title: Impaired decision-making in suicide attempters may increase the risk of problems in affective relationships.
abstract: BACKGROUND
  Decision-making has been found to be altered in suicide attempters and may represent a neuropsychological trait of vulnerability to suicidal behaviour. Environmental stressors such as adverse life events and interpersonal problems have been demonstrated to precipitate suicidal acts in vulnerable people. However, the link between vulnerability and stressors is complex and may even be circular. In the present study, we hypothesized that impaired decision-making may be associated with an increased risk of negative life events in suicide attempters.
  
  
  METHODS
  Forty-eight patients with a history of attempted suicide were assessed with the Iowa Gambling Task and interviewed regarding life events experienced over the past 12 months.
  
  
  RESULTS
  Decision-making performance was negatively correlated with interpersonal difficulties in the affective--namely marital and family--domain (rs=-0.39, p=0.006) but not with interpersonal difficulties in other social contexts, stressful life events or somatic health problems.
  
  
  CONCLUSIONS
  The relatively small sample size and the use of non-parametric methods may lead to a risk of type II errors. Furthermore, data on life events were retrospectively collected.
  
  
  CONCLUSIONS
  Altered decision-making may increase the risk of problematic affective relationships. These results underline the complex and possibly reciprocal link between environmental stress factors and cognitive vulnerability traits. This could be useful for the design of intervention strategies for suicidal behaviour.
authors.affiliation: Université Montpellier 1, Montpellier, F-34000 France. f-jollant@chu-montpellier.fr
authors.forename: Fabrice
authors.initials: F
authors.lastname: Jollant
authors.forename: Sébastien
authors.initials: S
authors.lastname: Guillaume
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaussent
authors.forename: Didier
authors.initials: D
authors.lastname: Castelnau
authors.forename: Alain
authors.initials: A
authors.lastname: Malafosse
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
mesh_terms: D000328:Adult; D000339:Affect; D015897:Comorbidity; D003657:Decision Making; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D013406:Suicide, Attempted / Q000523:psychology*