title: Risk-sensitive decision-making deficit in adolescent suicide attempters.
abstract: OBJECTIVE
  Suicide among adolescents is a major public health problem. Decision-making deficits may play an important role in vulnerability to suicidal behavior, but few studies have examined decision-making performance in youth at risk for suicide. In this study, we seek to extend recent findings that adolescent suicide attempters process risk evaluations differently than adolescents who have not attempted suicide.
  
  
  METHODS
  We assessed decision-making in 14 adolescent suicide attempters and 14 non-attempter comparison subjects, ages 15-19, using the Cambridge Gambling Task (CGT). Each participant was also administered a diagnostic interview (Mini-International Neuropsychiatric Interview [MINI]), structured suicide severity measures, and a brief intelligence quotient (IQ) measure.
  
  
  RESULTS
  After controlling for gender and IQ differences, suicide attempters displayed an elevated risk-taking propensity on the CGT relative to comparison subjects, such that they were more willing to take a large risk with their bank of points, a decision-making style that proves disadvantageous over time. No group differences in the latency or accuracy of decision-making were observed.
  
  
  CONCLUSIONS
  Adolescents with a history of suicide attempt display increased risk-taking and greater difficulty predicting probable outcomes on the CGT. Such deficits have been associated with dysfunction in the orbitofrontal prefrontal cortex, which supports other studies implicating impaired decision-making among individuals with a history of suicide attempt.
authors.affiliation: 1 Nationwide Children's Hospital Division of Behavioral Health , Columbus, Ohio.
authors.forename: John P
authors.initials: JP
authors.lastname: Ackerman
authors.forename: Sandy M
authors.initials: SM
authors.lastname: McBee-Strayer
authors.forename: Kristen
authors.initials: K
authors.lastname: Mendoza
authors.forename: Jack
authors.initials: J
authors.lastname: Stevens
authors.forename: Arielle H
authors.initials: AH
authors.lastname: Sheftall
authors.forename: John V
authors.initials: JV
authors.lastname: Campo
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Bridge
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology*; D055815:Young Adult