Neurocognitive vulnerability to youth suicidal behavior

Donna Ruch, Arielle H. Sheftall, Kendra Heck, Sandra M. McBee-Strayer, Jaclyn Tissue, Brady Reynolds, John Ackerman, David A. Brent, John V. Campo, Jeffrey A. Bridge

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Neurocognitive deficits have been associated with suicidal behavior in adults with major depressive disorder (MDD), but it is unclear if similar impairments are linked to youth suicidal behavior. This study compared neurocognitive functioning in suicidal and non-suicidal youth with a lifetime history of MDD and explored whether neurocognitive functioning predicted future suicide attempts. Neurocognition was examined using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and Iowa Gambling Task (IGT) in 309 youths ages 12–15 (117 suicide attempters; 132 suicidal ideators; 60 never-suicidal). Prospective analyses included 284 youths (41 youth with a future attempt; 243 without a future attempt). Multivariate analysis of variance (MANOVA) yielded a significant group-by-sex interaction effect [Wilks’ Λ = 0.901, F (16, 560) = 1.87, p = .021] for the primary neurocognitive outcomes, guiding the decision to stratify the sample by sex. Female suicide attempters and ideators were slower to respond correctly to both positive and negative emotion words than never-suicidal controls on tests of affective bias. Male suicide attempters and ideators made significantly more total and between errors than never-suicidal subjects. Exploratory analyses found that total commission errors on the Affective Go/No-Go (AGN) test significantly predicted future suicide attempts in females, and that higher strategy scores on Spatial Working Memory (SWM) tests predicted future male attempts. Study findings identified sex-specific neurocognitive deficits that differentiate suicidal and non-suicidal youth with histories of MDD. Extended longitudinal studies are needed to elucidate the temporal association between neurocognitive impairments and suicidal behavior and frame targets for early preventive interventions.

Original languageEnglish
Pages (from-to)119-126
Number of pages8
JournalJournal of Psychiatric Research
StatePublished - Dec 2020

Bibliographical note

Funding Information:
This work was supported by a grant from the National Institutes of Health, National Institute of Mental Health [grant number R01-MH093552 ]. The Extramural Division of the National Institute of Mental Health did not participate in the design and conduct of the study, in the collection, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript.

Publisher Copyright:
© 2020 Elsevier Ltd


  • Adolescent mental health
  • Neurocognitive functioning
  • Prevention/early detection
  • Suicidal behavior
  • Suicide risks

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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