, it is unknown whether these attentional biases reflect maladaptive thinking/eating pathology. We investigated the differences between maladaptive and adaptive ways of thinking about food by assessing fo...
Article
Introduction Emotion reactivity (ER) and distress intolerance (DI) may be associated with increased suicide attempt (SA) risk among U.S. Army soldiers. Method In this case–control study, 74 soldiers recently hospitalized for SA (cases) were compared with 133 control soldiers from the same Army installations selected based on either propensity scor...
Conference Paper
Every day, individuals post suicide notes on social media asking for support, resources, and reasons to live. Some posts receive few comments while others receive many. While prior studies have analyzed whether specific responses are more or less helpful, it is not clear if the quantity of comments received is beneficial in reducing symptoms or in...
Article
Objective Suicide is one of the leading causes of death worldwide, yet clinicians find it difficult to reliably identify individuals at high risk for suicide. Algorithmic approaches for suicide risk detection have been developed in recent years, mostly based on data from electronic health records (EHRs). Significant room for improvement remains in...
Article
Objectives. To examine associations of current mental and substance use disorders with self-reported gun ownership and carrying among recently separated US Army soldiers. Veterans have high rates of both gun ownership and mental disorders, the conjunction of which might contribute to the high suicide rate in this group. Methods. Cross-sectional sur...
Article
Advancements in the understanding and prevention of self-injurious thoughts and behaviors (SITBs) are urgently needed. Intensive longitudinal data collection methods—such as ecological momentary assessment—capture fine-grained, “real-world” information about SITBs as they occur and thus have the potential to narrow this gap. However, collecting rea...
Article
Restrictive eating is common and associated with negative psychological outcomes across the life span and eating disorder (ED) severity levels. Little is known about functional processes that maintain restriction, especially outside of narrow diagnostic categories (e.g., anorexia nervosa). Here, we extend research on operant four-function models (i...
Article
Full-text available
We still have little understanding of short-term predictors of suicidal thoughts and behaviors (STBs). Prior research links increased negative affect to STBs, but the vast majority of earlier work is limited by measuring negative affect at one time point and aiming to predict STBs months or years in the future. Recently, intensive longitudinal stud...
Article
The practice of therapeutic skills outside of sessions in which they are learned is one presumed key component of cognitive behavioral therapy (CBT). Yet, our understanding of how skills practice relates to clinical outcomes remains limited. Here, we explored patients’ emotional responses to CBT skills practices in a pilot study pairing smartphone...
Article
Full-text available
PurposeTo investigate the associations of childhood adversities (CAs) with lifetime onset and transitions across suicidal thoughts and behaviors (STB) among incoming college students.Methods Web-based self-report surveys administered to 20,842 incoming college students from nine countries (response rate 45.6%) assessed lifetime suicidal ideation, p...
Preprint
Full-text available
There has been growing interest in using wearable physiological monitors to passively detect the signals of distress (i.e., increases in autonomic arousal measured through increased electrodermal activity [EDA]) that may be imminently associated with suicidal thoughts. Before using these monitors in advanced applications such as creating suicide ri...
Preprint
Clinical risk prediction models powered by electronic health records (EHRs) are becoming increasingly widespread in clinical practice. With suicide-related mortality rates rising in recent years, it is becoming increasingly urgent to understand, predict, and prevent suicidal behavior. Here, we compare the predictive value of structured and unstruct...
Article
Objective: Traditional studies of treatment moderators have focused largely on psychological factors such as clinical severity. Racial and economic inequity exert large effects on youth mental health, on treatment efficacy, and on the likelihood of receiving treatment altogether. Yet, these factors are studied less often by clinical psychological...
Article
Researchers, clinicians and patients are increasingly using real-time monitoring methods to understand and predict suicidal thoughts and behaviours. These methods involve frequently assessing suicidal thoughts, but it is not known whether asking about suicide repeatedly is iatrogenic. We tested two questions about this approach: (a) does repeatedly...
Article
Objective We tested the aspects of social support, unit cohesion, and religiosity hypothesized to be protective factors for suicide among U.S. service members. Methods This case–control study compared U.S. Army soldiers who died by suicide while on active duty (n = 135) to controls of two types: those propensity score-matched on known sociodemogra...
Article
Background The hopelessness theory is one of the most studied cognitive vulnerability theories of depression. It proposes that risk for depression is conferred by attributing the causes of negative events to global, internal, stable causes and inferring future negative consequences and negative characteristics about oneself from these events. Nearl...
Article
Background Suicidal and nonsuicidal self-injurious thoughts and behaviors (SITBs) are major health concerns among military veterans yet little is known about the temporal relations among these outcomes. This study examined the temporal relations between suicidal and nonsuicidal SITBs among higher-risk veterans. Specifically, we identified when SITB...
Article
Full-text available
Background Although non-suicidal self-injury (NSSI) is an issue of major concern to colleges worldwide, we lack detailed information about the epidemiology of NSSI among college students. The objectives of this study were to present the first cross-national data on the prevalence of NSSI and NSSI disorder among first-year college students and its a...
Preprint
Background: Interest in developing machine learning algorithms that use electronic health record data to predict patients’ risk of suicidal behavior has recently proliferated. Whether and how such models might be implemented and useful in clinical practice, however, remains unknown. In order to ultimately make automated suicide risk prediction algo...
Preprint
Background. Suicide is one of the leading causes of death worldwide, yet clinicians find it difficult to reliably identify individuals at high risk for suicide. Algorithmic approaches for suicide risk detection have been developed in recent years, mostly based on data from electronics health records (EHRs). These models typically do not optimally e...
Preprint
BACKGROUND Interest in developing machine learning models that use electronic health record data to predict patients’ risk of suicidal behavior has recently proliferated. However, whether and how such models might be implemented and useful in clinical practice remain unknown. To ultimately make automated suicide risk–prediction models useful in pra...
Article
Despite functional models of non-suicidal self-injury (NSSI) helping to explain why people engage in this perplexing behavior, we still lack an understanding of some of the key properties of NSSI functions. Here, we address three unanswered questions about NSSI functions: how much do distinct NSSI functions (1) vary between people over time, (2) va...
Article
This issue contains a thoughtful report by Gradus et al. on a machine learning (ML) analysis of administrative variables to predict suicide attempts over two decades throughout Denmark. This is one of numerous recent studies that document strong concentration of risk of suicide-related behaviors (SRBs) among patients with high scores on ML models....
Article
Suicide is among the leading causes of death in the US and worldwide. Devastatingly, it disproportionately affects youth, making it a leading contributor to years of life lost as well. Whereas the US federal government has prioritized the study and prevention of other causes of death, causing mortality rates from them to drop precipitously (e.g., c...
Article
Importance Several statistical models for predicting suicide risk have been developed, but how accurate such models must be to warrant implementation in clinical practice is not known. Objective To identify threshold values of sensitivity, specificity, and positive predictive value that a suicide risk prediction method must attain to cost-effectiv...
Article
Full-text available
There is concern that the COVID-19 pandemic may cause increased risk of suicide. In the current study, we tested whether suicidal thinking has increased during the COVID-19 pandemic and whether such thinking was predicted by increased feelings of social isolation. In a sample of 55 individuals recently hospitalized for suicidal thinking or behavior...
Article
Suicide researchers commonly use a variety of assessment methods (e.g., surveys and interviews) to enroll participants into studies and assign them to study conditions. However, prior studies suggest that different assessment methods and items may yield different responses from participants. This study examines potential inconsistencies in particip...
Article
Full-text available
Importance: The weeks following discharge from psychiatric hospitalization are the highest-risk period for suicide attempts. Real-time monitoring of suicidal thoughts via smartphone prompts may be more indicative of short-term risk than a single, cross-sectional assessment. Objective: To test whether modeling dynamic changes in real-time suicida...
Article
Adolescent risk for self-injurious thoughts and behaviors (STBs) involves disturbance across multiple systems (e.g., affective valence, arousal regulatory, cognitive and social processes). However, research integrating information across these systems is lacking. Utilizing a multiple-levels-of-analysis approach (Cicchetti & Dawson, 2002), this pers...
Article
(248 words) Introduction There is public concern about potential associations between adolescent social media/smartphone use and risk for suicide. However, no prior studies leverage qualitative methods to explore the experiences of adolescents currently at-risk for suicide. Methods This study examined social technology use from the perspectives o...
Preprint
BACKGROUND People with suicidal thoughts are more inclined to seek technology-delivered interventions than in-person forms of treatment, making mobile apps for suicide prevention an ideal platform for treatment delivery. OBJECTIVE This review examines apps designed for suicide prevention, with a specific focus on user engagement. METHODS All apps...
Article
Full-text available
Background People with suicidal thoughts are more inclined to seek technology-delivered interventions than in-person forms of treatment, making mobile apps for suicide prevention an ideal platform for treatment delivery. This review examines apps designed for suicide prevention, with a specific focus on user engagement. Objective This study aims t...
Preprint
The suicide rate has not changed in the United States over the past 100 years and there is a need for new ways of preventing suicide. Research has revealed that suicidal thoughts and behaviors and the factors that drive them are dynamic, heterogeneous, and interactive. Most existing interventions are infrequent (e.g., weekly sessions), not accessib...
Article
Full-text available
Background Little is known about the epidemiology of Major Depressive Episode (mde) in university students. Aim To investigate the prevalence of mde, psychiatric comorbidity, and the association with academic performance among first-year university students, and to investigate to what extent these students use professional mental health services. M...
Article
Full-text available
Objective: Digital monitoring technologies (e.g., smart-phones and wearable devices) provide unprecedented opportunities to study potentially harmful behaviors such as suicide, violence, and alcohol/substance use in real-time. The use of these new technologies has the potential to significantly advance the understanding, prediction, and prevention...
Preprint
Full-text available
Researchers, clinicians, and patients are increasingly using real-time monitoring methods to understand and predict suicidal thoughts and behaviors. These methods involve frequently assessing suicidal thoughts, but it is unknown if asking about suicide repeatedly is iatrogenic. We tested two questions about this approach: (1) does repeatedly assess...
Article
Objective: Rates of some psychological disorders are higher among enlisted U.S. military personnel than socio-demographically matched civilians. Indirect evidence suggests some internalizing and externalizing psychological problems among enlistees onset prior to enlistment. However, the consistency and strength of the associations between pre-enlis...
Preprint
Full-text available
Restrictive eating is common across the lifespan and eating disorder (ED) severity levels, and associated with negative psychological outcomes. Little is known about functional processes that maintain restriction. Here, we extend research on four-function models (identifying automatic negative, automatic positive, social negative, and social positi...
Article
Full-text available
Background Risk for suicide attempt (SA) versus suicide ideation (SI) is clinically important and difficult to differentiate. We examined whether a history of self‐injurious thoughts and behaviors (SITBs) differentiates soldiers with a recent SA from nonattempting soldiers with current/recent SI. Methods Using a unique case‐control design, we admi...
Article
Full-text available
Objective The Interpersonal Theory of Suicide (IPTS) posits fearlessness of death and pain tolerance as two components of suicide capability. The German Capability for Suicide Questionnaire (GCSQ) is the first measure of both these components, but few data are available on its psychometrics. We (a) examined the psychometric properties of the GCSQ a...
Article
Full-text available
The Death/Suicide Implicit Association Test (IAT) is effective at detecting and prospectively predicting suicidal thoughts and behaviors. However, traditional IAT scoring procedures used in all prior studies (i.e., D‐scores) provide an aggregate score that is inherently relative, obfuscating the separate associations (i.e., “Me = Death/Suicide,” “M...
Article
Objective Emotional or psychological pain is a core symptom of complicated grief (CG), yet its correlates are largely unexamined among bereaved individuals. Method Bereaved adults (N = 135) completed self‐reports regarding psychological pain, CG, depression, and suicidality. We assessed correlations among these variables and tested whether psychol...
Article
Suicide is a leading cause of death worldwide and perhaps the most puzzling and devastating of all human behaviors. Suicide research has primarily been guided by verbal theories containing vague constructs and poorly specified relationships. We propose two fundamental changes required to move toward a mechanistic understanding of suicide. First, we...
Article
The interpersonal theory of suicide hypothesizes that perceived burdensomeness, thwarted belongingness, and hopelessness lead to active suicidal thoughts and individuals with active suicidal thoughts and elevated capability for suicide are most likely to attempt suicide. We retrospectively and prospectively tested this theory in a large sample of 7...
Article
Background: The university period carries risk for onset of common mental disorders. Epidemiological knowledge on mental disorders among Spanish university students is limited. Aims: To estimate lifetime and 12-month prevalence, persistence and age-of-onset of mental disorders among Spanish first-year university students, as well as associated role...
Article
Full-text available
There is a very high suicide rate in the year after psychiatric hospital discharge. Intensive postdischarge case management programs can address this problem but are not cost-effective for all patients. This issue can be addressed by developing a risk model to predict which inpatients might need such a program. We developed such a model for the 391...
Article
Full-text available
The Self-Injurious Thoughts and Behaviors Interview (SITBI) is a widely used measure of the presence, frequency, and characteristics of suicide and self-harming thoughts and behaviors. In response to advances in the conceptualization of these outcomes, and the potential for online data collection, we created a revised version of the SITBI (SITBI-R)...
Article
Researchers are increasingly using objective methods to study constructs related to suicidal thoughts and behavior (STB; e.g., self-identification with suicide), such as via behavioral tasks and brain imaging. Although promising, such approaches often are limited by the use of overly general stimuli (e.g., images, words) to represent constructs und...
Article
Despite decades of suicide research, our ability to predict suicide has not changed. Why is this the case? We outline the unique challenges facing suicide research. Borrowing successful strategies from other medical fields, we propose specific research directions that aim to translate scientific findings into meaningful clinical impact.
Article
Importance Suicide is a leading cause of mortality, with suicide-related deaths increasing in recent years. Automated methods for individualized risk prediction have great potential to address this growing public health threat. To facilitate their adoption, they must first be validated across diverse health care settings. Objective To evaluate the...
Article
Full-text available
Introduction: Although research over the past decade has resulted in significantly increased knowledge about distal risk factors for non-suicidal self-injury (NSSI), little is known about short-term (proximal) factors that predict NSSI thoughts and behaviors. Drawing on contemporaneous theories of NSSI, as well as the concept of ideation-to-action...
Article
Full-text available
Background: Depression rates increase markedly for girls across the adolescent transition, but the social-environmental and biological processes underlying this phenomenon remain unclear. To address this issue, we tested a key hypothesis from Social Signal Transduction Theory of Depression, which posits that individuals who mount stronger inflamma...