Oberlin College, Alpert Medical School of Brown University.
Alpert Medical School of Brown University, Providence VA Medical Center.
Behav Ther. 2021 Nov;52(6):1529-1542. doi: 10.1016/j.beth.2021.05.006. Epub 2021 May 26.
Childhood abuse and/or neglect adversely influences development of neurocognitive systems that regulate affect and behavior. Poor inhibitory control over emotional reactions is thus one potential pathway from maltreatment to suicide. Adult psychiatric inpatients completed the Childhood Trauma Questionnaire and an emotional stop-signal task indexing negative emotional action termination (NEAT): the ability to inhibit ongoing motor reactions to aversive stimuli triggered by negative affect. Clinical interviews assessed suicidal thoughts and behaviors during hospitalization (n = 131) and at follow-up assessments 6 months later (n = 87). Our primary aim was to examine whether maltreatment history and NEAT explain overlapping variance in suicidal behaviors (1) retrospectively and (2) 6 months following hospital discharge. Contrary to prediction, childhood maltreatment was unrelated to history of suicidal behaviors. However, NEAT was consistently associated with prior suicidal acts, even controlling for suicidal ideation and demographic covariates. NEAT similarly contributed to the prediction of post-discharge suicidal behaviors, whereas we found no effect of maltreatment history. The present study suggests that NEAT captures suicide risk independently of childhood maltreatment. Results implicated NEAT impairment specifically, rather than broader response inhibition deficits (e.g., to positive stimuli), in past and future suicidal behaviors. These findings provide preliminary support for NEAT as a behavioral vulnerability marker for suicide, with implications for understanding links between maltreatment history and suicidal acts.
童年期虐待和/或忽视会对调节情感和行为的神经认知系统的发育产生不利影响。因此,情绪反应抑制控制不良是虐待与自杀之间的潜在途径之一。成年精神科住院患者完成了《童年创伤问卷》和一项情绪停止信号任务,该任务可衡量负面情绪终止的负面情绪行为(NEAT):抑制由负性情绪引发的厌恶刺激下进行中运动反应的能力。临床访谈评估了住院期间(n=131)和 6 个月后随访评估时(n=87)的自杀念头和行为。我们的主要目的是检验虐待史和 NEAT 是否可以解释(1)自杀行为的回顾性和(2)出院后 6 个月的重叠方差。与预测相反,童年期虐待与自杀行为史无关。但是,即使控制了自杀意念和人口统计学协变量,NEAT 仍然与先前的自杀行为相关。NEAT 同样有助于预测出院后的自杀行为,而我们没有发现虐待史的影响。本研究表明,NEAT 可以独立于童年期虐待来捕捉自杀风险。研究结果表明,在过去和未来的自杀行为中,是 NEAT 损伤而不是更广泛的反应抑制缺陷(例如,对正性刺激的反应抑制缺陷)导致了自杀风险。这些发现为 NEAT 作为自杀的行为易感性标志物提供了初步支持,对理解虐待史与自杀行为之间的联系具有启示意义。