Imaging suicidal thoughts and behaviors: a comprehensive review of 2 decades of neuroimaging studies

AbstractIdentifying brain alterations that contribute to suicidal thoughts and behaviors (STBs) are important to develop more targeted and effective strategies to prevent suicide. In the last decade, and especially in the last 5 years, there has been exponential growth in the number of neuroimaging studies reporting structural and functional brain circuitry correlates of STBs. Within this narrative review, we conducted a comprehensive review of neuroimaging studies of STBs published to date and summarize the progress achieved on elucidating neurobiological substrates of STBs, with a focus on converging findings across studies. We review neuroimaging evidence across differing mental disorders for structural, functional, and molecular alterations in association with STBs, which converges particularly in regions of brain systems that subserve emotion and impulse regulation including the ventral prefrontal cortex (VPFC) and dorsal PFC (DPFC), insula and their mesial temporal, striatal and posterior connection sites, as well as in the connections between these brain areas. The reviewed literature suggests that impairments in medial and lateral VPFC regions and their connections may be important in the excessive negative and blunted positive internal states that can stimulate suicidal ideation, and that impairments in a DPFC and inferior frontal gyrus (IFG) system may be important in suicide attempt behaviors. A combination of VPFC and DPFC system disturbances may lead to very high risk circumstances in which suicidal ideation is converted to lethal actions via decreased top-down inhibition of behavior and/or maladaptive, inflexible decision-making and planning. The dorsal anterior cingulate cortex and insula may play important roles in switching between these VPFC and DPFC systems, which may contribute to the transition from suicide thoughts to behaviors. Future neuroimaging research of larger sample sizes, including global efforts, longitudinal designs, and careful consideration of developmental stages, and sex and gender, will facilitate more effectively targeted preventions and interventions to reduce loss of life to suicide.

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Psychobiological risk factors for suicidal thoughts and behaviors in adolescence: a consideration of the role of puberty

Molecular Psychiatry ◽

10.1038/s41380-021-01171-5 ◽

2021 ◽

Author(s):

Tiffany C. Ho ◽

Anthony J. Gifuni ◽

Ian H. Gotlib

Keyword(s):

Pubertal Timing ◽

Anterior Cingulate ◽

Neural Systems ◽

Hormonal Changes ◽

Suicidal Thoughts ◽

Social Stressors ◽

And Behaviors ◽

Suicidal Thoughts And Behaviors ◽

Pubertal Transition

AbstractSuicide is the second leading cause of death among adolescents. While clinicians and researchers have begun to recognize the importance of considering multidimensional factors in understanding risk for suicidal thoughts and behaviors (STBs) during this developmental period, the role of puberty has been largely ignored. In this review, we contend that the hormonal events that occur during puberty have significant effects on the organization and development of brain systems implicated in the regulation of social stressors, including amygdala, hippocampus, striatum, medial prefrontal cortex, orbitofrontal cortex, and anterior cingulate cortex. Guided by previous experimental work in adults, we also propose that the influence of pubertal hormones and social stressors on neural systems related to risk for STBs is especially critical to consider in adolescents with a neurobiological sensitivity to hormonal changes. Furthermore, facets of the pubertal transition, such as pubertal timing, warrant deeper investigation and may help us gain a more comprehensive understanding of sex differences in the neurobiological and psychosocial mechanisms underlying adolescent STBs. Ultimately, advancing our understanding of the pubertal processes that contribute to suicide risk will improve early detection and facilitate the development of more effective, sex-specific, psychiatric interventions for adolescents.

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Unsound sleep, wound-up mind: a longitudinal examination of acute suicidal affective disturbance features among an eating disorder sample

Psychological Medicine ◽

10.1017/s003329172100310x ◽

2021 ◽

pp. 1-9

Author(s):

Shruti S. Kinkel-Ram ◽

William Grunewald ◽

Lindsay P. Bodell ◽

April R. Smith

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Suicidal Ideation ◽

Sleep Quality ◽

Treatment Center ◽

Poor Sleep ◽

Suicidal Thoughts ◽

And Behaviors ◽

Ongoing Assessment ◽

Suicidal Thoughts And Behaviors

Abstract Background Suicide is one of the most commonly reported causes of death in individuals with eating disorders. However, the mechanisms underlying the suicide and disordered eating link are largely unknown, and current assessments are still unable to accurately predict future suicidal thoughts and behaviors. The purpose of this study is to test the utility of two promising proximal risk factors, sleep quality and agitation, in predicting suicidal ideation in a sample of individuals with elevated suicidal thoughts and behaviors, namely those with eating disorders. Methods Women (N = 97) receiving treatment at an eating disorder treatment center completed weekly questionnaires assessing suicidal ideation, agitation, and sleep. General linear mixed models examined whether agitation and/or sleep quality were concurrently or prospectively associated with suicidal ideation across 12 weeks of treatment. Results There was a significant interaction between within-person agitation and sleep quality on suicidal ideation [B(s.e.) = −0.02(0.01), p < 0.05], such that on weeks when an individual experienced both higher than their average agitation and lower than their average sleep quality, they also experienced their highest levels of suicidal ideation. However, neither agitation nor sleep quality prospectively predicted suicidal ideation. Conclusions This study was the first to examine dynamic associations between interpersonal constructs and suicidal ideation in individuals with eating disorders. Results suggest that ongoing assessment for overarousal symptoms, such as agitation and poor sleep quality, in individuals with eating disorders may be warranted in order to manage suicidal ideation among this vulnerable population.

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Alexithymia, Suicidal Ideation and Behaviour in Moroccan Psychoactive Substance Users

10.21203/rs.3.rs-143731/v1 ◽

2021 ◽

Author(s):

Khadija Karjouh ◽

Fatima-Zahra Azzaoui ◽

Riadh Ouerchefani ◽

Wafae idrissi semlali ◽

Khaoula Mammad ◽

...

Keyword(s):

Substance Use ◽

Suicidal Ideation ◽

Emotional Regulation ◽

Rating Scale ◽

Depressive Symptomatology ◽

Suicidal Thoughts ◽

Severity Rating ◽

Significant Difference ◽

And Behaviors ◽

Suicidal Thoughts And Behaviors

Abstract Alexithymia is an emotion regulation problem that may be related to suicidality, especially in patients with SUD.The study aimed at estimating the prevalence of alexithymia in Moroccan psychoactive substances users, and to establish the links between alexithymia and suicidal ideation and behaviors, anxiety and depression in drug-dependent patients.We also aimed to elucidate if alexithymia predicts suicidal thoughts and behaviors in these consumers. The study included 451 consecutively admitted patients with substance use. Consumers were examined with the Toronto alexithymia scale (TAS-20), State and Trait Anxiety Inventory (STAI-Y), Beck Depression Inventory (BDI) and The Columbia-Suicide Severity Rating Scale (C-SSRS)Among substance-dependent individuals, 72.7% was identified as a group with alexithymia. Current age and age at first substance use were lower in the alexithymic group (p<0.01).The mean STAI-Y state and C-SSRS scores were higher in the group with alexithymia (p<0.01). There was a statistically significant difference between the groups in terms of mean scores for anxiety traits (p<0.05) and no significant difference in terms of mean scores for depression. All of the scores correlated significantly with.Addicted patients with alexithymia could be targeted at preventing the onset of suicidal thoughts and behaviorThe present study also evokes that whenever an emotional regulation disorder is observed, the possibility of anxio-depressive symptomatology and suicidality (ideation and behavior) needs to be assessed.

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Preliminary Investigation of the Association Between COVID-19 and Suicidal Thoughts and Behaviors in the U.S.

10.31234/osf.io/68djp ◽

2020 ◽

Cited By ~ 6

Author(s):

Brooke A. Ammerman ◽

Taylor A. Burke ◽

Ross Jacobucci ◽

Kenneth McClure

Keyword(s):

United States ◽

Suicidal Ideation ◽

Online Survey ◽

Significant Proportion ◽

Well Being ◽

The United States ◽

Negative Consequences ◽

Suicidal Thoughts ◽

And Behaviors ◽

Suicidal Thoughts And Behaviors

Evidence suggests that the negative consequences of COVID-19 may extend far beyond its considerable death toll, having a significant impact on psychological well-being. Prior work has highlighted that previous epidemics are linked to elevated suicide rates, however, there is no research to date on the relationship between the COVID-19 pandemic and suicidal thoughts and behaviors. Utilizing an online survey, the current study aimed to better understand the presence, and extent, of the association between COVID-19-related experiences and past-month suicidal thoughts and behaviors among adults in the United States. Results support an association between several COVID-19-related experiences (i.e., general distress, fear of physical harm, effects of social distancing policies) and past-month suicidal ideation and attempts. Further, we found that a significant proportion of those with recent suicidal ideation explicitly link their suicidal thoughts to COVID-19. Exploratory analyses highlight a potential additional link between COVID-19 and suicidal behavior, suggesting that a portion of individuals may be intentionally exposing themselves to the virus with intent to kill themselves. These findings underscore the need for increased suicide risk screening and access to mental health services. Particular attention should be paid to employing public health campaigns to disseminate information on such services in order to reduce the enormity of distress and emotional impairment associated with COVID-19 in the United States.

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The interaction between suicidal ideation, insomnia symptoms, and student status

Experimental Results ◽

10.1017/exp.2021.25 ◽

2021 ◽

Vol 2 ◽

Author(s):

Jodie C. Stevenson ◽

Kamila Irvine ◽

Sarah Allen ◽

Umair Akram

Keyword(s):

Suicidal Ideation ◽

General Population ◽

Suicidal Behavior ◽

Suicidal Thoughts ◽

The Past ◽

Future Attempt ◽

And Behaviors ◽

Suicidal Thoughts And Behaviors ◽

Insomnia Symptoms

Abstract Evidence demonstrates increased vulnerability to thoughts and behaviors related to suicide (i.e., suicidal ideation) in students. This study examined the interaction between insomnia-symptoms and student-status (students vs. non-students) on reports of suicidal thoughts of behaviors. A total of 363 (N = 363) university students and 300 (N = 300) members of the general population provided complete data on measures of insomnia-symptoms and suicidal ideation. Students indicated greater reports of both total and lifetime ideation while also considering suicidal behavior within the past year. However, no differences were observed in reports of possible future attempt(s) and the disclosure of suicidal thoughts and behaviors to another person. Moreover, students presenting concurrent symptoms of insomnia reported significantly elevated levels of suicidal ideation relative to nonstudents. These outcomes highlight the possible role of insomnia symptoms in accentuating suicidal thoughts and behaviors in the student population.

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Differences in Suicidal Thoughts and Behaviors Among Three Racial Groups

Crisis ◽

10.1027/0227-5910/a000621 ◽

2020 ◽

Vol 41 (3) ◽

pp. 172-178

Author(s):

Brooke A. Ammerman ◽

Martha K. Fahlgren ◽

Kristen M. Sorgi ◽

Michael S. McCloskey

Keyword(s):

Suicide Attempts ◽

Health Concern ◽

Future Research ◽

Racial Groups ◽

Contributing Factors ◽

Suicidal Thoughts ◽

Final Sample ◽

And Behaviors ◽

Assessment Procedures ◽

Suicidal Thoughts And Behaviors

Abstract. Background: Despite being a major public health concern, it is unclear how suicidal thoughts and behaviors differentially impact separate racial groups. Aims: The aim of the current study was to examine the occurrence of nonlethal suicide events, in addition to suicide attempt characteristics and factors contributing to suicide attempts. Method: A final sample of 7,094 undergraduates from a large northeastern university, identifying as members of three racial groups (White [67.30%], Black [17.30%], and Asian [15.40%]), completed online questionnaires. Results: White participants reported increased likelihood of endorsing lifetime suicidal ideation and plan, whereas Black participants reported decreased likelihood of these events; no differences were found in rates of lifetime suicide attempts. Black participants' suicidal behavior may involve greater ambivalence of intent. A higher proportion of Asian participants endorsed interpersonal factors as contributing to their suicide attempts, whereas a greater percentage of White participants reported internal contributing factors. Limitations: Findings are limited by the sample size and assessment of lifetime suicidal thoughts and behaviors. Conclusion: The findings present a more nuanced look at attitudes and actions related to suicidal thoughts and behaviors that may inform future research and risk assessment procedures.

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