Symposia
Suicide and Self-Injury
Courtney Forbes, M.A., M.Ed.
Clinical Psychology Intern
Emory University School of Medicine
Atlanta, Georgia
Matthew Tull, PhD
Professor of Psychology
University of Toledo
Toledo, Ohio
Andrew Cotton, MD
Research Consultant
University of Toledo Medical Center
Toledo, Ohio
Xin Wang, MD, PhD
Professor of Psychiatry
University of Toledo Medical Center
Toledo, Ohio
Trauma exposure is associated with heightened risk for suicidality. Reward processing abnormalities have been linked to suicidality; however, these relations have not been examined among individuals with recent trauma exposure. Research in this domain could inform understanding of specific risk factors for suicidality and highlight targets for intervention. Thus, the present study examined cross-sectional and longitudinal relations between neural activity during reward-based decision-making and suicidal ideation (SI) in a recently traumatized sample.
Participants were adults (N = 19, mean age = 31, 79% women, 53% racial/ethnic minority) recruited from emergency departments upon presentation for treatment following trauma exposure. Within two weeks of the traumatic event, participants completed the Staggered Effort-Based Decision-Making Task (Arulpragasam et al., 2018), in which they made decisions about whether to exert effort to obtain monetary rewards. Task-based neural activity was examined via whole-brain analyses, corrected for multiple comparisons, using the fixation point between trials as an implicit baseline. SI was assessed using the Quick Inventory of Depressive Symptomatology.
Task-based activation in regions relevant to reward processing, specifically the insula and thalamus (rs = -.70 to -.53, ps ≤ .05), significantly correlated with baseline SI. Task-based activation in regions relevant to cognitive and regulatory processes (e.g., superior and inferior frontal gyri; paracingulate gyrus) also significantly correlated with baseline SI (rs = -.71 to -.46, ps < .05). Task-based activation did not significantly predict SI at 3-month follow-up.
In a recently traumatized sample, less activation in reward-relevant neural regions during decision-making was associated with more frequent and intense SI cross-sectionally, but not longitudinally. If replicated, these results may indicate that impaired reward-based decision-making following traumatic exposure contributes to risk for suicide. Relations between SI and task-based activation in regions related to cognitive and regulatory processes warrant further investigation.