Sleep influences daily suicidal ideation through affective reactivity to interpersonal events among high-risk adolescents and young adults.

BACKGROUND: Identifying proximal risk factors for suicidal ideation that are modifiable and relevant for adolescents and young adults is critical for suicide prevention. This study used an intensive monitoring approach to examine whether objectively- and subjectively- measured sleep characteristics predict next-day suicidal ideation occurrence and intensity through affective reactivity to interpersonal events in young people at high risk for suicide. METHODS: Participants included 59 (13-23 years; 76% White; 75% female) adolescents and young adults undergoing intensive outpatient program treatment for depression and suicidality. Participants completed daily ratings of suicidal ideation, sleep quality, and affective reactivity to positive and negative interpersonal events for up to 3 months (M = 56 days, SD = 24.13). Actigraphy captured behavioral sleep duration and timing. Multilevel modeling was used to evaluate within-person fluctuations in sleep and affective reactivity as predictors of suicidal ideation, and multilevel mediation tested the indirect effects of sleep on suicidal ideation via affective reactivity to interpersonal events. RESULTS: Results indicate significant indirect effects of objectively measured sleep duration and subjective sleep quality on next-day suicidal ideation via affective reactivity to negative and positive interpersonal events, respectively. Shorter-than-usual sleep predicted the presence and intensity of next-day suicidal ideation via heightened affective reactivity to negative interpersonal events. Worse sleep quality than usual predicted next-day suicidal ideation via reduced affective reactivity to positive interpersonal events. CONCLUSIONS: Affectivity reactivity is a proximal mechanism through which sleep indices may influence risk for suicidal thinking on a daily basis. Findings highlight the utility of targeting sleep and emotion regulation in suicide prevention among adolescents and young adults at high-risk for suicide.

Age differences in neural response to reward and loss in children.

The goal of this study was to examine age-related differences in children's reward processing. Focusing on reward outcome processing, we used event-related potentials to examine substages of neural response to gain versus loss feedback in a sample of 7-11-year-old children (M = 9.67, SD = 1.40) recruited from the community (N = 234; 47.6% girls, 66.2% non-Hispanic European American). Using principal components analysis (PCA), we focused on temporospatial combinations that closely resembled the RewP, fb-P3, and fb-LPP in temporal and spatial distributions. Two of these, the PCA factors reflecting the RewP and fb-LPP, demonstrated age-related differences in response to gains versus losses. Age-related changes in the RewP were specific to gain feedback, with RewP amplitudes to gain, but not loss, increasing from middle to late childhood. In contrast, age-related changes in fb-LPP were specific to loss feedback, with fb-LPP amplitudes to losses, but not gains, decreasing from middle to late childhood. Follow-up analyses revealed that children younger than age 8 exhibited larger fb-LPP responses to loss than gain, whereas children older than age 10 exhibited larger RewP responses to gain than loss. Similar results were obtained using mean amplitude-based ERP indices and the results do not appear to have been due to age-related differences in the latency or location of the ERPs themselves. These results highlight the importance of examining distinct substages of reward outcome processing and suggest that robust neural responses to loss feedback may emerge earlier in childhood than responses to gains.

Protective effects of reasons for living against suicidal ideation in daily life.

How do individuals resist suicidal urges in a crisis? Deterrents for suicide can be conceptualized as reasons for living (RFL), but our understanding of their protective effects is predominantly informed by cross-sectional research. We examined the protective effects of RFL on suicidal ideation (SI) in daily life in a high-risk sample. We also tested whether personality traits moderated the strength of the dynamic RFL-SI link. Adults with a borderline personality disorder diagnosis (N = 153, nsuicide attempters = 105) completed a 21-day ambulatory assessment protocol. Daily endorsements of RFL were negatively linked to SI at the within-person but not the between-person level. Whereas suicide attempters endorsed RFL less frequently than non-attempters, the protective effect of RFL was undiminished in this group. Furthermore, RFL's protective effect was particularly pronounced in those with higher average levels of suicidal ideation. While people high on extraversion endorsed RFL more often, this increase was not protective against SI, indicating that RFL reflect heterogeneous underlying psychological processes, only some of which protect against SI.

Delay discounting in suicidal behavior: Myopic preference or inconsistent valuation?

Prior studies sought to explain the predisposition to suicidal behavior in terms of myopic preference for immediate versus delayed reward, generating mixed evidence. Data from gambling and bandit tasks, however, suggest that suboptimal decisions in suicidal individuals are explained by inconsistent valuation rather than myopic preferences. We tested these two alternative hypotheses using a delay discounting task in 622 adults (suicide attempters with depression, suicide ideators with depression, nonsuicidal participants with depression, and healthy controls) recruited across three sites through inpatient psychiatric units, mood disorders clinics, primary care, and advertisements. Multilevel models revealed group differences in valuation consistencies in all three samples, with high-lethality suicide attempters exhibiting less consistent valuation than all other groups in Samples 1 and 3 and less consistent valuation than the healthy controls or participants with depression in Sample 2. In contrast, group differences in preference for immediate versus delayed reward were observed only in Sample 1 and were due to the high-lethality suicide attempters displaying a weaker preference for immediate reward than low-lethality suicide attempters. The findings were robust to confounds such as cognitive functioning and comorbidities. Seemingly impulsive choices in suicidal behavior are explained by inconsistent reward valuation rather than a true preference for immediate reward. In a suicidal crisis, this inconsistency may result in a misestimation of the value of suicide relative to constructive alternatives and deterrents. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Development of Overgeneral Autobiographical Memory in Offspring of Depressed Mothers.

Maternal depression increases the risk for offspring cognitive vulnerabilities, which may be a mechanism underlying the intergenerational transmission of depression. Little is known about how cognitive vulnerabilities, particularly memory biases, develop in the offspring of depressed mothers. Understanding the etiology of memory biases may lead to novel intervention targets. Therefore, the current study examined the prospective impact of maternal depression on the development of offspring overgeneral autobiographical memory (OGM; i.e., the tendency to recall less specific memories), a cognitive vulnerability implicated in the intergenerational transmission of depression. Participants were offspring (ages 8-14; 51% daughters, 81% Caucasian) of mothers with (n= 129) or without (n= 122) a history of major depressive disorder (MDD) during the offspring's life. Mothers and offspring completed assessments every 6 months for 2 years. Compared to offspring of never-depressed mothers, offspring of mothers with a history of MDD recalled less specific memories in response to negative, but not positive, cue words at the initial assessment, and this bias was maintained across the 2-year follow-up. For offspring of depressed, but not never-depressed, mothers, higher levels of maternal depressive symptoms at a given assessment predicted prospective decreases in the children's autobiographical memory specificity. Again, this finding was specific to negative, but not positive, cue words. These results suggest that maternal depression has both short- and long-term effects on the development of offspring OGM to negative cues, which may represent a malleable cognitive vulnerability for the intergenerational transmission of MDD that could be targeted for intervention.

Maternal criticism and children's neural responses to reward and loss.

Parental criticism is linked to a number of detrimental child outcomes. One mechanism by which parental criticism may increase risk for negative outcomes in children is through children's neural responses to valenced information in the environment. The goal of the current study, therefore, was to examine the relation between maternal criticism and children's neural responses to monetary gains and losses. To represent daily environmental experiences of reward and punishment, we focused on reactivity to monetary gains versus losses in a guessing task. Participants were 202 children and their mothers recruited from the community. The average age of the children was 9.71 years (SD = 1.38, range = 7-11), with 52.0% of them male and 72.8% Caucasian. Mothers completed the Five Minute Speech Sample to assess expressed emotion-criticism, and of these dyads 51 mothers were rated as highly critical. In addition, children completed a simple guessing game during which electroencephalography was recorded. Children of critical mothers displayed less neural reactivity to both monetary gain and loss than children without critical mothers. Our results were at least partially independent of children's and mothers' current levels of internalizing psychopathology. These findings suggest that children exposed to maternal criticism may exhibit disruptions in adaptive responses to environmental experiences regardless of valence. Targeted interventions aimed at reducing expressed emotion-criticism may lead to changes in a child's reward responsiveness and risk for psychopathology.

Reward Responsiveness in Suicide Attempters: An Electroencephalography/Event-Related Potential Study.

BACKGROUND: The present study aimed to objectively examine the Research Domain Criteria (RDoC) subconstructs of reward anticipation and initial response to reward in adult suicide attempters, compared with nonattempters, using electroencephalography (EEG) and event-related potentials (ERPs) within the context of the RDoC-recommended experimental paradigms for these subconstructs. METHODS: Participants had either a history of at least 1 suicide attempt (n = 30) or no history of attempting suicide (n = 30). They completed diagnostic interviews, self-report questionnaires, and 2 computer-based tasks-the monetary incentive delay task and the doors task-during which continuous EEG was recorded. Temporospatial principal component analysis was used to isolate each of the ERP components of interest from other temporally or spatially overlapping components. Exploratory time-frequency analyses were also conducted to supplement the ERP analyses. RESULTS: Suicide attempters, compared with nonattempters, exhibited specific deficits in reward anticipation (i.e., blunted cue-P3 ERP during the monetary incentive delay task) and in initial response to reward (i.e., reduced feedback-related delta power in the gain condition of the doors task). These results were at least partially independent of current symptoms or diagnoses of depression and anxiety. CONCLUSIONS: These findings constitute an important step in obtaining a more fine-grained understanding of the specific reward-related abnormalities that might contribute to suicide risk.

Time of day differences in neural reward responsiveness in children.

The Reward Positivity (∆RewP) event-related potential (ERP), generally quantified as the difference between neural responsiveness to monetary gains (RewP-Gain) and losses (RewP-Loss) is commonly used as an index of neural reward responsiveness. Despite the popularity of this ERP component in studies of reward processing, knowledge about the role of state-related influences on the ∆RewP is limited. The present study examined whether ∆RewP amplitudes may differ based on when during the day they are assessed and whether age or sex would moderate this link. Participants were 188 children between the ages of 7 and 11 (47.3% female) without a lifetime history of a major depressive disorder or any anxiety disorder recruited from the community. Children completed the Doors task during which continuous electroencephalography was recorded to isolate the ∆RewP. To better isolate this ERP component from other temporally or spatially overlapping ERPs, we used temporospatial principal component analysis. We found that time of day (ToD) differences in the ∆RewP amplitude varied based on children's age. Specifically, older, compared to younger, children exhibited stronger responses to gains versus losses between 11:15 a.m. and 12:30 p.m. and after around 5:15 p.m. Further, these age-related differences appeared to be driven specifically by older children's reduced neural responsiveness to losses. The findings have methodological implications by highlighting the importance of accounting for the ToD at which ∆RewP-focused study sessions are conducted as well as for demographic characteristics of the participants, such as their age.

Blunted Neural Reward Responsiveness in Children with Recent Suicidal Ideation.

Individuals with suicidal thoughts and behaviors experience abnormalities in reward-related processes, yet little is known about specific components or stages of reward processing that are impaired, especially in children. The primary aim of this study was to conduct an investigation of the Initial Response to Reward subconstruct of the National Institute of Mental Health's Research Domain Criteria in relation to recent suicidal ideation (SI) in children. Participants were 23 children between the ages of 7 and 11 with a history of recent SI and 46 demographically and clinically matched children with no recent SI. Children completed a simple guessing task during which continuous electroencephalography was recorded to isolate the Reward Positivity (ΔRewP) event-related potential, which reflects the difference in neural responses to monetary gains (RewP-gain) versus losses (RewP-loss). Children with recent SI exhibited significantly smaller (i.e., blunted) ΔRewP, providing initial evidence for blunted initial responses to reward in these children.

Neural reward responsiveness in children who engage in nonsuicidal self-injury: an ERP study.

BACKGROUND: A better understanding of the correlates of nonsuicidal self-injury (NSSI) in children is important for the identification and prevention of future suicide risk. However, although abnormalities in reward responsiveness might constitute one potential transdiagnostic mechanism of risk for NSSI, no studies have examined initial response to reward in children with a history of NSSI. The goal of the present study was to address this important gap in the literature. To objectively assess initial response to reward, we utilized the feedback negativity (FN) event-related potential, a well-established psychophysiological marker of reward responsiveness. METHODS: Participants were 57 children (19 with a history of NSSI and 38 demographically matched controls) between the ages of 7 and 11. Diagnostic interviews were used to assess for current and past DSM-IV mood and anxiety diagnoses and NSSI history. Children also completed a guessing task, during which continuous electroencephalography was recorded. RESULTS: Children with a history of NSSI exhibited significantly more negative ΔFN (i.e., FN to losses minus FN to gains) than children without NSSI. These findings appeared to be at least partially independent of children's history of psychopathology and current symptoms, suggesting their specificity to NSSI. CONCLUSIONS: These results provide initial evidence for heightened neural initial reward responsiveness to losses versus rewards in children with a history of NSSI. Pending replications and longitudinal studies, the ΔFN might represent a psychophysiological marker of risk for self-harm.

Episodic Life Stress and the Development of Overgeneral Autobiographical Memory to Positive Cues in Youth.

Overgeneral autobiographical memory (OGM) has been established as a risk factor for depression in both youth and adults, but questions remain as to how OGM develops. Although theorists have proposed that the experience of stressful life events may contribute to the development of OGM, no studies have examined the impact of negative life events on prospective changes in OGM. The goal of the current study was to address this gap in the literature. Participants included 251 mothers and their biological children (aged 8-14 years old at the initial assessment). Using a multi-wave prospective design with assessments every 6 months for 2 years, we found that episodic life stress predicted prospective decreases in youths' autobiographical memory specificity to positive, but not negative, cues. This study supports theories proposing that negative life events may contribute to the development of OGM, but suggest that, in youth, the impact of life stress on OGM may be specific to positive rather than negative memories.

Emotion Reactivity, Comfort Expressing Emotions, and Future Suicidal Ideation in Emerging Adults.

OBJECTIVE: Emotion reactivity and difficulties in expressing emotions have been implicated in risk for suicidal behavior. This study examined comfort in expressing emotions (positive vs. negative) and depressive symptoms as mediators of the prospective relation between emotion reactivity and suicidal ideation. DESIGN: Emerging adults (N = 143; 72% female; 28% White) completed measures of emotion reactivity, comfort expressing emotions, and suicidal ideation at baseline and of depressive symptoms and suicidal ideation 12 months later. RESULTS: Emotion reactivity predicted suicidal ideation at follow-up through depressive symptoms. Difficulty expressing love-but not happiness, sadness, and anger-partially mediated the relationship between emotion reactivity and suicidal ideation at follow-up before but not after adjusting for baseline ideation. CONCLUSION: The relation between high emotion reactivity and suicidal ideation may be explained by discomfort in the expression of positive emotions and by depressive symptoms. Promotion of comfort in positive emotion expression may reduce vulnerability to suicidal ideation.

Resting respiratory sinus arrhythmia in suicide attempters.

Although suicide attempts (SA) occur across a broad range of diagnoses as well as in the absence of a diagnosable disorder, most studies to date have focused on them within a single, specific disorder. Consistent with the NIMH RDoC initiative to identify biobehavioral vulnerabilities that cut across diagnoses, the goal of the present study was to examine potential differences in resting respiratory sinus arrhythmia (RSA) levels in a large, diagnostically heterogeneous sample of women with and without a history of SA who were matched on a broad range of demographic and clinical variables. Participants were 112 women with (n = 56) and without (n = 56) a history of SA recruited from the community. The two groups were equated on approximate age, race, household income, and lifetime histories of psychiatric diagnoses. Resting electrocardiogram was recorded during a 2-min rest period. RSA was calculated via spectral power analyses with a fast Fourier transform. We found that women with a history of SA exhibited significantly lower resting RSA levels than women with no history of SA, and this difference was maintained even after statistically controlling for the potential influence of women's history of psychiatric diagnoses and their current symptoms of depression and anxiety. These findings suggest the presence of a link between resting RSA and SA history.

Suicidal ideation and attentional biases in children: An eye-tracking study.

BACKGROUND: Despite theoretical and empirical evidence for a heighted responsiveness to signals of social-threat in suicidal individuals, no studies to date have examined whether this responsiveness might also manifest in the form of specific biases in attention to interpersonal stimuli. The current study, therefore, examined the presence and nature of attentional biases for facial expressions of emotion in children with and without a history of suicidal ideation (SI). METHOD: Participants were 88 children (44 with a history of SI and 44 demographically and clinically matched controls without such history) recruited from the community. The average age of children was 9.26 years (44.3% female; 67.0% Caucasian). Children's history of SI was assessed via structured interviews with children and their parent. Attentional biases were assessed using a dot probe task and included fearful, happy, and sad facial stimuli and focused on eye tracking and reaction time indices of attentional bias. RESULTS: Children with a history of SI exhibited significantly greater gaze duration toward fearful faces. The findings appeared to be at least partially independent of children's history of major depression or anxiety disorders or their current depressive or anxious symptoms. LIMITATIONS: The study is limited by its cross-sectional design, which precludes any causal conclusions regarding the role of attentional biases in future suicide risk. CONCLUSIONS: Our results suggest that children with a history of SI exhibit biases in sustained attention toward socially-threatening facial expressions. Pending replications, these findings might represent a new avenue of suicide risk assessment and intervention.

Neural responses to gains and losses in children of suicide attempters.

[Correction Notice: An Erratum for this article was reported in Vol 126(2) of Journal of Abnormal Psychology (see record 2016-56318-001). In the article, Figure 1 had incorrect axis labels. There was also an error in the abstract, which did not state that ΔFN was calculated as FN to losses minus FN to gains. All versions of this article have been corrected.] Suicidal behavior aggregates within families, yet the specific mechanisms of suicide-risk transmission are poorly understood. Despite some evidence that abnormal patterns of reward responsiveness might constitute one such potential mechanism, empirical evidence is lacking. The goal of this study was to examine neural responses to gains and losses in children of suicide attempters with no personal history of suicide attempt (SA) themselves. To objectively assess these neural responses, we used feedback negativity (FN), a psychophysiological marker of responsiveness to reward and loss. Participants were 66 parents and their 7-11-year-old children (22 with parental history of SA and 44 demographically and clinically matched children of parents with no SA history). Diagnostic interviews were used to gather information about psychiatric diagnoses, symptoms, and histories of suicidal thoughts and behaviors. Children also completed a guessing task, during which continuous electroencephalography (EEG) was recorded. The FN was scored as the mean amplitude, 275-375 ms, following gain or loss feedback at frontocentral sites (Fz and FCz). Children of suicide attempters exhibited significantly more negative ΔFN (i.e., FN to losses minus FN to gains) than children of parents with no SA history. We found that this difference in ΔFN was due specifically to children of parents with a history of SA exhibiting a stronger response to loss, and no group differences were observed for responses to gains. The results suggest that an increased neural response to loss might represent one of the potential pathways of the familial transmission of suicide risk. (PsycINFO Database Record

Cognitive vulnerabilities and development of suicidal thinking in children of depressed mothers: A longitudinal investigation.

Although children of depressed parents are at heightened risk for suicidal ideation, little is known about specific risk factors. This study focused on the relation between a broad range of cognitive vulnerabilities proposed by the leading cognitive theories and the development of suicidal ideation in children. Participants were 209 mothers (aged 24-55) and their 8-14 year old children. Children of depressed mothers who had previously experienced suicidal ideation themselves reported higher levels of brooding rumination than children of depressed mothers who had not experienced suicidal ideation as well as children of never depressed mothers who had not experienced suicidal ideation. Further, among children of depressed mothers with no prior history of suicidal ideation, higher levels of hopelessness and lower global self-worth predicted first onset of suicidal ideation over a 2-year follow-up. Importantly, these results were maintained even after taking the occurrence of major depressive disorder in children during the follow-up into account. The findings highlight specific cognitive vulnerabilities that could be targeted in early suicide prevention and intervention efforts.

Classification of facial expressions of emotion and risk for suicidal ideation in children of depressed mothers: Evidence from cross-sectional and prospective analyses.

BACKGROUND: Despite the increased risk for suicidal ideation (SI) in children of mothers with a history of major depressive disorder (MDD), little is known about specific risk factors for SI in these children. The present study is the first to our knowledge to examine the potential role of biases in the identification of facial expressions of emotion. METHODS: Participants were 202 children (aged 8-14 years) and their mothers (aged 24-55 years) that comprised three groups based on maternal history of MDD and children's history of SI: Mom MDD/Child SI (n=35); Mom MDD/No Child SI (n=76); and Controls (i.e., no mom MDD and no child SI; n=91). RESULTS: We found that children in the Mom MDD/Child SI group were more likely to misclassify full-intensity angry emotions as sad than children in the other groups. Among children in the two mother MDD groups, both the overall proportion of full-intensity angry emotions misclassified and the proportion of full-intensity angry emotions misclassified specifically as sad predicted the occurrence of SI over a 2-year follow-up, even after accounting for the impact of children's own diagnoses of MDD during the follow up. LIMITATIONS: Our findings might not generalize to other negative emotions, such as fear or disgust. CONCLUSION: This highlights specific emotion identification abnormalities that could be targeted in early suicide prevention efforts and suggests that these abnormalities are at least partially independent of children's risk for MDD.

Non-suicidal self-injury and suicidal thoughts and behaviors in heterosexual and sexual minority young adults.

OBJECTIVE: Despite consistently greater rates of non-suicidal self-injury (NSSI) and suicidal thoughts and behaviors (STBs; i.e., suicidal ideation, method/plan, and attempts) in lesbian, gay, and bisexual (LGB) individuals, prevalence, characteristics, and relations between these dangerous thoughts and behaviors are equivocal. The present study sought to examine and compare the rates of NSSI and STBs in a large sample of sexual minority and majority young adults. METHODS: Participants were 12,422 college students (ages 18-29; 57.3% female) who self-reported demographic characteristics, NSSI frequency, the number of NSSI forms used, the number of NSSI functions, as well as STB history (i.e., ideation, method/plan, and attempts). Each participant's degree of SA was assessed via a 7-point scale (i.e., K0-K6) from Alfred Kinsey's research of sexual attraction and sexual experiences. This scale was collapsed to create five categories of SA: exclusively other SA (K0), mostly other SA (K1/2), equally other and same SA (K3), mostly same SA (K4/5), and exclusively same SA (K6). RESULTS: Consistent with previous research, we found that being a sexual minority young adult was associated with significantly higher odds of STBs compared to being a heterosexual young adult. In addition, compared to the exclusively other SA group (K0), being in the mostly other SA group (K1/2), equally other and same SA group (K3), or mostly same SA group (K4/5) was associated with significantly higher odds of NSSI engagement. Among those with NSSI, we found that the number of NSSI forms was significantly associated with suicide attempts, but was not associated with either suicidal ideation or suicide method/plan in the mostly other SA group (K1/2) or in the equally other and same SA group (K3). We also found a significant curvilinear relation between NSSI frequency and STBs in the mostly other SA group (K1/2) and between NSSI frequency and suicide method/plan and attempt in the exclusively other SA group (K0). In addition, we revealed specificity with regard to the relation between the number of lifetime NSSI episodes and risk for STBs among the equally other and same SA (K3), mostly same SA (K4/5), and exclusively same SA (K6) groups. CONCLUSION: Our findings suggest that among sexual minority young adults, equally other and same SA individuals may be at higher risk of NSSI and STBs than their sexual minority counterparts. In addition, these findings extend previous research by suggesting that the relations between NSSI frequency, number of forms, and number of functions and STBs might vary according to SA. A multi-theory based explanation is provided to explain the key findings and the study implications are discussed.

Peer Victimization Mediates the Impact of Maternal Depression on Risk for Suicidal Ideation in Girls but not Boys: A Prospective Study.

Although children of depressed mothers are at an increased risk for suicidal thinking, little is known about the potential mechanisms by which this occurs. The present study is the first to our knowledge to utilize a prospective design with the goal of examining whether the impact of maternal depression on children's risk for suicidal ideation is mediated by children's levels of overt and relational peer victimization. Participants were 203 mother-child pairs recruited from the community. The age range of the children was 8 to 14 years old (50.2 % girls). Mothers either met criteria for a major depressive disorder (MDD) during their child's lifetime (n = 96) or had no lifetime diagnosis of any DSM-IV mood disorder and no current Axis I diagnosis (n = 107). At the baseline assessment, diagnostic interviews were used to assess mothers' and children's histories of MDD and children completed a self-report measure of peer victimization. Follow-up assessments were conducted at 6, 12, 18, and 24 months after the initial assessment during which time interviewers assessed for the occurrence of suicidal ideation in the children. Utilizing a mediated moderation model, we found significant indirect pathways from maternal depression to children's suicidal ideation through both relational and overt forms of peer victimization among girls, but not among boys. The current study suggests that peer victimization may constitute one of the potential mechanisms by which daughters of depressed mothers are at increased risk for suicidal thinking.