Impaired Decision Making in Suicide Attempters

Jollant, Fabrice; Bellivier, Frank; Leboyer, Marion; Astruc, Bernard; Torres, Stéphane; Verdier, Raymond; Castelnau, D.; Malafosse, Alain; Courtet, Philippe

doi:10.1176/appi.ajp.162.2.304

Cited by 475 publications

(373 citation statements)

References 45 publications

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“…However, Jollant authored two studies that were unable to provide supportive evidence, but which did not meet inclusion criteria. In his 2005 non-imaging study, there was no significant correlation in secondary analysis between the number of suicide attempts and performance on the IGT (Jollant et al, 2005). There was also no correlation between adults who showed risky decision-making and activation in the lateral orbitofrontal cortex, and the number of previous self-harm episodes in a later fMRI study (Jollant et al, 2010).…”

Section: Value-based Decision-makingmentioning

confidence: 94%

“…The factors identified include risky decisionmaking (Clark et al, 2011;Jollant et al, 2005;Jollant et al, 2010;Oldershaw et al, 2009;Richard-Devantoy et al, 2014a), weak problem solving abilities (D'Zurilla et al, 1998;Pollock and Williams, 2004), deficient cognitive inhibition and high sensitivity to interference (Keilp et al, 2014;Richard-Devantoy et al, 2014a;Richard-Devantoy et al, 2012), memory problems (Richard-Devantoy et al, 2015), and altered implicit processing and explicit recognition of emotional signals (Jollant et al, 2008b;Pan et al, 2013;Richard-Devantoy et al, 2013a). While these observations may be important to understand the mechanisms underlying complex behaviours, it is uncertain if we can use assessment of these factors in an individual to predict the risk of future self-harm.…”

Section: Can We Use Neurocognition To Predict Repetition Of Self-harm?mentioning

confidence: 99%

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Are neurocognitive factors associated with repetition of self-harm? A systematic review

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Rees

Jollant

et al. 2017

Neuroscience & Biobehavioral Reviews

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Background:Prediction of self-harm is limited clinically. Early identification of individuals likely to repeat self-harm could improve outcomes and reduce suicide risk. Various neurocognitive deficits have been found in people who self-harm, but the ability of these to predict repetition has yet to be established Aims:Identify neurocognitive factors that may predict repetition of self-harm. Methods:Systematic narrative review of English language publications assessing neurocognitive functioning and self-harm repetition, searching multiple databases from inception to March 2015. Quality of studies was appraised. A narrative synthesis was performed. Results:7026 unique records were identified, and 169 full-texts assessed. 15 unique studies provided data. No imaging studies could be included. Most studies assessed cognitive control or problem solving, but neither factor was consistently associated with repetition. However, specific tasks may show promise. Two studies in adolescents suggest that value-based decision-making impairments could be predictive of repetition. There were too few results for memory to draw specific conclusions. Conclusions:Selected studies suggest promise for particular neurocognitive factors and specific cognitive tasks in terms of repetition of self-harm.

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Section: Value-based Decision-makingmentioning

confidence: 94%

Section: Can We Use Neurocognition To Predict Repetition Of Self-harm?mentioning

confidence: 99%

Are neurocognitive factors associated with repetition of self-harm? A systematic review

Cates

Rees

Jollant

et al. 2017

Neuroscience & Biobehavioral Reviews

Self Cite

View full text Add to dashboard Cite

show abstract

“…Specifically, adult male suicide attempters showed greater activity in the right lateral orbitofrontal cortex and decreased activity in the right superior frontal gyrus to intense angry vs neutral faces relative to healthy and depressed non-attempter controls. In addition, cognitive inflexibility (inability to change strategy) is well documented in studies of adult patients with a history of suicide attempt (Jollant et al, 2005). However, few studies have explored the neural circuitry underlying adolescent suicidal behavior.…”

Section: Funding and Disclosurementioning

confidence: 99%

Toward Identification of Neural Markers of Suicide Risk in Adolescents

Pan

Phillips

2013

Neuropsychopharmacol

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“…Decision making has been a research target in substance and alcohol misuse disorders (Bechara et al, 2001;Ersche et al, 2008;Rogers et al, 1999b;Rogers and Robbins, 2001), unipolar depression and bipolar disorder (Chandler et al, 2009;Murphy et al, 2001), suicidaility (Dombrovski et al, 2010;Jollant et al, 2005), and impulsive personality disorders (Bazanis et al, 2002;Kirkpatrick et al, 2007). Adjunctive work has explored the idea that impairments in decision making can serve as markers for likely relapse (Adinoff et al, 2007;Bechara et al, 2001) and facilitate the exploration of therapeutic interventions (Rahman et al, 2006;Robbins and Arnsten, 2009).…”

Section: Introductionmentioning

confidence: 99%

The Roles of Dopamine and Serotonin in Decision Making: Evidence from Pharmacological Experiments in Humans

Rogers

2010

Neuropsychopharmacol

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Neurophysiological experiments in primates, alongside neuropsychological and functional magnetic resonance investigations in humans, have significantly enhanced our understanding of the neural architecture of decision making. In this review, I consider the more limited database of experiments that have investigated how dopamine and serotonin activity influences the choices of human adults. These include those experiments that have involved the administration of drugs to healthy controls, experiments that have tested genotypic influences upon dopamine and serotonin function, and, finally, some of those experiments that have examined the effects of drugs on the decision making of clinical samples. Pharmacological experiments in humans are few in number and face considerable methodological challenges in terms of drug specificity, uncertainties about pre-vs post-synaptic modes of action, and interactions with baseline cognitive performance. However, the available data are broadly consistent with current computational models of dopamine function in decision making and highlight the dissociable roles of dopamine receptor systems in the learning about outcomes that underpins value-based decision making. Moreover, genotypic influences on (interacting) prefrontal and striatal dopamine activity are associated with changes in choice behavior that might be relevant to understanding exploratory behaviors and vulnerability to addictive disorders. Manipulations of serotonin in laboratory tests of decision making in human participants have provided less consistent results, but the information gathered to date indicates a role for serotonin in learning about bad decision outcomes, non-normative aspects of risk-seeking behavior, and social choices involving affiliation and notions of fairness. Finally, I suggest that the role played by serotonin in the regulation of cognitive biases, and representation of context in learning, point toward a role in the cortically mediated cognitive appraisal of reinforcers when selecting between actions, potentially accounting for its influence upon the processing salient aversive outcomes and social choice.

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Impaired Decision Making in Suicide Attempters

Abstract: Impaired decision making, possibly due to emotional dysfunction, may be a neuropsychological risk factor for suicidal behavior.

Cited by 475 publications

References 45 publications

Are neurocognitive factors associated with repetition of self-harm? A systematic review

Are neurocognitive factors associated with repetition of self-harm? A systematic review

Toward Identification of Neural Markers of Suicide Risk in Adolescents

The Roles of Dopamine and Serotonin in Decision Making: Evidence from Pharmacological Experiments in Humans

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