Impaired Conflict Detection Differentiates Suicide Attempters From Ideating Nonattempters: Evidence From Event-Related Potentials
Impaired Conflict Detection Differentiates Suicide Attempters From Ideating Nonattempters: Evidence From Event-Related Potentials
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DOI：
10.1016/j.bpsc.2019.05.015
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发表时间：
2019-10-01
影响因子：
5.9
通讯作者：
Schmidt, Norman B.
中科院分区：
文献类型：
--
作者：
Albanese, Brian J.;Macatee, Richard J.;Schmidt, Norman B.
背景：现有研究表明，抑制控制缺陷可能会将有自杀念头的个体与企图自杀的个体区分开来。然而，据我们所知，没有可用的研究检验自杀行为是否与确定何时需要抑制性控制的能力中断或参与不适当或不适应行为的抑制能力有关。本研究利用事件相关电位，在一个报告了当前自杀意念的不同临床样本中，研究了抑制控制的特定方面及其与自杀未遂史的关系。方法：意想者(n=46)和有自杀未遂史(n=22)的人完成了一项复杂的进行/不进行任务。使用原始波形和时间空间主成分分析来指示冲突检测(即，增量n2)和运动抑制(即，增量P3a)。结果：自杀未遂者比有意识的非自杀未遂者表现出对抑制性控制需求的缺陷，即使在考虑精神疾病和年龄的情况下也是如此。然而，这些结果只出现在主成分分析衍生的潜在因素中。在行为表现或DELTA P3a波幅方面没有出现差异。结论：相对无法检测到何时抑制不良适应行为，但没有进行运动抑制来阻止该行为的能力，可能会区分自杀意念者有自杀企图和没有自杀企图。然而，需要具有前瞻性设计的未来研究来确定冲突检测缺陷如何可能有助于自杀危机的出现或升级。
BACKGROUND: Existing research suggests that inhibitory control deficits may differentiate individuals who think about suicide from those who make a suicide attempt. However, no available research, to our knowledge, has examined whether suicidal behaviors are associated with disruptions in the ability to determine when inhibitory control is needed or the ability to engage inhibition of an inappropriate or maladaptive behavior. The current study utilized event-related potentials to investigate specific facets of inhibitory control and their associations with suicide attempt history among a heterogeneous clinical sample who reported current suicidal ideation.METHODS: Ideators with no past suicide attempts (n = 46) and those with a history of suicide attempts (n = 22) completed a complex go/no-go task. Raw waveforms and temporospatial principal components analysis were used to index conflict detection (i.e., Delta N2) and motor inhibition (i.e., Delta P3a). Behavioral performance indices were also examined.RESULTS: Suicide attempters exhibited deficits in detecting the need for inhibitory control, as indexed by a more positive Delta N2 factor, than did ideating nonattempters, even when accounting for psychiatric comorbidity and age. However, these results only emerged in the principal components analysis-derived latent factor. No differences in behavioral performance or Delta P3a amplitude emerged.CONCLUSIONS: A relative inability to detect when to inhibit a maladaptive behavior, but not the ability to engage motor inhibition to stop that behavior, may distinguish suicide ideators who make a suicide attempt from those who do not. However, future research with prospective designs are needed to determine how conflict detection deficits may contribute to the emergence or escalation of a suicidal crisis.