title: Iowa Gambling Task Performance in Elderly Persons with a Lifetime History of Suicidal Acts.
abstract: Suicide in the elderly is a major public health problem. In the present study, we aimed to further understand the mechanisms of suicidal vulnerability in the elderly, focusing on high-risk decision-making. This trait-like impairment has been extensively studied in adolescent and middle-aged suicide attempters, but less often in older persons.
  
  
  
  Case-control study.
  
  
  
  Community and university hospital.
  
  
  
  All participants were aged 65 and older. Thirty-five persons with a lifetime history of suicide attempts and depressive disorder were compared with 52 individuals with a past history of depressive disorder but no history suicidal acts, and 43 healthy comparison subjects.
  
  
  
  The Iowa Gambling Task was used as a measure of value-based decision-making.
  
  
  
  Taking into account age, sex, and Beck depression scores, no difference in decision-making performance was found between the three groups. The group of suicide attempters exhibited a significant heterogeneity, however, with those using violent means performing worse than non-violent attempters.
  
  
  
  This study does not confirm the hypothesis of a significant role for poor Iowa Gambling Task performance as a general marker of suicidal behavior among the elderly but highlights its association with the specific subtype of violent suicidal attempters. Combined with previous findings among other age groups, it suggests that Iowa Gambling Task impairment may be a risk marker of vulnerability to violent suicidal acts. Future prospective studies should assess if this may represent a risk marker for suicide completion.
authors.affiliation: Academic Hospital CHU, Nimes, France. Electronic address: marilyn.wyart@chu-nimes.fr.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Wyart
authors.affiliation: Université Montpellier 1, Montpellier, France; Inserm U1061, Montpellier, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaussent
authors.affiliation: Université Montpellier 1, Montpellier, France; Inserm U1061, Montpellier, France.
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.affiliation: Academic Hospital CHU, Nimes, France.
authors.forename: Mocrane
authors.initials: M
authors.lastname: Abbar
authors.affiliation: Academic Hospital CHU, Nimes, France; McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Canada.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Jollant
authors.affiliation: Université Montpellier 1, Montpellier, France; Inserm U1061, Montpellier, France; CHU Montpellier, Hôpital Lapeyronie, Department of Emergency Psychiatry and Post Acute Care, Montpellier, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003657:Decision Making; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D005715:Gambling / Q000523:psychology*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D013406:Suicide, Attempted / Q000523:psychology*
keywords: decision-making; elderly; iowa gambling task; suicide; vulnerability