Deterministic learning and attempted suicide among older depressed individuals: Cognitive assessment using the Wisconsin Card Sorting Task
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Background Late-life suicide is an under-investigated public health problem. Among the putative vulnerabilities for this complex multifactorial behaviour are deficits in cognitive control, an ability to integrate and prioritize multiple cognitive processes in order to flexibly adapt behaviour and meet situational demands. We investigated cognitive control during rule learning in a complex and changing environment in older individuals with suicide attempts of varying lethality.Method Ninety-three participants over the age of 60 (30 healthy controls, 29 depressed never suicidal, 20 low-lethality suicide attempters, 14 high-lethality suicide attempters) underwent structured clinical and cognitive assessments. Participants then completed the Wisconsin Card Sorting Test (WCST), a well-studied task of cognitive control during rule learning.Results High-lethality attempters demonstrated a pattern of deficits involving poor conceptual reasoning, perseverative errors and total errors. Compared to low-lethality attempters and healthy controls, high-lethality attempters demonstrated poor conceptual reasoning, as well as increased rates of perseverative errors and total errors. Compared to non-suicidal depressed participants, high-lethality attempters also made more conceptual errors.Conclusion High-lethality suicide attempts among older people are associated with impaired cognitive control during rule learning as detected by the WCST. Our data suggest that impairment in cognitive control during rule learning may represent a vulnerability distinct from the impulsive diathesis, typically manifesting in young, low-lethality attempters. This vulnerability may contribute to the high incidence of serious or, often, fatal suicidal acts in old age.
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Suicide attempters have impaired deterministic learning in complex unambiguous environments.
“- Suicide attempters exhibit less language fluency and learning (38) and impaired deterministic learning in the context of complex unambiguous environments (39).”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [39]
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- Authors
- McGirr, A., Dombrovski, A. Y., Butters, M. A., Clark, L., & Szanto, K.
- Affiliations
- University of Toronto (CA)
- University of Pittsburgh (US)
- University of Cambridge (GB)
- Corresponding author
- Dombrovski, Alexandre Y.
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2012-02
- Volume
- 46
- Issue
- 2
- Pages
- 226-232
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC3326354
- OpenAlex
- W2090435772
- Cited by
- 127
- References
- 35
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 7 · 2022: 6 · 2021: 11 · 2020: 19 · 2019: 6 · 2018: 24 · 2017: 9 · 2016: 6 · 2015: 9 · 2014: 13 · 2013: 6 · 2012: 3
- FWCI
- 7.94
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000005)
- National Institute of Mental Health (MH 05436, K23MH086620, K23MH070471, R01MH085651)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- late-life suicide, suicide attempts, older adults, depression, cognitive control, rule induction, Wisconsin Card Sorting Test, conceptual reasoning, perseverative errors, lethality, cognitive vulnerability
- MeSH terms
- Aged, Aged, 80 and over, Cognition Disorders, Depression, Female, Humans, Learning Disabilities, Male, Middle Aged, Neuropsychological Tests, Problem Solving, Psychiatric Status Rating Scales, Reinforcement, Psychology, Suicide, Attempted, Statistics, Nonparametric
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