Do neurocognitive abilities distinguish suicide attempters from suicide ideators? A systematic review of an emerging research area

Abstract

Recent findings suggest that neurocognitive deficits may hasten progression from suicidal thoughts to behavior. To test this proposition, we examined whether neurocognitive deficits distinguish individuals who have attempted suicide (attempters) from those who have considered suicide but never attempted (ideators).A comprehensive literature search yielded 14 studies comparing attempters to ideators on a range of neurocognitive abilities. In general, attempters and ideators scored comparably across neurocognitive abilities (median Hedges' g = À.18). An exception was a moderate difference for inhibition and decision making (median Hedges' g = À.50 and g = À.49, respectively). Results suggest that some neurocognitive abilities might help explain the transition from suicidal thoughts to suicide attempts. However, findings are regarded as suggestive, given the small number of studies, few cross-study examinations of neurocognitive domains, and variability in sample characteristics. Recommendations for future research are included. K E Y W O R D Sneurocognitive abilities, neurocognitive functioning, suicide, suicide prevention, suicide risk ---

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“…As noted by Saffer and Klonsky (2018), deficits in executive functioning are common in violent, homicidal populations, and these findings raise the question of whether these associations are specific to suicidal behavior or to violent behavior more generally. As noted above, studies of Iowa Gambling Task (IGT) performance have found that this effect is most pronounced among those who make more violent attempts.…”

“…As noted by Saffer and Klonsky (2018) in their citation of recent metaanalyses, 50 years of empirical research on psychopathological risk factors for suicidal thinking and suicidal behavior has given us a better sense of the origins of suicidal thinking, but not of the ultimate precipitants of actual suicidal acts. As noted by Saffer and Klonsky (2018) in their citation of recent metaanalyses, 50 years of empirical research on psychopathological risk factors for suicidal thinking and suicidal behavior has given us a better sense of the origins of suicidal thinking, but not of the ultimate precipitants of actual suicidal acts.…”

“…Only 14 of the 159 articles found by Saffer and Klonsky (2018) that used neurocognitive measures to assess suicide attempters involved a comparison of attempters versus ideators. Only 14 of the 159 articles found by Saffer and Klonsky (2018) that used neurocognitive measures to assess suicide attempters involved a comparison of attempters versus ideators.…”

“…As noted by Saffer and Klonsky (2018), demographic and clinical features of various research samples, particularly across the lifespan, given that age alone has profound effects on neurocognition, can have a marked effect on the nature of results obtained. As noted by Saffer and Klonsky (2018), demographic and clinical features of various research samples, particularly across the lifespan, given that age alone has profound effects on neurocognition, can have a marked effect on the nature of results obtained.…”

“…Saffer and Klonsky (2018) correctly point out that future studies of neurocognition in suicidal behavior should gravitate to widely accepted measures of those functions with the greatest empirical support, and their review provides direction in this endeavor. "Disinhibition" or "poor decision making" is a relatively simple concept on the surface but must be carefully operationalized to be both clinically useful as well as to guide research into underlying neurobiology and functional neuroanatomy.…”