Neurocognition and the Suicidal Process
Early thinking about cognitive process and suicidal behaviors tended to focus on the immediate situation surrounding the individual – typically the underlying psychiatric condition that was seen as leading to his or her distress. However, we now know that
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Contents 1 Suicide and Cognition: An Introduction 1.1 History 1.2 Current Theoretical Perspectives 2 Suicide and Neurocognition in Psychiatric Disorders 2.1 Mood Disorders 2.2 Schizophrenia and Related Disorders 2.3 Borderline Personality Disorder 2.4 Transdiagnostic Effect of Cognition on Suicide 3 Cognitive Domains and Suicide 3.1 Overall Cognitive Ability 3.2 Intelligence 3.3 Executive Function 3.4 Processing Speed 3.5 Memory 3.6 Attention 3.7 Social Cognition 4 Neurocognition and Specific Suicidal Behaviors 4.1 Comparing Ideators and Attempters 4.2 First-Degree Relatives of Suicide Attempters 5 Conclusions References
Abstract Early thinking about cognitive process and suicidal behaviors tended to focus on the immediate situation surrounding the individual – typically the underlying psychiatric condition that was seen as leading to his or her distress. However, we now know that the cognitive processes involved in a range of suicidal thoughts and behaviors can exert a significant impact on the expression or development of these behaviors, even without an environmental stressor or psychiatric condition. In S. B. Rutter, N. Cipriani, E. C. Smith, E. Ramjas, D. H. Vaccaro, M. Martin Lopez, W. R. Calabrese, D. Torres, P. Campos-Abraham, M. Llaguno, E. Soto, M. Ghavami, and M. M. Perez-Rodriguez (*) Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 Curr Topics Behav Neurosci https://doi.org/10.1007/7854_2020_162
S. B. Rutter et al.
this chapter, we summarize theoretical perspectives that led to this realization and explore the current understanding of the link between cognition and suicide from recent research and clinical findings. We present these findings first by psychiatric disorder, then by cognitive domains, and finally by specific suicidal construct in order to highlight the importance of these factors in determining the role of cognition in the suicidal process. Within and across psychiatric disorders, certain cognitive processes – negativistic thinking, impulsivity, cognitive rigidity, and altered emotional processing – are frequently found to be linked to suicidal thoughts and behaviors. Overall cognitive performance, decreased processing speed, executive dysfunction, and negative biases in memory and attention have also been linked to suicidal thoughts and behaviors. However, these findings do not hold true for all populations. There seems to be a role both for cognitive distortions (such as hopelessness) and neurocognitive deficits (such as poor overall cognitive performance, slower processing speed, and executive dysfunction) in the suicidal process, which warrant further exploration both separately and together. Keywords Attempted suicide · Cognition · Neurocognition · Suicidal ideation · Suicide
1 Suicide and Cognition: An Introduction 1.1
History
It comes as no surprise that cognitive processes play a crucial role in a range of suicidal behaviors. However, where exactly in the suicidal process cognit
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