Department of Psychiatry, University of Pittsburgh.
Department of Psychology, University of Cambridge.
Psychol Aging. 2014 Mar;29(1):84-94. doi: 10.1037/a0035339.
Age-related cognitive changes may contribute to impairments in making complex social decisions. Interpersonal conflict is a key factor behind suicidal behavior in old age, with suicidal motivations ranging from escape to revenge. Such conflicts may prove catastrophic for people prone to suicide, in part because of their tendency to make disadvantageous decisions. Yet, little is known about social decision making in older suicidal individuals. We assessed economic bargaining behavior using the Ultimatum Game, where players decide whether to accept or punish (reject) unfair monetary offers from another player. Our sample included depressed older adults with a history of high-medical-lethality suicide attempts, low-medical-lethality suicide attempts, nonsuicidal depressed older adults, and those with no psychiatric history who served as control groups. Participants in all groups punished their counterparts in response to unfair offers. However, low-lethality attempters, nonsuicidal depressed, and nonpsychiatric controls punished less as the cost of punishment increased, accepting more unfair offers as the stakes grew large. High-lethality attempters did not adjust their choices based on stake magnitude, punishing unfair offers without regard to the cost. Two thirds of the difference between the high-lethality attempters and nonpsychiatric controls was explained by individual differences in fairness judgments: the comparison group judged offer fairness as a joint function of inequality and magnitude, whereas the high-lethality attempter participants judged offer fairness on the basis of inequality. In real life, high-lethality attempters' relative insensitivity to the cost of retaliation may lead to uncompromising, catastrophic responses to conflict.
年龄相关的认知变化可能导致复杂社会决策能力受损。人际冲突是老年人自杀行为背后的一个关键因素，自杀动机从逃避到报复不等。这些冲突可能对那些容易自杀的人造成灾难性的后果，部分原因是他们倾向于做出不利的决定。然而，对于老年自杀个体的社会决策，我们知之甚少。我们使用最后通牒博弈评估了经济谈判行为，在这个博弈中，玩家决定是否接受或惩罚（拒绝）另一个玩家不公平的金钱提议。我们的样本包括有过高医疗致死率自杀企图、低医疗致死率自杀企图、非自杀性抑郁老年患者和没有精神病史的对照组的抑郁老年患者。所有组的参与者都对不公平的提议进行了惩罚。然而，低致死率企图者、非自杀性抑郁者和非精神病对照组随着惩罚成本的增加而减少惩罚，当赌注增加时，他们会接受更多不公平的提议。高致死率企图者并没有根据赌注的大小来调整他们的选择，他们不考虑惩罚成本就会拒绝不公平的提议。高致死率企图者与非精神病对照组之间的差异有三分之二可以用公平判断的个体差异来解释：对照组将提议公平判断为不平等和幅度的联合函数，而高致死率企图者参与者则根据不平等来判断提议公平。在现实生活中，高致死率企图者对报复成本的相对不敏感可能导致他们对冲突做出不妥协、灾难性的反应。
