Abstract
Although neurocognitive deficits have been documented in adolescents with suicidal ideation (SI) and suicide attempts (SA), it is unclear whether certain impairments differentiate these groups, potentially suggesting heightened risk for SA. Focus on specific facets of impulsivity and cognitive control may indicate distinctions between adolescents with SA vs. SI. The current study examined dimensions of impulsivity and cognitive control in 141 adolescents with SA (n = 41) vs. SI without SA (n = 49) vs. typically-developing controls (TDCs; n = 51). Adolescents completed cross-sectional neurocognitive tasks via the Cambridge Neuropsychological Testing Automated Battery, in addition to demographic and clinical measures. Analyses involved ANOVAs and ANCOVAs. Results indicated that adolescents with SA demonstrated less set shifting/cognitive flexibility (reduced ability to adapt to/disengage from stimuli) and greater impulsive decision making (reduced ability to collect/evaluate information before making decisions) compared to TDCs. In addition, both TDCs and adolescents with SA had greater response inhibition (increased ability to stop motor responses that have begun/become prepotent) than those with SI. Similar results were found when analyzing female adolescents separately. There were no significant differences for male adolescents, potentially due to the small subsample (n = 40). There were no significant findings for spatial planning/problem solving or visuospatial working memory. Findings suggest: 1) less set shifting/cognitive flexibility and greater impulsive decision making for adolescents with SA vs. TDCs; and 2) greater response inhibition for TDCs and adolescents with SA vs. SI. Such information may be useful for improving risk assessments (adding neurocognitive tasks) and targeted treatments (incorporating cognitive remediation) for this impaired population.
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We gratefully acknowledge and thank the adolescent participants and their families for their time and effort participating in this study, without which this research would not be possible.
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Primary funding for this research was from the National Institute of Mental Health grant R01MH097703 (PIs: Esposito-Smythers/Spirito). Additional funding sources included the National Institute of Mental Health grants R01MH110379 (PI: Dickstein), R01MH111542 (PI: Dickstein), and K24MH110402 (PI: Dickstein). The funders had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.
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MacPherson, H.A., Kim, K.L., Seymour, K.E. et al. Cognitive Flexibility and Impulsivity Deficits in Suicidal Adolescents. Res Child Adolesc Psychopathol 50, 1643–1656 (2022). https://doi.org/10.1007/s10802-022-00952-y
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DOI: https://doi.org/10.1007/s10802-022-00952-y