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Neuropsychological deficits in past suicide attempters with varying levels of depression severity

Published online by Cambridge University Press:  09 April 2014

J. G. Keilp ,
S. R. Beers ,
A. K. Burke ,
N. M. Melhem ,
M. A. Oquendo ,
D. A. Brent  and
J. J. Mann
J. G. Keilp*
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
S. R. Beers
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
A. K. Burke
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
N. M. Melhem
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
M. A. Oquendo
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
D. A. Brent
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
J. J. Mann
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
*
*Address for correspondence: J. G. Keilp, Ph.D., Box 42, NYSPI, 1051 Riverside Drive, New York, New York 10032, USA. (Email: jgk13@columbia.edu)
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Abstract

Background

Our previous work identified deficits in interference processing and learning/memory in past suicide attempters who were currently depressed and medication-free. In this study, we extend this work to an independent sample studied at various stages of illness and treatment (mild symptoms, on average) to determine if these deficits in past suicide attempters are evident during a less severe clinical state.

Method

A total of 80 individuals with a past history of major depression and suicide attempt were compared with 81 individuals with a history of major depression and no lifetime suicide attempts on a battery of neurocognitive measures assessing attention, memory, abstract/contingent learning, working memory, language fluency and impulse control.

Results

Past attempters performed more poorly in attention, memory and working memory domains, but also in an estimate of pre-morbid intelligence. After correction for this estimate, tests that had previously distinguished past attempters – a computerized Stroop task and the Buschke Selective Reminding Test – remained significantly worse in attempters. In a secondary analysis, similar differences were found among those with the lowest levels of depression (Hamilton Depression Rating Scale score <10), suggesting that these deficits may be trait markers independent of current symptomatology.

Conclusions

Deficits in interference processing and learning/memory constitute an enduring defect in information processing that may contribute to poor adaptation, other higher-order cognitive impairments and risk for suicidal behavior.

Keywords

Attentiondepressionmemoryneuropsychologicalsuicidal behavior
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 14 , October 2014 , pp. 2965 - 2974
Copyright
Copyright © Cambridge University Press 2014 

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References

Arie, M, Apter, A, Orbach, I, Yefet, Y, Zalzman, G (2008). Autobiographical memory, interpersonal problem solving, and suicidal behavior in adolescent inpatients. Comprehensive Psychiatry 49, 22–29.CrossRefGoogle ScholarPubMed
Baer, RA (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice 10, 125–143.Google Scholar
Barratt, ES (1985). Impulsiveness defined within a system model of personality. In Advances in Personality Assessment (ed. Spielberger, C. D. and Butcher, J. N.), vol. 5, pp. 113–132. Earlbaum: New York.Google Scholar
Barratt, ES (1994). Impulsivity and aggression. In Violence and Mental Disorder: Developments in Risk Assessment (ed. Monahan, J. and Steadman, H. J.), pp. 61–80. University of Chicago Press: Chicago.Google Scholar
Batty, GD, Whitley, E, Deary, IJ, Gale, CR, Tynelius, P, Rasmussen, F (2010). Psychosis alters association between IQ and future risk of attempted suicide: cohort study of 1109475 Swedish men. BMJ 340, c2506.CrossRefGoogle ScholarPubMed
Beck, AT, Beck, R, Kovacs, M (1975). Classification of suicidal behaviors: I. Quantifying intent and medical lethality. American Journal of Psychiatry 132, 285–287.Google ScholarPubMed
Beck, AT, Kovacs, M, Weissman, A (1979). Assessment of suicidal ideation: the scale for suicidal ideation. Journal of Consulting and Clinical Psychology 47, 343–352.CrossRefGoogle Scholar
Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 53–63.CrossRefGoogle ScholarPubMed
Beck, AT, Weissman, A, Lester, D, Trexler, L (1974). The measurement of pessimism: the Hopelessness Scale. Journal of Consulting and Clinical Psychology 46, 861–865.CrossRefGoogle Scholar
Bishop, SR, Lau, M, Shapiro, S, Carlson, L, Anderson, ND, Carmody, J, Segal, ZV, Abbey, S, Speca, M, Velting, D, Devins, G (2004). Mindfulness: a proposed operational definition. Clinical Psychology: Science and Practice 11, 230–241.Google Scholar
Brent, DA, Oquendo, M, Birmaher, B, Greenhill, L, Kolko, D, Stanley, B, Zelazny, J, Brodsky, B, Bridge, J, Ellis, S, Salazar, JO, Mann, JJ (2002). Familial pathways to early-onset suicide attempt: risk for suicidal behavior in offspring of mood-disordered suicide attempters. Archives of General Psychiatry 59, 801–807.CrossRefGoogle ScholarPubMed
Bridge, JA, McBee-Strayer, SM, Cannon, EA, Sheftall, AH, Reynolds, B, Campo, JV, Pajer, KA, Barbe, RP, Brent, DA (2012). Impaired decision making in adolescent suicide attempters. Journal of the American Academy of Child and Adolescent Psychiatry 51, 394–403.CrossRefGoogle ScholarPubMed
Buss, AR, Durkee, A (1961). An inventory for assessing different kinds of hostility. Journal of Consulting Psychology 21, 343–349.CrossRefGoogle Scholar
Clark, L, Dombrovski, AY, Siegle, GJ, Butters, MA, Shollenberger, CL, Sahakian, BJ, Szanto, K (2011). Impairment in risk-sensitive decision-making in older suicide attempters with depression. Psychology and Aging 26, 321–330.CrossRefGoogle ScholarPubMed
Dombrovski, AY, Clark, L, Siegle, GJ, Butters, MA, Ichikawa, N, Sahakian, BJ, Szanto, K (2010). Reward/punishment reversal learning in older suicide attempters. American Journal of Psychiatry 167, 699–707.CrossRefGoogle ScholarPubMed
Dombrovski, AY, Szanto, K, Siegle, GJ, Wallace, ML, Forman, SD, Sahakian, B, Reynolds, CF 3rd, Clark, L (2011). Lethal forethought: delayed reward discounting differentiates high- and low-lethality suicide attempts in old age. Biological Psychiatry 70, 138–144.CrossRefGoogle ScholarPubMed
Dunn, LM, Dunn, LM, Dunn, DM (1997). Peabody Picture Vocabulary Test, 3rd revision. American Guidance Service: Circle Pines, MN.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW, Loma, B (1996). Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), version 2.0. New York State Psychiatric Institute, Biometric Research Department: New York, NY.Google Scholar
Gunnell, D, Magnusson, PKE, Rasmussen, F (2005). Low intelligence test scores in 18 year old men and risk of suicide: cohort study. British Medical Journal 330, 167–171.CrossRefGoogle ScholarPubMed
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 56–62.CrossRefGoogle ScholarPubMed
Hamilton, M (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology 6, 278–296.CrossRefGoogle ScholarPubMed
Jollant, F, Bellivier, F, Leboyer, M, Astruc, B, Torres, S, Verdier, R, Castelnau, D, Malafosse, A, Courtet, P (2005). Impaired decision making in suicide attempters. American Journal of Psychiatry 162, 304–310.CrossRefGoogle ScholarPubMed
Jollant, F, Lawrence, NL, Olié, E, Guillaume, S, Courtet, P (2011). The suicidal mind and brain: a review of neuropsychological and neuroimaging studies. World Journal of Biological Psychiatry 12, 319–339.CrossRefGoogle ScholarPubMed
Keilp, JG, Gorlyn, M, Oquendo, MA, Burke, AK, Mann, JJ (2008). Attention deficit in depressed suicide attempters. Psychiatry Research 159, 7–17.CrossRefGoogle ScholarPubMed
Keilp, JG, Gorlyn, M, Russell, M, Oquendo, MA, Burke, AK, Harkavy-Friedman, J, Mann, JJ (2013). Neuropsychological function and suicidal behavior: attention control, memory and executive dysfunction in suicide attempt. Psychological Medicine 43, 539–551.CrossRefGoogle ScholarPubMed
Keilp, JG, Sackeim, HA, Brodsky, BS, Oquendo, MA, Malone, KM, Mann, JJ (2001). Neuropsychological dysfunction in depressed suicide attempters. American Journal of Psychiatry 158, 735–741.CrossRefGoogle ScholarPubMed
Keilp, JG, Sackeim, HA, Mann, JJ (2005). Correlates of trait impulsiveness in performance measures and neuropsychological tests. Psychiatry Research 135, 191–201.CrossRefGoogle ScholarPubMed
Linehan, MM, Dexter-Mazza, ET (2008). Dialectical behavior therapy for borderline personality disorder. In Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, 4th edn. (ed. Barlow, D. H.), pp. 365–420. Guilford Press: New York.Google Scholar
Malloy-Diniz, LF, Neves, FS, Abrantes, SS, Fuentes, D, Corrêa, H (2009). Suicide behavior and neuropsychological assessment of type I bipolar patients. Journal of Affective Disorders 112, 231–236.CrossRefGoogle ScholarPubMed
Mann, JJ, Waternaux, C, Haas, GL, Malone, KM (1999). Toward a clinical model of suicidal behavior in psychiatric patients. American Journal of Psychiatry 156, 181–189.CrossRefGoogle Scholar
Marzuk, PM, Hartwell, N, Leon, AC, Portera, L (2005). Executive functioning in depressed patients with suicidal ideation. Acta Psychiatrica Scandinavica 112, 294–301.CrossRefGoogle ScholarPubMed
McGirr, A, Dombrovski, AY, Butters, MA, Clark, L, Szanto, K (2012). Deterministic learning and attempted suicide among older depressed individuals: cognitive assessment using the Wisconsin Card Sorting Task. Journal of Psychiatric Research 46, 226–232.CrossRefGoogle ScholarPubMed
Melhem, NM, Brent, DA, Ziegler, M, Iyengar, S, Kolko, D, Oquendo, M, Birmaher, B, Burke, A, Zelazny, J, Stanley, B, Mann, JJ (2007). Familial pathways to early-onset suicidal behavior: familial and individual antecedents of suicidal behavior. American Journal of Psychiatry 164, 1364–1370.CrossRefGoogle ScholarPubMed
Oquendo, MA, Halberstam, B, Mann, JJ (2003). Risk factors of suicidal behavior: the utility and limitations of research instruments. In Standardized Evaluation in Clinical Practice: Review of Psychiatry, volume 22 (ed. First, M.), pp. 103–130. American Psychiatric Publishing: Washington, DC.Google Scholar
Riedel, M, Möller, HJ, Obermeier, M, Schennach-Wolff, R, Bauer, M, Adli, M, Kronmüller, K, Nickel, T, Brieger, P, Laux, G, Bender, W, Heuser, I, Zeiler, J, Gaebel, W, Seemüller, F (2010). Response and remission criteria in major depression – a validation of current practice. Journal of Psychiatric Research 44, 1063–1068.CrossRefGoogle ScholarPubMed
Sinclair, JM, Crane, C, Hawton, K, Williams, JM (2007). The role of autobiographical memory specificity in deliberate self-harm: correlates and consequences. Journal of Affective Disorders 102, 11–18.CrossRefGoogle ScholarPubMed
Sörberg, A, Allebeck, P, Melin, B, Gunnell, D, Hemmingsson, T (2013). Cognitive ability in early adulthood is associated with later suicide and suicide attempt: the role of risk factors over the life course. Psychological Medicine 43, 49–60.CrossRefGoogle ScholarPubMed
Spitzer, RL, Williams, JBW, Gibbon, M, First, MB (1990). Instruction Manual for the Structured Clinical Interview for the DSM-IV (SCID-P). American Psychiatric Press: Washington, DC.Google Scholar
Spreen, O, Strauss, E (2006). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary, 3rd edn. Oxford University Press: New York, NY.Google Scholar
Westheide, J, Quednow, BB, Kuhn, KU, Hoppe, C, Cooper-Mahkorn, D, Hawellek, B, Eichler, P, Maier, W, Wagner, M (2008). Executive performance of depressed suicide attempters: the role of suicidal ideation. European Archives of Psychiatry and Clinical Neuroscience 258, 414–421.CrossRefGoogle ScholarPubMed