Blunted neural reward responsiveness in children with recent suicidal ideation

Individuals with suicidal thoughts and behaviors experience abnormalities in reward-related processes, yet little is known about specific components or stages of reward processing that are impaired, especially in children. The primary aim of this study was to conduct an investigation of the Initial Response to Reward subconstruct of the National Institute of Mental Health’s Research Domain Criteria in relation to recent suicidal ideation (SI) in children. Participants were 23 children between the ages of 7 and 11 with a history of recent SI and 46 demographically and clinically matched children with no recent SI. Children completed a simple guessing task during which electroencephalographic signals were continuously recorded to isolate the reward positivity (RewP) event-related potential; specifically, we examined change in RewP (∆RewP), quantified as the difference between neural responses to monetary gains and neural responses to monetary losses. Children with recent SI exhibited significantly smaller (i.e., blunted) ∆RewP, providing initial evidence for blunted initial responses to reward in these children

Suicidal ideation and attentional biases in children: An eye-tracking study.

Background: Despite theoretical and empirical evidence for a heighted responsiveness to signals of social-threat in suicidal individuals, no studies to date have examined whether this responsiveness might also manifest in the form of specific biases in attention to interpersonal stimuli. The current study, therefore, examined the presence and nature of attentional biases for facial expressions of emotion in children with and without a history of suicidal ideation (SI). Method: Participants were 88 children (44 with a history of SI and 44 demographically and clinically matched controls without such history) recruited from the community. The average age of children was 9.26 years (44.3% female; 67.0% Caucasian). Children\u27s history of SI was assessed via structured interviews with children and their parent. Attentional biases were assessed using a dot probe task and included fearful, happy, and sad facial stimuli and focused on eye tracking and reaction time indices of attentional bias. Results: Children with a history of SI exhibited significantly greater gaze duration toward fearful faces. The findings appeared to be at least partially independent of children\u27s history of major depression or anxiety disorders or their current depressive or anxious symptoms. Limitations: The study is limited by its cross-sectional design, which precludes any causal conclusions regarding the role of attentional biases in future suicide risk. Conclusions: Our results suggest that children with a history of SI exhibit biases in sustained attention toward socially-threatening facial expressions. Pending replications, these findings might represent a new avenue of suicide risk assessment and intervention

Rajappa K: Rumination and Hopelessness as Mediators of the Relation Between Perceived Emotion Dysregulation and Suicidal Ideation. Cognit Ther Res 2013

Abstract The present study examined whether particular emotion dysregulation dimensions were associated with suicidal ideation through their effects on ruminative thinking and hopelessness. Emerging adults (ages 18-25) with (n = 32) and without (n = 111) a suicide attempt history completed an emotion dysregulation measure at baseline and measures of rumination, hopelessness, depressive symptoms, and suicidal ideation 2-3 years later. Multiple suicide attempters (n = 15) were distinguished by elevated scores on emotion dysregulation dimensions involving impulse control difficulties and inability to access effective emotion regulation strategies. The Strategies dimension, assessed at baseline, was significantly associated with both rumination and hopelessness at follow-up, and with higher ideation at follow-up. Rumination and hopelessness mediated the relation between Strategies and ideation, even when adjusting for depressive symptoms. Perceived inability to access emotion regulation strategies may increase vulnerability to suicidal ideation through its effects on rumination and hopelessness

Neural responses to gains and losses in children of suicide attempters.

Suicidal behavior aggregates within families, yet the specific mechanisms of suicide-risk transmission are poorly understood. Despite some evidence that abnormal patterns of reward responsiveness might constitute one such potential mechanism, empirical evidence is lacking. The goal of this study was to examine neural responses to gains and losses in children of suicide attempters with no personal history of suicide attempt (SA) themselves. To objectively assess these neural responses, we used feedback negativity (FN), a psychophysiological marker of responsiveness to reward and loss. Participants were 66 parents and their 7–11-year-old children (22 with parental history of SA and 44 demographically and clinically matched children of parents with no SA history). Diagnostic interviews were used to gather information about psychiatric diagnoses, symptoms, and histories of suicidal thoughts and behaviors. Children also completed a guessing task, during which continuous electroencephalography (EEG) was recorded. The FN was scored as the mean amplitude, 275–375 ms, following gain or loss feedback at frontocentral sites (Fz and FCz). Children of suicide attempters exhibited significantly more negative ∆FN (i.e., FN to losses minus FN to gains) than children of parents with no SA history. We found that this difference in ∆FN was due specifically to children of parents with a history of SA exhibiting a stronger response to loss, and no group differences were observed for responses to gains. The results suggest that an increased neural response to loss might represent one of the potential pathways of the familial transmission of suicide risk

Ethnic differences in prevalence and correlates of self-harm behaviors in a treatment-seeking sample of emerging adults. Psychiatry research. 2014; 220 (3):927–34. doi: 10.1016/j.psychres.2014.09.017 PMID: WOS:000347361300029

a b s t r a c t The present study examined differences between White and ethnic minority emerging adults in the prevalence of self-harm behaviors -i.e., non-suicidal self-injury (NSSI) and suicide attempts (SA) -and in well-documented risk (i.e., depressive symptoms, generalized anxiety symptoms, social anxiety symptoms, suicidal ideation (SI), substance use, abuse history) and protective factors (i.e., religiosity/ spirituality, family support, friend support) associated with NSSI and SAs. Emerging adults (N ¼1156; 56% ethnic minority), ages 17-29 (M¼ 22.3, S.D.¼ 3.0), who were presented at a counseling center at a public university in the Northeastern U.S., completed a clinical interview and self-report symptom measures. Univariate and multivariate logistic regression models were used to examine the association between risk and protective factors in predicting history of NSSI-only, any SA, and no self-harm separately among White and ethnic minority individuals. Ethnic differences emerged in the prevalence and correlates of NSSI and SAs. Social anxiety was associated with SAs among White individuals but with NSSI among ethnic minority individuals. Substance use was a more relevant risk factor for White individuals, and friend support was a more relevant protective factor for ethnic minority individuals. These findings suggest differing vulnerabilities to NSSI and SAs between White and ethnic minority emerging adults

Protective Effects of Reasons for Living Against Suicidal Ideation in Daily Life

How do individuals resist suicidal urges in a crisis? Deterrents for suicide can be conceptualized as reasons for living (RFL), but our understanding of their protective effects is predominantly informed by cross-sectional research. We examined the protective effects of RFL on suicidal ideation (SI) in daily life in a high-risk sample. We also tested whether personality traits moderated the strength of the dynamic RFL-SI link. Adults with a borderline personality disorder diagnosis (N=153, n suicide attempters=105) completed a 21-day ambulatory assessment protocol. Daily endorsements of RFL were negatively linked to SI at the within-person but not the between-person level. Whereas suicide attempters endorsed RFL less frequently than non-attempters, the protective effect of RFL was undiminished in this group. Furthermore, RFL’s protective effect was particularly pronounced in those with higher average levels of suicidal ideation. While people high on openness and extraversion endorsed RFL more often, this increase was not protective against SI, indicating that RFL reflect heterogeneous underlying psychological processes, only some of which protect against SI