Identifying differences between depressed adolescent suicide ideators and attempters

Auerbach, Randy P.; Millner, Alexander J.; Stewart, Jeremy G.; Esposito, Erika C.

doi:10.1016/j.jad.2015.06.031

Cited by 117Suicide and Self-Harm StudiesAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeural and Behavioral Psychology Studies

Identifying differences between depressed adolescent suicide ideators and attempters

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Auerbach, Randy P., Millner, Alexander J., Stewart, Jeremy G., Esposito, Erika C.·2015·Journal of Affective Disorders

DOI 10.1016/j.jad.2015.06.031PMC PMC4565772

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Abstract

Background Adolescent depression and suicide are pressing public health concerns, and identifying key differences among suicide ideators and attempters is critical. The goal of the current study is to test whether depressed adolescent suicide attempters report greater anhedonia severity and exhibit aberrant effort-cost computations in the face of uncertainty.Methods Depressed adolescents (n=101) ages 13-19 years were administered structured clinical interviews to assess current mental health disorders and a history of suicidality (suicide ideators=55, suicide attempters=46). Then, participants completed self-report instruments assessing symptoms of suicidal ideation, depression, anhedonia, and anxiety as well as a computerized effort-cost computation task.Results Compared with depressed adolescent suicide ideators, attempters report greater anhedonia severity, even after concurrently controlling for symptoms of suicidal ideation, depression, and anxiety. Additionally, when completing the effort-cost computation task, suicide attempters are less likely to pursue the difficult, high value option when outcomes are uncertain. Follow-up, trial-level analyses of effort-cost computations suggest that receipt of reward does not influence future decision-making among suicide attempters, however, suicide ideators exhibit a win-stay approach when receiving rewards on previous trials.Limitations Findings should be considered in light of limitations including a modest sample size, which limits generalizability, and the cross-sectional design.Conclusions Depressed adolescent suicide attempters are characterized by greater anhedonia severity, which may impair the ability to integrate previous rewarding experiences to inform future decisions. Taken together, this may generate a feeling of powerlessness that contributes to increased suicidality and a needless loss of life.

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Depressed adolescent suicide attempters were more likely to demonstrate disrupted goal behavior, opting out of higher value but more effortful tasks in the face of uncertainty.
“Auerbach et al. (2015) compared depressed adolescent suicide ideators and attempters. Attempters were more likely to demonstrate disrupted goal behavior, opting out of higher value but more effortful tasks in the face of uncertainty.”
From A hope intervention for adolescents: a randomized controlled trial delivered by paraprofessionals (2025) · cites this paper as Auerbach et al., 2015

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Authors: Auerbach, R. P., Millner, A. J., Stewart, J. G., & Esposito, E. C.
Affiliations: Harvard University (US)
Corresponding author: Auerbach, Randy P.
ORCID: Auerbach, Randy P.
Millner, Alexander J.
Stewart, Jeremy G.
Esposito, Erika C.
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2015-11
Volume: 186
Pages: 127-133
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/j.jad.2015.06.031
PMC: PMC4565772
OpenAlex: W1780023465
Cited by: 117
References: 39
Citations by year: 2026: 4 · 2025: 12 · 2024: 9 · 2023: 6 · 2022: 13 · 2021: 17 · 2020: 10 · 2019: 16 · 2018: 8 · 2017: 8 · 2016: 14
FWCI: 12.40
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: McLean Hospital
Centers for Disease Control and Prevention
National Institute of Mental Health (K23MH097786)
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords: adolescent depression, suicidal ideation, suicide attempters, anhedonia, decision making under uncertainty, reward processing, powerlessness, suicidality
MeSH terms: Adolescent, Adolescent Behavior, Anxiety, Choice Behavior, Cross-Sectional Studies, Depression, Female, Humans, Male, Reward, Suicide, Attempted, Uncertainty, Young Adult, Suicidal Ideation, Anhedonia

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Identifying differences between depressed adolescent suicide ideators and attempters

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