Iowa gambling task performance in currently depressed suicide attempters

Area of Science:

• Neuroscience
• Psychiatry
• Behavioral Science

Background:

• Past suicide attempters often exhibit decision-making deficits, particularly when euthymic or medicated.
• The Iowa Gambling Task (IGT) is frequently used to assess decision-making abilities.

Purpose of the Study:

• To compare IGT performance in medication-free, depressed patients with and without a history of suicide attempts against healthy volunteers.
• To investigate if attempter status, method of attempt, suicide intent, ideation, impulsiveness, or aggression correlate with IGT performance.

Main Methods:

• IGT performance was assessed in three groups: medication-free depressed patients with past suicide attempts (n=26), without past attempts (n=46), and healthy controls (n=42).
• Statistical analyses accounted for sex, mood disorder type, and Borderline Personality Disorder comorbidity.
• Correlations with impulsiveness, hostility, and aggression were examined.

Main Results:

• Suicide attempt history, particularly non-violent attempts, was not associated with impaired IGT performance.
• A trend towards poorer IGT performance was observed in a small subgroup of attempters who used violent methods.
• No significant relationships were found between IGT scores and suicide intent, ideation, impulsiveness, hostility, or aggression.

Conclusions:

• Decision-making impairment on the IGT is not a universal marker for all suicide attempters, especially those with non-violent histories.
• Impaired decision-making may be specific to certain subtypes of suicidal behavior, particularly violent attempts.
• The utility of the IGT as a general risk marker for suicidal behavior may be limited by psychometric and conceptual issues.