title: The experience of social exclusion in women with a history of suicidal acts: a neuroimaging study.
abstract: Suicidal behaviors result from a complex interaction between social stressors and individual vulnerability. However, little is known of the specific neural network supporting the sensitivity to social stressors in patients at risk of suicidal acts. Using functional Magnetic Resonance Imaging, we investigated brain processing of social rejection in suicide attempters. Thirty-six euthymic women with a history of depression and suicidal behavior were compared to 41 euthymic women with a history of depression but no suicidal attempt, and 28 healthy controls. The Cyberball Game was used as a validated social exclusion paradigm. Relative to healthy controls, both patient groups reported higher levels of social distress related to the task, without significant differences according to suicidal status. Compared to patients without any history of suicide attempt and healthy controls, suicide attempters showed decreased contrast in the left insula and supramarginal gyrus during the exclusion vs. inclusion condition, after controlling for number of depressive episodes, medication, mood disorder type or social phobia. Our study highlights impaired brain response to social exclusion in euthymic female suicide attempters in regions previously implicated in pain tolerance and social cognition. These findings suggest sustained brain dysfunctions related to social perception in suicide attempters.
authors.affiliation: Department of Emergency Psychiatry & Post Acute Care, Academic hospital of Montpellier, Montpellier University, & INSERM U1061, Montpellier, France. e-olie@chu-montpellier.fr.
authors.forename: Emilie
authors.initials: E
authors.lastname: Olié
authors.affiliation: Department of Psychiatry, Academic hospital of Nimes, Nimes, France.|McGill University, Department of psychiatry, and Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montreal, Québec, Canada.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Jollant
authors.affiliation: Department of Neuroradiology, Academic hospital of Montpellier & U1051, Institut of Neurosciences of Montpellier, Montpellier, France.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Deverdun
authors.affiliation: Department of Neuroradiology, Academic hospital of Montpellier & U1051, Institut of Neurosciences of Montpellier, Montpellier, France.|I2FH & CNRS UMR 5221, University of Montpellier, Montpellier, France.
authors.forename: Nicolas Menjot
authors.initials: NM
authors.lastname: de Champfleur
authors.affiliation: Neurosurgery, Academic Hospital of Montpellier & INSERM U1061, Montpellier, France.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Cyprien
authors.affiliation: Department of Neuroradiology, Academic hospital of Montpellier & U1051, Institut of Neurosciences of Montpellier, Montpellier, France.|I2FH & CNRS UMR 5221, University of Montpellier, Montpellier, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Le Bars
authors.affiliation: Center for clinical investigation, Academic hospital of Montpelier, Montpellier University, Montpellier, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Mura
authors.affiliation: Department of Neuroradiology, Academic hospital of Montpellier & U1051, Institut of Neurosciences of Montpellier, Montpellier, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Bonafé
authors.affiliation: Department of Emergency Psychiatry & Post Acute Care, Academic hospital of Montpellier, Montpellier University, & INSERM U1061, Montpellier, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
mesh_terms: D000293:Adolescent; D000328:Adult; D002540:Cerebral Cortex / Q000000981:diagnostic imaging*; D002648:Child; D003863:Depression / Q000000981:diagnostic imaging* / Q000523:psychology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods*; D009483:Neuropsychological Tests; D012929:Psychological Distance; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*; D055815:Young Adult