Myers Catherine E, Del Pozzo Jill, Perskaudas Rokas, Dave Chintan V, Chesin Megan S, Keilp John G, Kline Anna, Interian Alejandro
Research Service, VA New Jersey Health Care Service, East Orange, NJ, United States of America; Department of Pharmacology, Physiology & Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, United States of America.
Mental Health and Behavioral Services, VA New Jersey Health Care Service, Lyons, NJ, United States of America; Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
J Affect Disord. 2024 Apr 1;350:7-15. doi: 10.1016/j.jad.2024.01.018. Epub 2024 Jan 12.
Prior work has implicated several neurocognitive domains, including memory, in patients with a history of prior suicide attempt. The current study evaluated whether a delayed recognition test could enhance prospective prediction of near-term suicide outcomes in a sample of patients at high-risk for suicide.
132 Veterans at high-risk for suicide completed a computer-based recognition memory test including semantically-related and -unrelated words. Outcomes were coded as actual suicide attempt (ASA), other suicide-related event (OtherSE) such as aborted/interrupted attempt or preparatory behavior, or neither (noSE), within 90 days after testing.
Reduced performance was a significant predictor of upcoming ASA, but not OtherSE, after controlling for standard clinical variables such as current suicidal ideation and history of prior suicide attempt. However, compared to the noSE reference group, the OtherSE group showed a reduction in the expected benefit of semantic relatedness in recognizing familiar words. A computational model, the drift diffusion model (DDM), to explore latent cognitive processes, revealed the OtherSE group had decreased decisional efficiency for semantically-related compared to semantically-unrelated familiar words.
This study was a secondary analysis of an existing dataset, involving participants in a treatment trial, and requires replication; ~10 % of the sample was excluded from analysis due to failure to master the practice tasks and/or apparent noncompliance.
Impairments in recognition memory may be associated with near-term risk for suicide attempt, and may provide a tool to improve prediction of when at-risk individuals may be transitioning into a period of heightened risk for suicide attempt.
先前的研究表明，有过自杀未遂史的患者存在包括记忆在内的多个神经认知领域的问题。本研究评估了延迟识别测试是否能增强对自杀高风险患者近期自杀结局的前瞻性预测。
132名自杀高风险退伍军人完成了一项基于计算机的识别记忆测试，包括语义相关和不相关的单词。将测试后90天内的结局编码为实际自杀未遂（ASA）、其他与自杀相关的事件（OtherSE），如未遂/中断的自杀企图或准备行为，或两者都无（noSE）。
在控制了当前自杀意念和既往自杀未遂史等标准临床变量后，识别能力下降是即将发生ASA的显著预测因素，但不是OtherSE的预测因素。然而，与noSE参照组相比，OtherSE组在识别熟悉单词时语义相关性的预期益处有所降低。一个用于探索潜在认知过程的计算模型——漂移扩散模型（DDM）显示，与语义不相关的熟悉单词相比，OtherSE组在语义相关单词上的决策效率降低。
本研究是对现有数据集的二次分析，涉及一项治疗试验的参与者，需要重复验证；约10%的样本因未能掌握练习任务和/或明显不依从而被排除在分析之外。
识别记忆受损可能与近期自杀未遂风险相关，并可能提供一种工具，以改善对处于风险中的个体何时可能过渡到自杀未遂风险升高期的预测。
