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

DOI 10.1097/yco.0000000000000297PMC PMC5291285

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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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Authors: Dombrovski, A. Y., & Hallquist, M. N.
Affiliations: Pennsylvania State University (US)
Corresponding author: Dombrovski, Alexandre Y.
ORCID: Dombrovski, Alexandre Y.
Hallquist, Michael N.
Venue: Current Opinion in Psychiatry
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2017-01
Volume: 30
Issue: 1
Pages: 7-14
ISSN: 0951-7367 (ISSN-L)
DOI: 10.1097/yco.0000000000000297
PMC: PMC5291285
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: green
www.ncbi.nlm.nih.gov
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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The decision neuroscience perspective on suicidal behavior: evidence and hypotheses

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