The Ohio State University Wexner Medical Center, Department of Psychiatry & Behavioral Health, 1670 Upham Dr., Columbus, OH, 43210, United States.
The Ohio State University Wexner Medical Center, Department of Psychiatry & Behavioral Health, 1670 Upham Dr., Columbus, OH, 43210, United States.
J Anxiety Disord. 2021 Jun;81:102414. doi: 10.1016/j.janxdis.2021.102414. Epub 2021 May 2.
PTSD is an established risk factor for suicide attempts and suicide death, but the mechanisms underlying this association remain unknown. The present study examined associations among delayed reward discounting-the balance between smaller immediate available rewards versus larger delayed rewards-self-reported PTSD symptoms, and recent suicide attempts among individuals reporting suicide ideation within the past year.
A cross-sectional survey of U.S. adults completed the Primary Care PTSD Screen for DSM-5, the 21-item Monetary Choice Questionnaire, and the Self-Injurious Thoughts and Behaviors Interview-Revised. Analyses of variance and multinomial regression models were used to test associations among variables.
Among participants reporting suicide ideation within the past year, discount rates were significantly higher among those reporting more PTSD symptoms and a past-year suicide attempt, suggesting these participants expressed a preference for immediately available rewards.
Choice behavior among individuals reporting many PTSD symptoms and a recent suicide attempt is influenced to a greater degree by immediately available rewards. Sensitivity to immediate rewards at the expense of larger delayed rewards may reflect a vulnerability for suicidal behavior among individuals screening positive for PTSD.
创伤后应激障碍（PTSD）是自杀未遂和自杀死亡的既定风险因素，但这种关联的机制尚不清楚。本研究考察了延迟奖励折扣（较小的即时可得奖励与较大的延迟奖励之间的平衡）、自我报告的 PTSD 症状与报告在过去一年中有过自杀意念的个体中最近自杀尝试之间的关联。
对美国成年人进行了一项横断面调查，他们完成了 DSM-5 创伤后应激障碍初步筛查、21 项货币选择问卷和修订后的自我伤害思维和行为访谈。方差分析和多项回归模型用于测试变量之间的关联。
在过去一年中有过自杀意念的参与者中，报告 PTSD 症状较多和过去一年有自杀尝试的参与者的折扣率明显较高，这表明这些参与者更倾向于即时可得的奖励。
在报告有许多 PTSD 症状和最近自杀尝试的个体中，对即时可得奖励的选择行为受到更大程度的影响。以即时奖励为代价而牺牲更大的延迟奖励可能反映了 PTSD 筛查阳性个体自杀行为的脆弱性。
