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Sci Rep. 2017 Sep 11;7(1):11228. doi: 10.1038/s41598-017-10541-5.

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

Author information

1
Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Republic of Korea.
2
Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom.
3
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea. alberto@catholic.ac.kr.
4
Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
5
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
6
Institute for the Developing Mind, Children's Hospital Los Angeles and the Keck School of Medicine at the University of Southern California, Los Angeles, CA 90033, United States.
7
Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Republic of Korea. jsjeong@kaist.ac.kr.

Abstract

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.

PMID:
28894106
PMCID:
PMC5593974
DOI:
10.1038/s41598-017-10541-5
[Indexed for MEDLINE]
Free PMC Article

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