BackgroundsDecision-making deficits have been reported as trans-diagnostic characteristics of vulnerability to suicidal behaviors, independent of co-existing psychiatric disorders. Individuals with suicidal behaviors often regret their decision to attempt suicide and may have impairments in future-oriented processing. However, it is not clear how people with suicidal dispositions use future-oriented cognition and past experience of regret to guide decision-making. Here, we examined the processes of regret anticipation and experience in subclinical youth with and without suicidal ideation during value-based decision-making.MethodsIn total, 80 young adults with suicidal ideation and 79 healthy controls completed a computational counterfactual thinking task and self-reported measures of suicidal behaviors, depression, anxiety, impulsivity, rumination, hopelessness, and childhood maltreatment.ResultsIndividuals with suicidal ideation showed a reduced ability to anticipate regret compared to healthy controls. Specifically, suicidal ideators’ experience of regret/relief was significantly different from that of healthy controls upon obtained outcomes, while their disappointment/pleasure experience was not significantly different from healthy controls.ConclusionThese findings suggest that young adults with suicidal ideation have difficulty predicting the consequences or the future value of their behavior. Individuals with suicidal ideation showed impairments in value comparison and flat affect to retrospective rewards, whereas individuals with high suicidality showed blunted affect to immediate rewards. Identifying the counterfactual decision-making characteristics of at-risk suicidal individuals may help to elucidate measurable markers of suicidal vulnerability and identify future intervention targets.

中文翻译：

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有自杀风险的个体预期和经历的后悔的分离缺陷

背景决策缺陷已被报告为易受自杀行为影响的跨诊断特征，与并存的精神疾病无关。有自杀行为的人常常对他们试图自杀的决定感到后悔，并且可能在面向未来的处理过程中存在障碍。然而，尚不清楚有自杀倾向的人如何利用面向未来的认知和过去的后悔经历来指导决策。在这里，我们检查了在基于价值的决策过程中有和没有自杀意念的亚临床青年的后悔预期和经历的过程。方法总共有 80 名有自杀意念的年轻人和 79 名健康对照者完成了计算反事实思维任务并自我报告自杀行为、抑郁、焦虑、冲动、沉思、绝望和童年虐待。结果与健康对照组相比，有自杀意念的个体预测后悔的能力降低。具体而言，有自杀意念者的后悔/解脱体验与健康对照者在获得结果时的体验有显着差异，而他们的失望/愉悦体验与健康对照者没有显着差异。结论这些发现表明，有自杀意念的年轻人难以预测后果或他们行为的未来价值。有自杀意念的人在价值比较方面表现出障碍，对回顾性奖励的影响平淡，而自杀倾向高的人对即时奖励表现出迟钝的影响。