Neurocognition and Suicide Risk in Adults

Abstract

Neurocognitive deficits (impaired mental abilities corresponding to brain dysfunction) are transdiagnostic features of psychiatric illness, which account for the vast majority of suicide deaths. Here, we provide a selective empirical overview of neurocognitive factors and associated pathophysiology implicated in adult suicide. The present report draws primarily from the neuropsychology literature to complement and update prior reviews and meta-analyses. Suicidality is linked to impairment across neurocognitive domains, particularly inhibition and decision-making components of executive functioning (EF). Extant research has primarily examined “cool” EF in suicide, yet there is strong preliminary evidence for the importance of “hot” EF involved in affect regulation and value-based decision-making. Our review accordingly integrates what is known about neurocognition and suicidality under a conceptual framework informed by this literature and prior theory. We specifically propose that hot EF deficits represent a common pathway to suicide from various distal risk factors.