title: Distinct alterations in value-based decision-making and cognitive control in suicide attempters: toward a dual neurocognitive model.
abstract: OBJECTIVE
  The literature suggests that many suicide attempters show impairment in both decision-making and cognitive control. However, it is not clear if these deficits are linked to each other, and if they may be related to more basic alterations in attention. This is a relevant question in the perspective of future interventions targeting cognitive deficits to prevent suicidal acts.
  
  
  METHODS
  Two different populations of patients with histories of suicide attempts were assessed (N=142 and 119). The Iowa Gambling Task (IGT) was used to measure decision-making in both populations. We used a D2 cancellation task and a verbal working memory task in population 1; the Stroop test, the N-Back task, the Trail Making Test, and the Hayling Sentence Completion test in population 2.
  
  
  RESULTS
  Regarding decision-making, we only found a small negative correlation between the Hayling test error score (r=-0.24; p=0.01), and the net score from the second half of the IGT. In contrast, working memory, cognitive flexibility and cognitive inhibition measures were largely inter-correlated.
  
  
  CONCLUSIONS
  Most patients were medicated. Only patients with mood disorders.
  
  
  CONCLUSIONS
  These results add to previous findings suggesting that the neurocognitive vulnerability to suicidal behavior may rely on impairments in two distinct anatomical systems, one processing value-based decision-making (associated with ventral prefrontal cortex, among others) and one underlying cognitive control (associated with more dorsal prefrontal regions). This distinction may result in tailored-made cognitive interventions.
authors.affiliation: McGill University, Department of Psychiatry & Douglas Mental Health University Institute McGill Group for Suicide Studies, Montréal, Québec, Canada; Laboratoire de Psychologie des Pays de la Loire EA 4638, Université de Nantes et Angers, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Richard-Devantoy
authors.forename: Emilie
authors.initials: E
authors.lastname: Olié
authors.forename: Sébastien
authors.initials: S
authors.lastname: Guillaume
authors.forename: Antoine
authors.initials: A
authors.lastname: Bechara
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
authors.forename: Fabrice
authors.initials: F
authors.lastname: Jollant
mesh_terms: D000328:Adult; D003071:Cognition; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D008960:Models, Psychological; D019964:Mood Disorders / Q000523:psychology; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D057190:Stroop Test; D013406:Suicide, Attempted / Q000523:psychology*
keywords: Attention; Cognitive flexibility; Cognitive inhibition; Decision-making; Suicide attempts; Working memory