Impaired decision making in suicide attempters

Area of Science:

• Neuroscience
• Psychiatry
• Behavioral Science

Background:

• Suicidal behavior is not fully understood.
• The stress-diathesis model implicates serotonergic deficits in the orbitofrontal cortex in suicidal behavior susceptibility.
• The orbitofrontal cortex is crucial for decision-making, a process potentially modulated by serotonin.

Purpose of the Study:

• To assess decision-making capabilities in individuals who have attempted suicide.
• To investigate the relationship between decision-making and factors like impulsivity and emotional instability.

Main Methods:

• The Iowa Gambling Task was administered to violent suicide attempters (N=32), nonviolent suicide attempters (N=37), affective disorder patients without suicidal history (N=25), and healthy controls (N=82).
• Participants were assessed when free of current Axis I disorders.
• Performance was correlated with psychometric measures of impulsivity, hostility, anger, aggression, and emotional instability.

Main Results:

• Suicide attempters, across both violent and nonviolent groups, demonstrated significantly poorer performance on the Iowa Gambling Task compared to healthy controls.
• Violent suicide attempters performed worse than individuals with affective disorders but no history of suicide attempts.
• Performance deficits were not explained by demographic factors, suicide history, or medication use, but correlated with affective lability and anger expression.

Conclusions:

• Impaired decision-making, potentially linked to emotional dysfunction, emerges as a significant neuropsychological risk factor for suicidal behavior.
• These findings contribute to understanding the neurobiological underpinnings of suicide risk.