Background

PTSD is an established risk factor for suicide attempts and suicide death, but the mechanisms underlying this association remain unknown. The present study examined associations among delayed reward discounting—the balance between smaller immediate available rewards versus larger delayed rewards—self-reported PTSD symptoms, and recent suicide attempts among individuals reporting suicide ideation within the past year.

Methods

A cross-sectional survey of U.S. adults completed the Primary Care PTSD Screen for DSM-5, the 21-item Monetary Choice Questionnaire, and the Self-Injurious Thoughts and Behaviors Interview-Revised. Analyses of variance and multinomial regression models were used to test associations among variables.

Results

Among participants reporting suicide ideation within the past year, discount rates were significantly higher among those reporting more PTSD symptoms and a past-year suicide attempt, suggesting these participants expressed a preference for immediately available rewards.

Conclusions

Choice behavior among individuals reporting many PTSD symptoms and a recent suicide attempt is influenced to a greater degree by immediately available rewards. Sensitivity to immediate rewards at the expense of larger delayed rewards may reflect a vulnerability for suicidal behavior among individuals screening positive for PTSD.

中文翻译：

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在可能患有PTSD的美国成年人中，延误奖励折扣和自杀未遂的风险增加

背景

PTSD是自杀未遂和自杀死亡的既定危险因素，但这种关联的机制尚不清楚。本研究研究了延迟奖励折扣（即较小的即时可用奖励与较大的延迟奖励之间的平衡），自我报告的PTSD症状与最近一年自杀者自杀企图之间的关联。

方法

一项针对美国成年人的横断面调查完成了DSM-5的初级保健PTSD屏幕，21个项目的货币选择问卷以及自我伤害的思想和行为访谈修订版。方差分析和多项式回归模型用于测试变量之间的关联。

结果

在过去一年中报告自杀念头的参与者中，报告更多PTSD症状和过去一年自杀未遂的参与者中的折现率明显更高，这表明这些参与者表示愿意立即获得奖励。

结论

报告许多PTSD症状和最近自杀未遂的个体之间的选择行为在很大程度上受到立即可获得的奖励的影响。以较大的延迟奖励为代价对立即奖励的敏感性可能反映出对PTSD筛查呈阳性的个体有自杀行为的脆弱性。