VISN 19 Mental Illness Research, Education, and Clinical Center, Denver, Colorado 80220, USA.
Rehabil Psychol. 2012 Nov;57(4):337-41. doi: 10.1037/a0030480.
The aim of this pilot study was to explore the relationship between executive dysfunction and suicidal behavior in two groups of participants: (Group 1, n = 18) veterans with traumatic brain injury (TBI) and a history of at least one suicide attempt (SA), and (Group 2, n = 29) veterans with TBI and no history of SA. Controlling for the severity of TBI, it was hypothesized that participants in Group 1 would perform more poorly than those in Group 2 on measures of executive functioning.
The primary outcome variable was decision making as assessed by performance on the Iowa Gambling Task (IGT). Secondary outcome variables included laboratory-measured impulsivity as measured by the Immediate and Delayed Memory Test (IMT/DMT), abstract reasoning as measured by the Wisconsin Card Sorting Test (WCST), and aggression as measured by the Lifetime History of Aggression (LHA) scale.
Among those in Group 1, time between TBI and first suicide attempt postinjury varied widely (months to nearly 30 years). Only the WCST perseverative errors score differed significantly between individuals with and without histories of one or more suicide attempts (SAs).
Suggestions for future study of SA among those with TBI are provided. When working with individuals with TBI, clinicians are encouraged to incorporate suicide risk assessment into their practice. Augmenting this process with a measure of perseveration may be beneficial.
本初步研究旨在探讨两组参与者（第 1 组，n=18，有创伤性脑损伤[TBI]和至少一次自杀未遂史）和第 2 组（n=29，有 TBI 且无自杀未遂史）之间执行功能障碍与自杀行为之间的关系。控制 TBI 的严重程度，假设第 1 组参与者在执行功能测量上的表现会比第 2 组差。
主要结局变量是通过爱荷华赌博任务（IGT）评估的决策制定。次要结局变量包括通过即时和延迟记忆测试（IMT/DMT）测量的实验室冲动性、威斯康星卡片分类测试（WCST）测量的抽象推理和通过终身攻击史（LHA）量表测量的攻击性。
第 1 组中，TBI 与损伤后首次自杀未遂之间的时间间隔差异很大（从几个月到近 30 年）。只有 WCST 的持续错误得分在有或无一次或多次自杀未遂史的个体之间存在显著差异。
为 TBI 患者的自杀研究提供了建议。当与 TBI 患者合作时，鼓励临床医生将自杀风险评估纳入其实践。通过增加持续评估的措施可能会有所帮助。
