Factors influencing emergency department staff decision-making for people attending in suicidal crisis: A systematic review

Background: Emergency department (ED) staff are often the first point of contact for individuals in suicidal crisis. Despite this, there is no published research systematically examining the factors influencing decision-making for this patient group. Methods: MedLine, CINAHL, PsycINFO, Web of Science and Cochrane Library databases were searched for three key concepts: (1) suicide, (2) accident and emergency […]

Longitudinal associations between executive function impairments and suicide risk in patients with major depressive disorder: A 1-year follow-up study

Impaired executive function (EF) is a key feature of patients with major depressive disorder (MDD) that several studies have linked to suicidal ideation and suicide attempts. This is the first longitudinal study to examine the association between impaired EF and suicide risk in adult patients with MDD. Longitudinal prospective study with 3 assessment points: baseline, […]

Cognitive effort avoidance in veterans with suicide attempt histories

Suicide attempts (SA) are increasing in the United States, especially in veterans. Discovering individual cognitive features of the subset of suicide ideators who attempt suicide is critical. Cognitive theories attribute SA to facile schema-based negative interpretations of environmental events. Over-general autobiographical memory and facile solutions in problem solving tasks in SA survivors suggest that aversion […]

Anticipatory, relief-oriented and permissive beliefs in patients with suicidal behaviors: An exploratory case-control study

Objective: The objective is to propose a specific understanding of decision-making in suicidal behavior by using a psychometric instrument, namely the Suicidal Ambivalence Scale (SAS). The SAS, initially used in addictive disorders, allows to distinguish 3 types of thoughts: first anticipatory beliefs [A] (positive expectations regarding behavior); second relief-oriented beliefs [R] (aim to reduce the feeling […]

Lethal means counseling for suicide prevention: Views of emergency department clinicians

Objective Lethal means safety – counseling and guidance about reducing access to home firearms and medications – is recommended for emergency department patients at risk of suicide. Decision aids are tools that can facilitate potentially difficult decisions by incorporating personal preferences and values. The present study evaluates clinician perceptions about the implementation and utility of […]

Deciding to die: The relations of decision-making styles to suicide ideation and attempts

Research has struggled to distinguish individuals who have attempted suicide from individuals with suicidal thoughts but no history of suicide attempts. Cognitive attributes such as decision-making mediate thought-behavior relationships; we therefore examined whether different decision-making styles distinguished those who had made suicide attempts from those with suicidal ideation only. Six hundred participants were recruited using […]

The serious suicide attempts approach for understanding suicide: Review of the psychological evidence

The study of survivors of a serious suicide attempt (SSA)––an attempt that would have been fatal had it not been for the provision of rapid and effective emergency treatment––can help researchers understand the suicidal mind. Serious suicide attempters are epidemiologically very similar to those who died by suicide, and thus can serve as valid proxies for studying […]

Decision-making and cognitive control in adolescent suicidal behaviors: A qualitative systematic review of the literature

Suicide and suicidal behaviors represent a leading cause of morbidity and mortality during adolescence. While several lines of evidence suggest that suicidal behaviors are associated with risky decisions and deficient cognitive control in laboratory tasks in adults, comparatively less is known about adolescents. Here, we systematically reviewed the literature on the association between these neurocognitive […]

Adolescent decision-making: The value of perceived behavioral control in predicting engagement in suicide prevention behaviors

Adolescent perceived behavioral control (self-efficacy) plays a key role in influencing decision-making processes within the context of suicide prevention programming. Guided by Theory of Planned Behavior, models tested attitudinal and social factors predicting adolescent intentions and actual engagement in suicide prevention behaviors. Participants included 233 racially and ethnically diverse high school students (54% female) in […]

The decision-making process for disclosing suicidal ideation and behavior to family and friends

Objective This study was designed to explore the decision‐making processes for disclosing suicidal ideation and behavior. Background Suicide attempt survivors are an invaluable resource that can provide essential information about suicidal behavior and related communication to family and friends. Because of the stigma associated with suicide and seeking help, many individuals choose to conceal their […]

Neuropsychological markers of suicidal risk in the context of medical rehabilitation.

While great strides have been made to advance the understanding of the neurobiology of suicidal behavior (SB), the neural and neuropsychological mechanisms associated with SB are not well understood. The purpose of the current study is to identify neurocognitive markers of SB in the context of medical rehabilitation. The performances of 39 patients at a […]

Decision making in social context in patients with suicide attempt history.

Decision making has been found to be altered in suicide attempters, but little is known of their performance in social contexts. Twenty-seven depressed suicide attempters (DSA), 25 nonsuicidal depressed patients (DP), and 60 healthy participants (HC) were evaluated by a decision-making task in social context. Results indicated DSA and DP obtained lower gains and invested […]

Decisional support for young people who self-harm: Protocol for a feasibility trial.

Introduction Self-harm is common in adolescents, and it is the strongest predictor of suicide. Young people who self-harm are often unsure of how and where to get help. Decision aids (DAs) have been shown to help with decisional conflict where there is uncertainty around different options. We have developed an online DA to support young […]

Decision tree identified risk groups with high suicidal ideation in South Korea: A population-based study.

Objective The aim of this study was to identify risk groups with high suicidal ideation among South Korean adults. Design and Sample A descriptive cross-sectional design was adopted using secondary data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 5,963 adults aged 19 years and older who participated in […]

Longitudinal risk profiling for suicidal thoughts and behaviours in a community cohort using decision trees.

Background While associations between specific risk factors and subsequent suicidal thoughts or behaviours have been widely examined, there is limited understanding of the interplay between risk factors in the development of suicide risk. This study used a decision tree approach to develop individual models of suicide risk and identify the risk factors for suicidality that […]

Impaired decision-making in adolescent suicide attempters.

Objective Decision-making deficits have been linked to suicidal behavior in adults. However, it remains unclear whether impaired decision making plays a role in the etiopathogenesis of youth suicidal behavior. The purpose of this study was to examine decision-making processes in adolescent suicide attempters and never-suicidal comparison subjects. Method Using the Iowa Gambling Task, the authors […]

Classification trees distinguish suicide attempters in major psychiatric disorders: A model of clinical decision making.

Determining risk for a suicide attempt in psychiatric patients requires assessment of multiple risk factors and knowledge of their relative importance. Classification and regression tree (CART) analysis generates decision trees that select the variables that perform best in identifying the group of interest and model clinical decision making. Hypothetical decision trees to identify recent and […]

Decision-making competence and attempted suicide.

The propensity of people vulnerable to suicide to make poor life decisions is increasingly well documented. Do they display an extreme degree of decision biases? The present study used a behavioral-decision approach to examine the susceptibility of low-lethality and high-lethality suicide attempters to common decision biases that may ultimately obscure alternative solutions and deterrents to […]

First-degree relatives of suicide completers may have impaired decision-making but functional cognitive control.

Highlights: Deficits in value-based decision-making and cognitive control have previously been found in suicide attempters. Here, we report disadvantageous decision-making in first-degree relatives of suicide completers. Risky decision-making may therefore be a heritable endophenotype of suicide. Normal cognitive control could be a protective factor against suicide in this population. Contact us for a copy of […]

On the role of impulsivity and decision-making in suicidal behavior.

Suicide risk constitutes a complex set of interacting demographic, clinical, psychobiological and environmental variables. Impulsivity is a long-known risk factor for suicide attempts. However, research based on clearer conceptual refinement in this area is imperative. One emerging field of study is that of decision-making. Impulsivity involves a failure of higher-order control, including decision-making. Using standardized […]

Clinical and neurocognitive markers of suicidality in young adults.

Suicide represents a leading cause of death in young people, yet relatively little is known regarding the neurobiological sequelae of preceding suicidal thoughts and behaviours. Although some studies have reported cognitive deficits associated with suicidality, very few studies have been undertaken in young people, especially from non-clinical contexts. Impaired decision-making exists in young people with […]

Risk-sensitive decision-making deficit in adolescent suicide attempters.

Decision-making deficits may play an important role in vulnerability to suicidal behavior, but few studies have examined decision-making performance in youth at risk for suicide. In this study, we seek to extend recent findings that adolescent suicide attempters process risk evaluations differently than adolescents who have not attempted suicide. Adolescents with a history of suicide […]

Relationship between neuropsychological and clinical aspects and suicide attempts in euthymic bipolar patients.

Some studies have investigated the possible relationship between suicide attempts and impulsivity in patients with bipolar disorder. The objective of this study was to assess the relationship between neuropsychological and clinical aspects and suicide behavior in euthymic bipolar patients. The Iowa Gambling Task and the ConnerÕs Continuous Performance Test evaluated impulsivity in 95 euthymic bipolar […]