Delayed reward discounting and increased risk for suicide attempts among U.S. adults with probable PTSD
Abstract
Background PTSD is an established risk factor for suicide attempts and suicide death, but the mechanisms underlying this association remain unknown. The present study examined associations among delayed reward discounting-the balance between smaller immediate available rewards versus larger delayed rewards-self-reported PTSD symptoms, and recent suicide attempts among individuals reporting suicide ideation within the past year.Methods A cross-sectional survey of U.S. adults completed the Primary Care PTSD Screen for DSM-5, the 21-item Monetary Choice Questionnaire, and the Self-Injurious Thoughts and Behaviors Interview-Revised. Analyses of variance and multinomial regression models were used to test associations among variables.Results Among participants reporting suicide ideation within the past year, discount rates were significantly higher among those reporting more PTSD symptoms and a past-year suicide attempt, suggesting these participants expressed a preference for immediately available rewards.Conclusions Choice behavior among individuals reporting many PTSD symptoms and a recent suicide attempt is influenced to a greater degree by immediately available rewards. Sensitivity to immediate rewards at the expense of larger delayed rewards may reflect a vulnerability for suicidal behavior among individuals screening positive for PTSD.
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Prior suicide attempts are linked to high delay discounting.
“Prior suicide attempts linked to high delay discounting ( Bryan & Bryan, 2021 ; Dombrovski et al., 2011 ; Liu et al., 2012 ; Mathias et al., 2011 ), with exceptions (e.g., Bridge et al., 2015 ).”
From Toward objective characterizations of suicide risk: A narrative review of laboratory-based cognitive and behavioral tasks (2023) · cites this paper as Bryan & Bryan, 2021
High delay discounting has been associated with prior suicide attempts in several studies, with some exceptions.
“High delay discounting has been associated with prior suicide attempts in several studies (Bryan & Bryan, 2021; Dombrovski et al., 2011; Liu et al., 2012; Mathias et al., 2011), with some exceptions (e.g., Bridge et al., 2015).”
From Toward objective characterizations of suicide risk: A narrative review of laboratory-based cognitive and behavioral tasks (2023) · cites this paper as Bryan & Bryan, 2021
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
The interpersonal theory of suicide.
Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010) · Psychological Review · doi:10.1037/a0018697 · Cited by 5,292 · see citing works
The Three-Step Theory (3ST): A New Theory of Suicide Rooted in the “Ideation-to-Action” Framework
Klonsky, E. D., & May, A. M. (2015) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2015.8.2.114 · Cited by 1,799 · see citing works
The integrated motivational–volitional model of suicidal behaviour
O'Connor, R. C., & Kirtley, O. J. (2018) · Philosophical Transactions of the Royal Society B: Biological Sciences · doi:10.1098/rstb.2017.0268 · Cited by 1,559 · see citing works
Prins, A., Bovin, M. J., Smolenski, D. J., Marx, B. P., Kimerling, R., Jenkins-Guarnieri, M. A., Kaloupek, D. G., Schnurr, P. P., Kaiser, A. P., Leyva, Y. E., et al. (2016) · Journal of General Internal Medicine · doi:10.1007/s11606-016-3703-5 · Cited by 1,303 · see citing works
A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse
Paolucci, E. O., Genuis, M. L., & Violato, C. (2001) · The Journal of Psychology · doi:10.1080/00223980109603677 · Cited by 1,144 · see citing works
Delay-discounting probabilistic rewards: Rates decrease as amounts increase
Kirby, K. N., & Maraković, N. N. (1996) · Psychonomic Bulletin & Review · doi:10.3758/bf03210748 · Cited by 916 · see citing works
Manea, L., Gilbody, S., & McMillan, D. (2015) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2014.09.009 · Cited by 795 · see citing works
What distinguishes suicide attempters from suicide ideators? A meta-analysis of potential factors.
May, A. M., & Klonsky, E. D. (2016) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12136 · Cited by 459 · see citing works
Rudd, M. D., Bryan, C. J., Wertenberger, E. G., Peterson, A. L., Young-McCaughan, S., Mintz, J., Williams, S. R., Arne, K. A., Breitbach, J., Delano, K., et al. (2015) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2014.14070843 · Cited by 384 · see citing works
Self-citationSingle-item measurement of suicidal behaviors: Validity and consequences of misclassification
Millner, A. J., Lee, M. D., & Nock, M. K. (2015) · PLOS ONE · doi:10.1371/journal.pone.0141606 · Cited by 361 · see citing works
Posttraumatic Stress Disorder and Completed Suicide
Gradus, J. L., Qin, P., Lincoln, A. K., Miller, M., Lawler, E. V., Sørensen, H. T., & Lash, T. L. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwp456 · Cited by 315 · see citing works
Panagioti, M., Gooding, P. A., & Tarrier, N. (2012) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2012.02.009 · Cited by 280 · see citing works
Self-Injurious Thoughts and Behaviors Interview—Revised: Development, reliability, and validity.
Fox, K. R., Harris, J. A., Wang, S. B., Millner, A. J., Deming, C. A., & Nock, M. K. (2020) · Psychological Assessment · doi:10.1037/pas0000819 · Cited by 249 · see citing works
Automating Scoring of Delay Discounting for the 21- and 27-Item Monetary Choice Questionnaires
Kaplan, B. A., Amlung, M. T., Reed, D. D., Jarmolowicz, D. P., McKerchar, T. L., & Lemley, S. M. (2016) · The Behavior Analyst · doi:10.1007/s40614-016-0070-9 · Cited by 218 · see citing works
Suicide risk in civilian PTSD patients: Predictors of suicidal ideation, planning and attempts
Tarrier, N., & Gregg, L. (2004) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-004-0799-4 · Cited by 213 · see citing works
Dombrovski, A. Y., Siegle, G. J., Szántó, K., Clark, L., Reynolds, C. F., & Aizenstein, H. J. (2011) · Psychological Medicine · doi:10.1017/s0033291711002133 · Cited by 206 · see citing works
GUILT, SHAME, AND SUICIDAL IDEATION IN A MILITARY OUTPATIENT CLINICAL SAMPLE
Bryan, C. J., Morrow, C. E., Etienne, N., & Ray-Sannerud, B. N. (2012) · Depression and Anxiety · doi:10.1002/da.22002 · Cited by 204 · see citing works
Self-citationDombrovski, A. Y., Szanto, K., Siegle, G. J., Wallace, M. L., Forman, S. D., Sahakian, B., Reynolds, C. F., & Clark, L. (2011) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.12.025 · Cited by 198 · see citing works
Guerra, V. S., & Calhoun, P. S. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.06.025 · Cited by 179 · see citing works
Delay discounting: Concepts and measures.
da Matta, A., Gonçalves, F. L., & Bizarro, L. (2012) · Psychology & Neuroscience · doi:10.3922/j.psns.2012.2.03 · Cited by 138 · see citing works
TREATMENT OF POSTTRAUMATIC STRESS DISORDER REDUCES SUICIDAL IDEATION
Gradus, J., Suvak, M. K., Wisco, B. E., Marx, B. P., & Resick, P. A. (2013) · Depression and Anxiety · doi:10.1002/da.22117 · Cited by 124 · see citing works
Bell, J. B., & Nye, E. C. (2007) · Military Medicine · doi:10.7205/milmed.172.11.1144 · Cited by 122 · see citing works
Comparison between two measures of delay discounting in smokers.
Epstein, L. H., Richards, J. B., Saad, F. G., Paluch, R. A., Roemmich, J. N., & Lerman, C. E. (2003) · Experimental and Clinical Psychopharmacology · doi:10.1037/1064-1297.11.2.131 · Cited by 118 · see citing works
Panagioti, M., Gooding, P. A., Triantafyllou, K., & Tarrier, N. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0978-x · Cited by 116 · see citing works
Tradeoffs among delay, rate, and amount of reinforcement
Mazur, J. (2000) · Behavioural Processes · doi:10.1016/s0376-6357(00)00070-x · Cited by 109 · see citing works
Reasons for suicide attempts in a clinical sample of active duty soldiers
Bryan, C. J., Rudd, M. D., & Wertenberger, E. G. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.06.030 · Cited by 81 · see citing works
Self-citationBryan, C. J., Clemans, T. A., Hernandez, A. M., Mintz, J., Peterson, A. L., Yarvis, J. S., & Resick, P. A. (2015) · Depression and Anxiety · doi:10.1002/da.22456 · Cited by 79 · see citing works
Self-citationThe Integrated Motivational‐Volitional Model of Suicidal Behavior
O’Connor, R. C., Cleare, S., Eschle, S., Wetherall, K., & Kirtley, O. J. (2016) · doi:10.1002/9781118903223.ch13 · Cited by 66 · see citing works
Nijdam, M. J., Martens, I. J. M., Reitsma, J. B., Gersons, B. P. R., & Olff, M. (2018) · British Journal of Clinical Psychology · doi:10.1111/bjc.12183 · Cited by 60 · see citing works
Sinyor, M., Williams, M., Mitchell, R. H. B., Zaheer, R., Bryan, C. J., Schaffer, A., Westreich, N., Ellis, J., Goldstein, B. I., Cheung, A., et al. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.178 · Cited by 54 · see citing works
Self-citationBryan, C. J., Roberge, E. M., Bryan, A. O., Ray-Sannerud, B. N., Morrow, C. E., & Etienne, N. (2015) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2015.8.2.143 · Cited by 47 · see citing works
Self-citationSimon, N. M., Hoeppner, S. S., Lubin, R. E., Robinaugh, D. J., Malgaroli, M., Norman, S. B., Acierno, R., Goetter, E. M., Hellberg, S. N., Charney, M. E., et al. (2020) · Depression and Anxiety · doi:10.1002/da.22911 · Cited by 42 · see citing works
Reduced Salience and Enhanced Central Executive Connectivity Following PTSD Treatment
Abdallah, C. G., Averill, C. L., Ramage, A. E., Averill, L. A., Alkin, E., Nemati, S., Krystal, J. H., Roache, J. D., Resick, P. A., Young‐McCaughan, S., et al. (2019) · Chronic Stress · doi:10.1177/2470547019838971 · Cited by 40 · see citing works
Does prolonged exposure increase suicide risk? Results from an active duty military sample
Brown, L. A., McLean, C. P., Zang, Y., Zandberg, L. J., Mintz, J., Yarvis, J. S., Litz, B. T., Peterson, A. L., Bryan, C. J., Fina, B. A., et al. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.04.003 · Cited by 39 · see citing works
Self-citationRugo, K. F., Tabares, J. V., Crowell, S. E., Baucom, B. R. W., Rudd, M., & Bryan, C. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.095 · Cited by 20 · see citing works
Self-citationBryan, C. J., Rudd, M. D., & Wertenberger, E. G. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.05.028 · Cited by 18 · see citing works
Self-citationBryan, C. J., May, A. M., & Harris, J. A. (2018) · Psychological Services · doi:10.1037/ser0000234 · Cited by 15 · see citing works
Self-citation
Flagged first, then by citations
1 of the 39 references couldn’t be matched to a known paper.
Cited by
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Auerbach, R. P., Pagliaccio, D., & Kirshenbaum, J. S. (2022) · Current topics in behavioral neurosciences · doi:10.1007/7854_2022_358 · Cited by 47 · see citing works
Wang, X., Xia, Y. X., Yan, R., Wang, H., Sun, H., Huang, Y., Hua, L., Tang, H., Yao, Z., & Lü, Q. (2023) · NeuroImage Clinical · doi:10.1016/j.nicl.2023.103512 · Cited by 32 · see citing works
Bettis, A. H., Benningfield, M. M., Dao, A., Dickey, L., Pegg, S. L., Venanzi, L., & Kujawa, A. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.10.033 · Cited by 26 · see citing works
Öz, İ. T., & Cona, G. (2024) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70008 · Cited by 26 · see citing works
BIS sensitivity, BAS sensitivity, and recent suicide attempts
Bryan, C. J., Kyron, M. J., & Page, A. C. (2022) · Personality and Individual Differences · doi:10.1016/j.paid.2022.111552 · Cited by 13 · see citing works
Self-citationPosttraumatic stress and delay discounting: a meta-analytic review
Bird, B. M., Levitt, E. E., Stewart, S. H., Wanklyn, S. G., Meyer, E. C., Murphy, J. G., McDevitt‐Murphy, M. E., & MacKillop, J. M. (2023) · Psychological Medicine · doi:10.1017/s0033291723003069 · Cited by 12 · see citing works
Brown, J. M., Sofis, M. J., Zimmer, S., & Kaplan, B. A. (2024) · Addictive Behaviors Reports · doi:10.1016/j.abrep.2024.100545 · Cited by 12 · see citing works
Lamontagne, S. J., Zabala, P. K., Zarate, C. A., & Ballard, E. D. (2023) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105361 · Cited by 12 · see citing works
A multinational analysis of how emotions relate to economic decisions regarding time or risk
Pertl, S. M., Srirangarajan, T., & Urminsky, O. (2024) · Nature Human Behaviour · doi:10.1038/s41562-024-01927-3 · Cited by 12 · see citing works
Review: Suicide and its relationship to aggression and impulsivity
Lee, Y., Gilbert, J. R., Waldman, L. R., Zarate, C. A., & Ballard, E. D. (2025) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-025-01321-0 · Cited by 14 · see citing works
Imagining emotional future events in PTSD: clinical and neurocognitive correlates
Verfaellie, M. H., Patt, V. M., Lafleche, G., Hunsberger, R., & Vasterling, J. J. (2023) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-023-01121-4 · Cited by 11 · see citing works
Positive valence system function and anhedonia in middle-aged and older adults at high suicide risk
Bress, J. N., Arslanoglou, E., Banerjee, S., Alexopoulos, G. S., & Kiosses, D. N. (2023) · Biological Psychology · doi:10.1016/j.biopsycho.2023.108647 · Cited by 6 · see citing works
Fang, Y., Tan, X., Du, Q., Ren, Y., Mai, Y., Jiang, T., & Zhao, J. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.10.011 · Cited by 5 · see citing works
McManimen, S. L., Hay, J. M., Long, C. M., Bryan, C. J., & Aase, D. M. (2024) · Stress and Health · doi:10.1002/smi.3370 · Cited by 4 · see citing works
Self-citationWang, H., Xu, S., Aku, Y., Ren, Z., & Chen, R. (2024) · Research Square · doi:10.21203/rs.3.rs-4127644/v1 · Cited by 3 · see citing works
Chen, T.-H., Chen, Y.-J., Huang, T.-S., Hsiao, M., Lin, C.-C., & Liu, Y. (2021) · The Chinese Journal of Physiology · doi:10.4103/cjp.cjp_63_21 · Cited by 2 · see citing works
Associations between PTSD and temporal discounting: The role of future thinking
Verfaellie, M. H., Patt, V. M., Lafleche, G., & Vasterling, J. J. (2024) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2024.101978 · Cited by 3 · see citing works
Lempert, K. M., Huber, B., Batistuzzo, M., Sheshachala, K., Hezel, D. M., de Joode, N. D., Marincowitz, C., Lochner, C., Stein, D., Narayanaswamy, J., et al. (2024) · Clinical psychological science : a journal of the Association for Psychological Science · doi:10.1177/21677026241289927 · Cited by 3 · see citing works
Gilroy, S. P., Tucker, R. P., Hill, R. M., Anestis, M. D., Bryan, C. J., & Bauer, B. W. (2024) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.13149 · Cited by 2 · see citing works
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Machine Learning Prediction of First Suicide Attempts in Early Adolescence Among Child Ideators
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- Authors
- Bryan, C. J., & Bryan, A. O.
- Affiliations
- The Ohio State University Wexner Medical Center (US)
- Corresponding author
- Bryan, Craig J.
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2021-06
- Volume
- 81
- Pages
- 102414
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W3157080114
- Cited by
- 38
- References
- 39
- Citations by year
- 2026: 3 · 2025: 15 · 2024: 10 · 2023: 5 · 2022: 4 · 2021: 1
- FWCI
- 3.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Keywords
- post-traumatic stress disorder, delay discounting, suicide attempts, suicidal ideation, impulsivity, self-harm, monetary choice
- MeSH terms
- Adult, Cross-Sectional Studies, Humans, Reward, Stress Disorders, Post-Traumatic, Suicide, Attempted, Suicidal Ideation
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