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Updated: Jul 11, 2026

A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents
Published on: July 10, 2017
Effects associated with adolescent standardized patient simulation of depression and suicidal ideation
Mark D Hanson1, Anne Niec, Anna Marie Pietrantonio
1HSC 3G41, McMaster University, Hamilton, ON, L8N 3Z5, Canada. hansonm@mcmaster.ca
Background:
Because of common use of adolescent simulated patients (ASPs), clarification of the risk of negative effects associated with high-stress simulations is essential. This study evaluates the safety of suicidality simulations.
Method:
ASPs participated in a suicidality role or pediatric role. Explicit measures of their impact included the Suicidal Ideation Questionnaire (SIQ) and Reynolds Adolescent Depression Scale-2 (RADS-2), both of which were completed pre-/poststudy. Implicit behavioral measures of impact were also collected during training, including the Implicit Association Test.
Results:
Three of the 24 participants had clinical RADS-2 and/or SIQ scores. None of these adolescents' mental status deteriorated with SP participation. ASPs in the suicidality role showed behavioral effects consistent with a negative reaction, and two reported brief depression.
Conclusions:
ASPs participated in a suicidality simulation without evidence of suicide contagion. However, ASPs' behavioral reactions and self-reported depression suggested a transient depressive reaction.
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