Impaired decision-making in suicide attempters may increase the risk of problems in affective relationships

Abstract

Background Decision-making has been found to be altered in suicide attempters and may represent a neuropsychological trait of vulnerability to suicidal behaviour. Environmental stressors such as adverse life events and interpersonal problems have been demonstrated to precipitate suicidal acts in vulnerable people. However, the link between vulnerability and stressors is complex and may even be circular. In the present study, we hypothesized that impaired decision-making may be associated with an increased risk of negative life events in suicide attempters. Methods Forty-eight patients with a history of attempted suicide were assessed with the Iowa Gambling Task and interviewed regarding life events experienced over the past 12 months. Results Decision-making performance was negatively correlated with interpersonal difficulties in the affective – namely marital and family – domain (rs = − 0.39, p = 0.006) but not with interpersonal difficulties in other social contexts, stressful life events or somatic health problems. Limitations The relatively small sample size and the use of non-parametric methods may lead to a risk of type II errors. Furthermore, data on life events were retrospectively collected. Conclusions Altered decision-making may increase the risk of problematic affective relationships. These results underline the complex and possibly reciprocal link between environmental stress factors and cognitive vulnerability traits. This could be useful for the design of intervention strategies for suicidal behaviour.