Risk-Sensitive Decision-Making and Self-Harm in Youth Bipolar Disorder

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Psychology

Background:

• Youth with bipolar disorder (BD) face elevated risks for suicide and self-harm.
• Previous research links increased risk-taking to suicide attempts in major depressive disorder, but this connection is unexplored in youth with BD.

Purpose of the Study:

• To investigate the association between suicide risk and risk-sensitive decision-making in a controlled sample of youth diagnosed with bipolar disorder.

Main Methods:

• Recruited 81 youth with BD (52 with self-harm history [BDSH+], 29 without [BDSH-]) and 82 controls (ages 13-20).
• Assessed decision-making and risk-taking using the Cambridge Gambling Task (CANTAB).
• Employed general linear models, controlling for age, sex, and IQ, to analyze group differences.

Main Results:

• Youth with BD but no self-harm history (BDSH-) demonstrated better performance (proportion of points bet) than both BDSH+ and control groups.
• BDSH- youth exhibited longer deliberation times compared to controls.
• Significant differences in risk-taking were observed, with BDSH- youth showing greater self-control than BDSH+ and control groups.

Conclusions:

• Youth with BD and no history of self-harm display enhanced self-control and reduced risk-taking behaviors.
• This pattern may indicate a compensatory mechanism offering protection against suicide risk.
• Further longitudinal research is necessary to understand the neurocognitive and self-harm relationship in youth with BD.