Decision-making deficits in suicidal acute psychiatric patients: Insights from the Cambridge Gambling Task

Abstract

Objective: Suicidality is a major health problem. Decision-making deficits, including a lack of cognitive control (e.g., impulsivity and risk-taking behavior), have been associated with an increased risk of suicide. Method: This study examined decision-making in a clinical group of 23 adult, suicidal acute psychiatric patients and compared their data to that of a control group of 17 healthy adults using the Cambridge Gambling Task (CGT) from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Group differences in outcomes on the six CGT subtests were compared using chi-square tests, t tests, and Mann–Whitney U tests where appropriate. Multiple regression analysis was used to explore whether background variables were associated with CGT outcomes. Results: The main findings were significantly lower scores for risk-taking, quality of decision-making, and risk adjustment in the clinical group than in the control group. Within the clinical group, differences were observed in which suicide ideators scored worse in some measures than did suicide attempters. These findings suggest that suicidal acute psychiatric patients may struggle with making low-risk decisions that are considered reasonable. Conclusions: These results support the potential for cognitive control training, specifically aimed at enhancing decision-making abilities, in suicide prevention efforts. The observed decision-making deficits in suicidal patients underscore the importance of further research on a larger population to solidify the foundation for targeted interventions, and we suggest adding to this knowledge by differentiate between depressed patients with and without severe suicidal ideation.