Clinical and Neuropsychological Differences in Low and High Worst-point Suicide Ideators

Suicide is a major public health concern that is complicated by the multidimensional nature of suicidal behaviors. Uncovering markers of vulnerability to acting on suicidal thoughts can aid in creating prevention interventions. Previous studies have found that serious and significant suicidal ideation in the past may be a predictor of later risk for suicide attempt. This paper examined worst-point suicide ideation (lifetime) in depressed patients who have never made an attempt. Depressed patients were divided on the basis of worst-point ideation to determine if these groups differed on a variety of clinical measures and neurocognitive tasks known to be associated with suicide attempt. Patients with high worst-point ideation – comparable to that in past suicide attempters – exhibited greater depression severity, as well as greater feelings of entrapment, stronger propensity to rumination, less mindful awareness, and poorer social problem-solving skills. They performed significantly worse on tests of attention and working memory that had previously been found to be poorer in suicide attempters. These results suggest the presence of both cognitive and clinical vulnerabilities to later suicide attempt in severe suicide ideators who have yet to make an attempt and suggest possible means of identifying these high-risk individuals with greater precision