The Decision Neuroscience Perspective on Suicidal Behavior: Evidence and Hypotheses  

Oleh:

Dombrovski, Alexandre Y. ; Hallquist, Michael N.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Current Opinion in Psychiatry vol. 30 no. 01 (Jan. 2017), page 7-14.
Topik: Suicidal Behavior; Neuroscience Perspective

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Perpustakaan FK Nomor Panggil: C16.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Purpose of review: Suicide attempts are usually regretted by people who survive them. Furthermore, addiction and gambling are over-represented among people who attempt or die by suicide, raising the question whether their decision-making is impaired. Advances in decision neuroscience have enabled us to investigate decision processes in suicidal people and to elucidate putative neural substrates of disadvantageous decision-making. Recent findings: Early studies have linked attempted suicide to poor performance on gambling tasks. More recently, functional MRI augmented with a reinforcement learning computational model revealed that impaired decision-making in suicide attempters is paralleled by disrupted expected value (expected reward) signals in the ventromedial prefrontal cortex. Behavioral studies have linked increased delay discounting to low-lethality/poorly planned attempts, multiple attempts, and the co-occurrence of attempted suicide and addiction. This behavioral tendency may be related to altered integrity of the basal ganglia. By contrast, well-planned, serious suicide attempts were associated with intact/diminished delay discounting. One study has linked high-lethality suicide attempts and impaired social decision-making. Summary: This emerging literature supports the notion that various impairments in decision-making – often broadly related to impulsivity – may mark different pathways to suicide. We propose that aggressive and self-destructive responses to social stressors in people prone to suicide result from a predominance of automatic, Pavlovian processes over goal-directed computations.

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