Cognitive Control in Suicide Ideators and Suicide Attempters.

Silje Støle Brokke,Nils Inge Landrø,Vegard Øksendal Haaland

doi:10.3389/fpsyg.2020.595673

Silje Støle Brokke, Nils Inge Landrø + Show 1 more

Open Access

https://doi.org/10.3389/fpsyg.2020.595673

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Abstract

There is a need to understand more of the risk factors involved in the process from suicide ideation to suicide attempt. Cognitive control processes may be important factors in assessing vulnerability to suicide. A version of the Stroop procedure, Delis–Kaplan Executive Function System (D-KEFS) Color–Word Interference Test (CWIT) and Behavior Rating Inventory of Executive Function (BRIEF-A) were used in this study to test attention control and cognitive shift, as well as to assess everyday executive function of 98 acute suicidal psychiatric patients. The Columbia Suicide History Form (CSHF) was used to identify a group of suicide ideators and suicide attempters. Results showed that suicide attempters scored lower on attention control than suicide ideators who had no history of attempted suicide. The self-report in the BRIEF-A inventory did not reflect any cognitive differences between suicide ideators and suicide attempters. A logistic regression analysis showed that a poorer attention control score was associated with the suicide attempt group, whereas a poorer cognitive shift score was associated with the suicide ideation group. The results found in this study suggest that suicide attempters may struggle with control of attention or inhibiting competing responses but not with cognitive flexibility.

Highlights

Suicide is a worldwide growing public health problem (Bertolote and Fleischmann, 2015)
The study found that suicide attempters needed more time and made more errors in an original Stroop condition in comparison to non-depressed participants, but no difference was found between the patient groups. These results suggest that patients with suicide attempt can struggle with attention control as measured by the Stroop condition and score higher on cognitive shift as measured by Behavior Rating Inventory of Executive Function (BRIEF) than non-depressed individuals (Loyo et al, 2013)
The participants included in the analysis for this specific paper were patients with suicide ideation and no suicide attempt, and suicide attempters who all had completed a set of different cognitive tests (N = 98)

Summary

Introduction

Suicide is a worldwide growing public health problem (Bertolote and Fleischmann, 2015). It is difficult to explain exactly why some people choose to end their life, but suicide can best be understood as a multicausal act (Shermer, 2018). William’s Cry of Pain model explains suicidal behavior as a response to a stressful situation that creates feelings of defeat and is judged to be both inescapable and having no chance of rescue (Williams, 2014). Suicidal behavior has different levels of severity. Definitions of the behavior range from deliberate self-harm to completed suicide (Turecki and Brent, 2016). It can be difficult to assess the intent of self-harm behaviors and an ambivalence toward life or death. Clinicians often try to understand the relevance and severity of different risk factors, the severity of suicidal ideation, and the intention to attempt suicide (Bryan and Rudd, 2006)

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