Category: Suicide and Self-Injury
Adam Jaroszewski, Ph.D.
Postdoctoral Fellow
Massachusetts General Hospital
Boston, Massachusetts
Peter Franz, Ph.D.
Montefiore Medical Center
New York, New York
Alexander Millner, Ph.D.
Director of Mental Health Research
Franciscan Children's Hospital
Brighton, Massachusetts
Adam Jaroszewski, Ph.D.
Postdoctoral Fellow
Massachusetts General Hospital
Boston, Massachusetts
Rebecca G Fortgang, Ph.D.
Postdoctoral Fellow
Harvard University
Cambridge, Massachusetts
Peter Franz, Ph.D.
Montefiore Medical Center
New York, New York
Aliona Tsypes, Ph.D.
University of Pittsburgh
Pittsburgh, Pennsylvania
Suicide is one of the most tragic, costly, and perplexing of all human behaviors. Though it is by definition a deliberative action, some report that it does not feel like a “choice.” In the face of distress, the selection of suicide among available options may be facilitated by aberrant decision-making processes that bias the estimates of the relative value of suicide compared to alternatives (Dombrovski & Hallquist, 2021). Thus, understanding the decision-making processes driving people to select suicide could shed light on how to best detect and prevent suicide risk by identifying and modifying these decision-making biases.
Decision-making is the mental process of selecting an option among alternatives. Research over the past few decades has identified several ways in which decision-making differs among people with suicidal thoughts or behaviors (STBs). First, suicidal people struggle to determine which options maximize beneficial outcomes and to flexibly update instrumental values of these options (e.g., Clark et al., 2010; Dombrovski & Hallquist, 2016; Dombrovski et al., 2018; Jollant et al., 2005, 2010). This increases the chances of suboptimal selections. Second, suicidal people prefer immediate versus delayed rewards (e.g., Cáceda, 2014; Mathias et al., 2012) and/or value delayed rewards inconsistently (Tsypes et al., 2021). This increases the likelihood of selecting options that require less time or effort. Third, suicidal people generate fewer alternative ways to solve problems (Levenson & Neuringer, 1971; Schotte & Clum, 1982; Linehan et al., 1987). This increases the possibility of selecting habit-based or emotion-driven options. These findings indicate that suicidal people display several decision-making biases that could drive harmful outcomes. The goal of the present symposium is to assist researchers and mental health professionals in conceptualizing and treating STBs by highlighting new directions in decision-making and suicide.
In this symposium, we provide a deep dive into new decision science research relevant to STBs using a range of laboratory-based experiments and ecological sampling methods. First, Dr. Adam Jaroszewski will present new experimental evidence on how perceived valence of self-relevant suicide-information biases suicidal people’s decisions, which predicts past and future suicide attempt. Next, Dr. Peter Franz will describe evidence from a novel relief-based decision-making task indicating that people who engage in nonsuicidal self-injury, a top risk factor for suicide, are more influenced by effort costs when making decisions about relief. Third, Dr. Rebecca Fortgang will present on the association between impulsive decision-making and real-time suicide risk using smartphone-based ecological momentary assessment. Finally, Dr. Aliona Tsypes will describe new findings from a reinforcement-based timing paradigm showing that high-lethality suicide attempters exhibit deficient adjustment to short-term reinforcement. Our discussant, Dr. Alex Millner, Research Scientist at Harvard University and Director of Mental Health Research at Franciscan Children’s, will provide commentary as an expert with numerous peer-reviewed publications on decision-making and STBs.
Presenter: Adam Jaroszewski, Ph.D. – Massachusetts General Hospital
Co-author: Millner Alexander, Ph.D. – Franciscan Children's Hospital
Co-author: Samuel Gershman, Ph.D. – Harvard University
Co-author: Matthew Nock, Ph.D. – Harvard University
Presenter: Rebecca G Fortgang, Ph.D. – Harvard University
Co-author: Daniel Coppersmith, M.A. – Harvard University
Co-author: Alexander Millner, Ph.D. – Harvard University
Co-author: Evan M. Kleiman, PhD – Rutgers, The State university of new jersey
Co-author: Matthew Nock, Ph.D. – Harvard University
Presenter: Peter J. Franz, Ph.D. – Montefiore Medical Center
Co-author: Rebecca G Fortgang, Ph.D. – Harvard University
Co-author: Alexander Millner, Ph.D. – Franciscan Children's Hospital
Co-author: Adam Jaroszewski, Ph.D. – Massachusetts General Hospital
Co-author: Ellen Wittler, PhD – Butler Hospital
Co-author: Vilma Gabbay, M.D. – Albert Einstein College of Medicine
Co-author: Jonathan Alpert, M.D., Ph.D. – Montefiore Medical Center
Co-author: Joshua Buckholtz, Ph.D. – Harvard University
Co-author: Matthew Nock, Ph.D. – Harvard University
Presenter: Aliona Tsypes, Ph.D. – University of Pittsburgh
Co-author: Michael Hallquist, PhD – University of North carolina at chapel hill
Co-author: Alexandre Dombrovski, MD – University of PIttsburgh