Cited by 91Suicide and Self-Harm StudiesNeural and Behavioral Psychology StudiesDecision-Making and Behavioral Economics

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The decision neuroscience perspective on suicidal behavior: evidence and hypotheses

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Dombrovski, Alexandre Y., Hallquist, Michael N.·2017·Current Opinion in Psychiatry

Abstract

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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Metadata

Authors
Dombrovski, A. Y., & Hallquist, M. N.
Affiliations
Pennsylvania State University (US)
Corresponding author
Dombrovski, Alexandre Y.
Venue
Current Opinion in Psychiatry
Published
2017-01
Volume
30
Issue
1
Pages
7-14
ISSN
0951-7367 (ISSN-L)
OpenAlex
W2553902797
Cited by
91
References
82
Citations by year
2026: 2 · 2025: 14 · 2024: 12 · 2023: 12 · 2022: 9 · 2021: 11 · 2020: 10 · 2019: 11 · 2018: 7 · 2017: 3
FWCI
1.04
Type
journal article
Language
en
Open access
Locations
  • Current Opinion in Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Institute of Mental Health (R01MH100095, K01MH097091, K23MH086620, R03MH090791, R01MH124092, R01MH085651)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
Keywords
suicidal behavior, suicide attempts, decision-making impairment, impulsivity, delay discounting, gambling behavior, addiction, ventromedial prefrontal cortex, basal ganglia, social decision-making, reinforcement learning
MeSH terms
Decision Making, Humans, Suicide, Attempted

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