title: Intact alternation performance in high lethality suicide attempters.
abstract: Suicide attempters often perform poorly on tasks linked to ventral prefrontal cortical (VPFC) function. Object Alternation (OA) - a VPFC probe - has not been used in these studies. In this study, currently depressed medication-free past suicide attempters whose most severe attempt was of high (n=31) vs. low (n=64) lethality, 114 medication-free depressed non-attempters, and 86 non-patients completed a computerized OA task. Participants also completed comparison tasks assessing the discriminant validity of OA (Wisconsin Card Sort), its concurrent validity relative to tasks associated with past attempt status (computerized Stroop task, Buschke Selective Reminding Test), and its construct validity as a VPFC measure (Go-No Go and Iowa Gambling Task). Against expectations, high lethality suicide attempters - the majority of whom used non-violent methods in their attempts with some planning - outperformed other depressed groups on OA, with no group differences observed on Wisconsin Card Sort. Despite intact performance on OA, past attempters exhibited deficits on the Stroop and Buschke. OA performance was associated with performance on Go-No Go and Iowa Gambling, confirming that OA measures a similar construct. VPFC dysfunction may not be a characteristic of all suicide attempters, especially those who make more carefully planned, non-violent - though potentially lethal - attempts.
authors.affiliation: Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, USA. Electronic address: jgk13@columbia.edu.
authors.forename: John G
authors.initials: JG
authors.lastname: Keilp
authors.affiliation: Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, USA.
authors.forename: Gwinne
authors.initials: G
authors.lastname: Wyatt
authors.affiliation: Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, USA.
authors.forename: Marianne
authors.initials: M
authors.lastname: Gorlyn
authors.affiliation: Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, USA.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Oquendo
authors.affiliation: Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, USA.
authors.forename: Ainsley K
authors.initials: AK
authors.lastname: Burke
authors.affiliation: Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, USA.
authors.forename: J
authors.initials: J
authors.lastname: John Mann
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D003863:Depression / Q000150:complications* / Q000523:psychology*; D005260:Female; D005717:Games, Experimental; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D017397:Prefrontal Cortex / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Affective disorders; Depression; Neuropsychological; Object Alternation; Ventral Prefrontal Cortex