Heightened aversion to risk and loss in depressed patients with a suicide attempt history

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Suicide attempters have been found to be impaired in decision-making; however, their specific biases in evaluating uncertain outcomes remain unclear. Here we tested the hypothesis that suicidal behavior is associated with heightened aversion to risk and loss, which might produce negative predictions about uncertain future events. Forty-five depressed patients with a suicide attempt history, 47 nonsuicidal depressed patients, and 75 healthy controls participated in monetary decision-making tasks assessing risk and loss aversion. Suicide attempters compared with the other groups exhibited greater aversion to both risk and loss during gambles involving potential loss. Risk and loss aversion correlated with each other in the depressed patients, suggesting that a common pathophysiological mechanism underlies these biases. In addition, emotion regulation via suppression, a detrimental emotional control strategy, was positively correlated with loss aversion in the depressed patients, also implicating impairment in regulatory processes. A preliminary fMRI study also found disrupted neural responses to potential gains and losses in the subgenual anterior cingulate cortex, insula cortex, and left amygdala, brain regions involved in valuation, emotion reactivity, and emotion regulation. The findings thus implicate heightened negative valuation in decision-making under risk, and impaired emotion regulation in depressed patients with a history of suicide attempts.
Publisher
NATURE PUBLISHING GROUP
Issue Date
2017-09
Language
English
Article Type
Article
Keywords

ANTERIOR CINGULATE CORTEX; DECISION-MAKING; NEURAL BASIS; EMOTION REGULATION; PREFRONTAL CORTEX; MOOD DISORDERS; INDIVIDUAL-DIFFERENCES; NEGATIVE FEEDBACK; PROSPECT-THEORY; RIGHT INSULA

Citation

SCIENTIFIC REPORTS, v.7

ISSN
2045-2322
DOI
10.1038/s41598-017-10541-5
URI
http://hdl.handle.net/10203/226440
Appears in Collection
BiS-Journal Papers(저널논문)
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