CClinicalTrials.gg
Not yet recruitingNCT07020143Updated Jun 13, 2025

Chinese University Students' Death Attitudes and Their Initial Sandplay Characteristics

An observational study in Death Attitude (Implicit/Explicit) and Sandplay Therapy, sponsored by Kai Huang. Not yet recruiting at 1 site in China. Open to participants aged 18 Years to 22 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-06-13.

Sponsored by Kai Huang · Observational

Study type
Observational
Model
Cohort
Time perspective
Cross-sectional
Enrollment
100
Ages
18 Years to 22 Years
Sex
All
01

Study summary

Death attitudes are different emotional reactions, evaluations, and behavioral tendencies of individuals experiencing near-death or death scenes, including positive or negative attitudes toward death such as denial, fear, curiosity, acceptance, avoidance, anxiety, etc. Wilson proposed a dual-attitude model to differentiate between implicit death attitudes and explicit death attitudes. Subsequently, some scholars have launched a discussion on the measurement and validity of implicit attitudes, Schimmack reviewed the evidence and found that the validity of implicit attitudes was lower than that of explicit instruments in all domains, but could be used as a complementary measure of sensitive attitudes; there are also several studies suggesting that implicit attitudes toward death could play a complementary role in the assessment of suicidal risk, and Wong found that a color image-based implicit association test was superior to a text-based one.

Sandplay therapy was developed by Swiss psychologist Dore M. Kalff in 1954 by combining Jung's analytical psychology and projection techniques with Lowenfeld's "The world technique". It was introduced to Japan by Hayao Kawai, a Japanese clinical psychologist, and introduced to China by Risheng Zhang in 1998. Sandplay therapy as a kind of deep-level expressive art therapy that uses sandboxes and tools to work with the self of individual cases, inherits the theories of Jungian psychotherapy about interpretation and metaphorical symbols, and can help individual cases to present unconscious contents and accomplish certain organization and transformation, which is very helpful to the development of the unconscious. It has a theoretical basis for reflecting the individual's implicit attitude toward death. Sandplay can express deeper emotional contents through metaphors and symbols .

Initial sandplay is the first one or two sandplays produced by a case. Research on the characteristics of the initial sandplay is helpful for clinicians to better grasp the psychological state and psychological traits of similar groups of people . Risheng Zhang does not advocate for the use of sandplay as a diagnostic tool, but sandplay does have a certain degree of diagnostic function, and by comparing the characteristics with those of the normative group, it can be used as one of the bases for preliminary judgment of the visitor. Renhui Lv suggested that Kalf and subsequent different scholars have combined their own experience in clinical practice to summarize the different methods and concerns of the box court assessment, although subjective assessment is criticized by scholars who hold a scientistic viewpoint, but it has to be admitted that any objectivization means cannot replace the flexibility and wholeness of the subjective assessment. The analytical dimensions of this study were defined in conjunction with the analytical dimensions used by several researchers regarding the study of sandplay characteristics.

This study planned to recruit 100 subjects through double-blind randomization, from which at least 82 subjects were selected from university students who had no religious beliefs, had an age range of 20±2 years old, had normal vision or corrected vision, none of them had participated in similar experiments before, and were familiar with basic computer operations. The study was based on a two-dimensional model of death attitudes, i.e., death attitudes were categorized into exoteric and implicit attitudes, and exoteric death attitudes were measured using the Depiction of Attitudes Toward Death Scale-Revised (DAP-R), and implicit death attitudes were measured using the Single-Category Implicit Association Test (SC-IAT), respectively. The study first explored the correlation between implicit and explicit attitudes toward death by correlating the implicit effect value D of the SC-IAT with the mean of the subdimensions of the DAP-R as pearson product difference. Secondly, based on the DAP-R scores, the university students with external death attitudes were categorized into positive and negative groups; based on the D values of the implicit effects of the SC-IAT, the university students with internal death attitudes were categorized into positive and negative groups, and the significance of the differences was investigated by conducting independent samples t-tests on the box characteristics of the university students of the two groups respectively.

02

Conditions studied

  • Death Attitude (Implicit/Explicit)
  • Sandplay Therapy

Browse trials for

Keywords

  • Chinese university students
  • implicit and explicit attitudes
  • death attitudes
  • the characteristics of initial sandplay
03

Who can participate

Ages eligible
18 Years to 22 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Probability sample

Study population

The trial randomly and double-blindly recruited 100 Han Chinese, with no religious beliefs, age range of 20 ± 2 years old, university students to participate in the trial, the subjects had normal vision or corrected vision, none of them had previously participated in similar experiments, and they were familiar with basic computer operation.

Eligibility criteria

Inclusion Criteria Be aged 18-22 years (20 ± 2 years old) Self-identified as Han Chinese ethnicity Currently enrolled as an undergraduate student Normal or corrected-to-normal vision No prior participation in similar psychological experiments (e.g., IAT, sandplay therapy) Proficient in basic computer operations (e.g., keyboard use, mouse navigation) Willing to provide written informed consent Exclusion Criteria Presence of diagnosed psychiatric disorders (e.g., major depressive disorder, PTSD) Regular use of psychotropic medications within the past 6 months Religious affiliation or spiritual practices influencing death-related beliefs History of traumatic bereavement (e.g., loss of immediate family member within 1 year) Physical disabilities affecting sandplay manipulation (e.g., severe hand tremor)

04

Study design

Observational model
Cohort
Time perspective
Cross-sectional
Enrollment
100 participants (estimated)
Target follow-up
1 Day
Patient registry
Yes

Groups and cohorts

  • Chinese university students

    The study firstly explored the correlation between the implicit death attitudes and the explicit death attitudes by making pearson product-difference correlation between the implicit effect value D-value of the SC-IAT and the mean value of the sub-dimensions of the DAP-R. Secondly, based on the DAP-R scores, the university students with external death attitudes were categorized into positive and negative groups; based on the D values of the implicit effects of the SC-IAT, the university students with internal death attitudes were categorized into positive and negative groups, and the significance of the differences was investigated by conducting independent sample t-tests on the initial sandplay characteristics of the university students of the two groups respectively.

05

What researchers measure

Primary outcomes

  1. Sandplay Feature Profile (SFP) via Sandplay Therapy Observation Scale

    Quantitative analysis of initial sandplay characteristics using 5 validated dimensions: Toy Utilization Index: Count of distinct categories used (person/animal/plant/etc.) Sand Manipulation Score: 0-3 scale (0=no manipulation; 3=landform creation) Construction Time: Minutes from first toy selection to completion Self-Representation Coding: 0-2 nominal scale (0=absent; 1=symbolic; 2=literal) Spatial Occupancy Ratio: Calculated as (used area/total sandbox area)×100%

    Time frame: 1 day

Secondary outcomes

  1. Death Attitude Implicit Association (DA-IA) via SC-IAT

    Description: D-value computed using Greenwald's improved algorithm (2003), reflecting response time differences between compatible (death-negative association) and incompatible (death-positive association) trials

    Time frame: 1 day

Other outcomes

  1. Explicit Death Attitude Profile via DAP-R

    Composite scores from Chinese-validated Death Attitude Profile-Revised: Negative Attitude Score: Sum of Fear (5 items) \& Avoidance (7 items) subscales Positive Attitude Score: Sum of Neutral/Acceptance/Escape Acceptance subscales

    Time frame: 1 day

06

Study locations

1 site
  • Ocean University of China
    Qingdao, Shandong 266100, China
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07020143
Lead sponsor
Kai Huang
Responsible party
Kai Huang (Assistant Professor, Ocean University of China) — Sponsor-investigator
First posted
Jun 13, 2025
Start date
Jun 20, 2025 (estimated)
Primary completion
Aug 20, 2025 (estimated)
Completion
Aug 20, 2025 (estimated)
Last update
Jun 13, 2025

Study contacts

kai huang, master
Contact
huangkai@ouc.edu.cn
+8615694456686

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jun 2025. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion