Suicide and Self-Injury
Natasha Kulviwat, N/A, None
Student
Jericho High School
Jericho, New York
Hannah R. Lawrence, Ph.D.
Assistant Professor
Oregon State University
Corvallis, Oregon
Richard Liu, Ph.D.
Associate Professor
Massachusetts General Hospital/Harvard Medical School
Boston, Massachusetts
Suicide is the 2nd leading cause of death in adolescents. Despite decades of research leading to advancements in prediction of long-term suicide risk, far less is known regarding predictors of short-term risk in adolescence. In particular, identifying objective markers of short-term adolescent suicide risk could improve suicide risk assessment. This study investigated three neurocognitive tasks evaluating all three core executive functions as predictors of suicidal ideation (SI) 3 and 6 months post-hospitalization among high-risk adolescents. The Cambridge Neuropsychological Test Automated Battery Intra-Extra Dimensional Set Shift (CANTAB IED) assessed cognitive flexibility, the Stop-Signal Task (SST) assessed impulsivity, and Letter-Number Sequencing (LNS) assessed working memory. Adolescents (N = 235) were administered the CANTAB IED, SST, LNS, and additional assessments during hospitalization. SI was assessed using the Suicide Ideation Questionnaire during hospitalization and 3 and 6 months post-hospitalization. Linear regression was used to test whether neurocognitive task performance predicted 3- and 6-month SI. We also tested whether sex moderated this relation to investigate if the strength of the relation between neurocognitive task performance and SI would differ for males and females. Results indicated that neurocognitive task performance predicted 3-month and 6-month SI. Lower CANTAB IED scores were associated with higher 3-month SI (p < 0.05) and higher SST scores were associated with higher 6-month SI, though only in males (p < 0.01). The associations between LNS and 3- or 6-month SI were not statistically significant. Study findings suggest that cognitive flexibility, as measured by the CANTAB IED, may serve as an objective marker of SI 3 months post-hospitalization. Impulsivity, as measured by the SST, also predicted SI 6 months post-hospitalization. Sex-specific differences were also identified, suggesting that sex-specific risk assessment may be beneficial. Eventually, neurocognitive task performance, in combination with demographic and clinical information, could be used to develop a suicide risk calculator to aid in predicting the severity of suicide risk. Development of a suicide risk calculator would have the ability to aid clinicians in identifying those most at risk for suicide and would help in formulating intervention recommendations.