Value-Based Choice, Contingency Learning, and Suicidal Behavior in Mid- and Late-Life Depression

Area of Science:

• Cognitive Neuroscience
• Behavioral Economics
• Psychiatry

Background:

• Suicidal behavior is linked to impaired decision-making under uncertainty.
• Previous research has not clarified if suicide attempters have deficits in learning from experience or in value-based choice.

Purpose of the Study:

• To investigate impairments in learning from experience and value-based choice in suicide attempters.
• To utilize a reinforcement learning model to analyze decision-making in suicide attempters.

Main Methods:

• A probabilistic three-choice decision-making task was administered to suicide attempters, suicide ideators, patients with depression, and healthy controls.
• Reinforcement learning models and mixed-effects models analyzed decision times and choices, with a second experiment dissociating learned value from reward magnitude.

Main Results:

• Suicide attempters demonstrated reduced sensitivity to reinforcement learning and longer decision times when choosing between similarly valued options.
• Learning deficits correlated with suicide attempt lethality and were partly explained by poor cognitive control.
• Impaired value-based choice persisted even after controlling for various confounding factors.

Conclusions:

• Serious suicidal behavior is associated with impaired reward learning, hindering the search for alternative solutions.
• Suicide attempts are linked to impaired value comparison, potentially affecting the consideration of deterrents during crises.