1
|
Cattarinussi G, Meda N, Miola A, Sambataro F. The functional connectivity of the right superior temporal gyrus is associated with psychological risk and resilience factors for suicidality. J Affect Disord 2024; 357:51-59. [PMID: 38653349 DOI: 10.1016/j.jad.2024.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/13/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Suicide attempters show increased activation in the right superior temporal gyrus (rSTG). Here, we investigated the rSTG functional connectivity (FC) to identify a functional network involved in suicidality and its associations with psychological suicidality risk and resilience factors. METHODS The resting state functional magnetic resonance imaging data of 151 healthy individuals from the Human Connectome Project Young Adult database were used to explore the FC of the rSTG with itself and with the rest of the brain. The correlation between the rSTG FC and loneliness and purpose in life scores was assessed with the NIH Toolbox. The effect of sex was also investigated. RESULTS The rSTG had a positive FC with bilateral cortical and subcortical regions, including frontal, temporal, parietal, occipital, limbic, and cerebellar regions, and a negative FC with the medulla oblongata. The FC of the rSTG with itself and with the left central operculum were associated with loneliness scores. The within rSTG FC was also negatively correlated with purpose in life scores, although at a trend level. We did not find any effect of sex on FC and its associations with psychological factors. LIMITATIONS The cross-sectional design, the limited age range, and the lack of measures of suicidality limit the generalizability of our findings. CONCLUSIONS The rSTG functional network is associated with loneliness and purpose in life. Together with the existing literature on suicide, this supports the idea that the neural activity of rSTG may contribute to suicidality by modulating risk and resilience factors associated with suicidality.
Collapse
Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience, University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Nicola Meda
- Department of Neuroscience, University of Padova, Padua, Italy; Padova University Hospital, Padua, Italy
| | - Alessandro Miola
- Department of Neuroscience, University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy; Casa di Cura Parco dei Tigli, Padova, Italy
| | - Fabio Sambataro
- Department of Neuroscience, University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy; Padova University Hospital, Padua, Italy.
| |
Collapse
|
2
|
Orsolini L, Corona D, Cervelli AL, Ribuoli E, Longo G, Volpe U. The role of Theory of Mind in the transition towards suicidal attempts in youth NSSI: an exploratory pilot study. Front Psychiatry 2024; 15:1403038. [PMID: 38873534 PMCID: PMC11170150 DOI: 10.3389/fpsyt.2024.1403038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/22/2024] [Indexed: 06/15/2024] Open
Abstract
Non-suicidal self-injury (NSSI) can both precede and co-occur with suicidal attempts (SA). Underlying mechanisms/factors leading to the transition to SA in NSSI youths have been proposed (including the role of social cognition), despite they should be yet confirmed. Therefore, the study aims at exploring the role of the Theory of Mind in the differentiation of a sample of NSSI youngsters (aged 15-24) according to the presence of SA. We divided the sample into 4 groups using the Deliberate Self Harm Inventory (DSHI) and Columbia Suicide Severity Rating Scale (C-SSRS): control group (notNSSInotSA), NSSI without SA (NSSInotSA), NSSI with SA (NSSIplusSA), and SA without NSSI (SAonly). NSSIplusSA patients displayed higher Reading the Mind in the Eyes Test (RMET) scores (indicative of ToM abilities) than both the NSSInotSA (p=0.0016) and SAonly groups (p=0.0198), while SAonly patients showed lower RMET scores compared to the control group (p=0.0214). Multiple regression models used to differentiate NSSInotSA and NSSIplusSA found a significant association between RMET and LOSCS-CSC (Level Of Self-Criticism Scale-Comparative Self-Criticism) (pC=0.0802, pD=0.0016, pG=0.0053). Our findings supported the hypothesis that a hypertrophic affective ToM may possibly be associated with the occurrence of SA in youth NSSI. Further larger and longitudinal studies should confirm these preliminary findings, by exploring all social cognition dimensions.
Collapse
|
3
|
Nestor BA, Kossowsky J, Nelson SM. Topical Review: Getting into the head of youth with chronic pain: how theory of mind deficits may relate to the development and maintenance of pediatric pain. J Pediatr Psychol 2024; 49:224-230. [PMID: 38366580 PMCID: PMC10954304 DOI: 10.1093/jpepsy/jsae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE Theory of mind (ToM) is the ability to understand the thoughts, feelings, and mental states of others and is critical for effective social and psychological functioning. ToM deficits have been associated with various psychological disorders and identified in adult pain populations. For youth with chronic pain, ToM deficits may underlie the biological, psychological, and social factors that contribute to their experience of pain, but this remains poorly understood. METHODS This topical review explored the extant literature in the areas of ToM and chronic pain, particularly for pediatric populations, with respect to biological, psychological, and social elements of the biopsychosocial model of pain. RESULTS ToM deficits may be present alongside previously identified biological, psychological, and social correlates of pediatric pain, as a vulnerability, mechanism, and/or consequence. Biologically, ToM deficits may relate to cortisol abnormalities and neurobiological substrates of pain processing. Psychologically, ToM deficits may stem from pain-focused cognitions, thus impacting relationships and fueling impairment. Socially, chronic pain may preclude normative development of ToM abilities through social withdrawal, thereby exacerbating the experience of pain. CONCLUSION Taken together, ToM deficits may be associated with increased risk for the development and/or maintenance of pediatric chronic pain, and pediatric chronic pain may similarly confer risk for ToM deficits. Future research should investigate the nature of ToM abilities in youth with chronic pain to test these hypotheses and ultimately inform ToM-focused and pain-based interventions, as this ability has been demonstrated to be modifiable.
Collapse
Affiliation(s)
- Bridget A Nestor
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, MA, United States
- Department of Anesthesia, Harvard Medical School, Boston, MA, United States
| | - Joe Kossowsky
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, MA, United States
- Department of Anesthesia, Harvard Medical School, Boston, MA, United States
| | - Sarah M Nelson
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
4
|
Andreo-Jover J, Curto Ramos J, Bobes J, Bravo-Ortiz M, Cebria AI, Crespo-Facorro B, De la Torre-Luque A, Díaz-Marsa M, Fernández-Rodrigues V, Garrido-Torres N, Grande I, López Peña MP, Pemau A, Roberto N, Ruiz-Veguilla M, Saiz P, Rodríguez-Vega B, Pérez-Sola V. The mediating role of reflective functioning in the association between childhood trauma and suicide attempt. J Psychiatr Res 2024; 171:30-37. [PMID: 38241967 DOI: 10.1016/j.jpsychires.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Childhood trauma is intimately related with suicidal behaviour. Patients who have suffered childhood trauma develop impaired Reflective Functioning (RF), which refers to the capacity to understand ourselves and others in terms of intentional mental states. An improvement in RF has been associated with a reduction in suicidal attempts, but the mediating role of RF between childhood trauma and suicidal behaviour has not been addressed so far. OBJECTIVE We aim to examine the potential mediating effect of RF among childhood trauma and suicide attempts. METHOD We included 748 patients who had attempted suicide at least once. They were asked to complete the Reflective Functioning Questionnaire (RFQ-8), the Columbia-Suicide Severity Rating scale (CSSRS), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We conducted linear regressions by simple mediating model to examine the role of RF in the indirect association between childhood trauma and the number of suicide attempts. RESULTS Our results show significant indirect effects through hypo and hypermentalizing between Emotional Abuse (EA) and Sexual Abuse (SA) in childhood and the number of suicide attempts in lifetime. These results indicate that ineffective RF significantly mediates the association between childhood trauma and suicidality. CONCLUSION This is the first study supporting the mediational role of RF in the relationship between EA and SA, and the number of suicide attempt in lifetime. These findings have important implications for reducing suicide rates and preventing future re-attempts. Further studies analysing this mediating role and focusing efforts on increasing RF-based interventions are required.
Collapse
Affiliation(s)
- J Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - J Curto Ramos
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - J Bobes
- Department of Psychiatry, Universidad de Oviedo, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - M Bravo-Ortiz
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain.
| | | | - B Crespo-Facorro
- Hospital Virgen del Rocio/IBIS, Sevilla, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Psiquiatría, Universidad de Sevilla, Spain
| | - A De la Torre-Luque
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense de Madrid, Spain
| | | | - V Fernández-Rodrigues
- Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense de Madrid, Spain
| | - N Garrido-Torres
- Hospital Virgen del Rocio/IBIS, Sevilla, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Psiquiatría, Universidad de Sevilla, Spain
| | - I Grande
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
| | | | - A Pemau
- Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense de Madrid, Spain
| | - N Roberto
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
| | - M Ruiz-Veguilla
- Hospital Virgen del Rocio/IBIS, Sevilla, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Psiquiatría, Universidad de Sevilla, Spain
| | - P Saiz
- Department of Psychiatry, Universidad de Oviedo, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - B Rodríguez-Vega
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - V Pérez-Sola
- Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
| |
Collapse
|
5
|
Parrish EM, Steenkamp L, Chalker SA, Moore RC, Pinkham A, Depp CA. Systematic Review of the Link Between Social Cognition and Suicidal Ideation and Behavior in People With Serious Mental Illness. SCHIZOPHRENIA BULLETIN OPEN 2024; 5:sgae007. [PMID: 38617732 PMCID: PMC11014866 DOI: 10.1093/schizbullopen/sgae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Background and Hypothesis People with serious mental illness (SMI; psychotic and affective disorders with psychosis) are at an increased risk of suicide, yet there is limited research on the correlates of suicide in SMI. Social cognitive impairments are common among people with SMI and several studies have examined social cognition and suicidal ideation (SI) and behavior. This systematic review aims to evaluate the links between various domains of social cognition, SI, and suicidal behavior in SMI. Study Design Electronic databases (PubMed and PsycInfo) were searched through June 2023. Records obtained through this search (N = 618) were screened by 2 independent reviewers according to inclusion criteria. Relevant data were extracted, and study quality was assessed. Study Results Studies (N = 16) from 12 independent samples were included in the systematic review (N = 2631, sample sizes ranged from N = 20 to N = 593). Assessments of social cognition and SI and behavior varied widely between studies. Broadly, effects were mixed. Better emotion recognition of negative affect was linked to SI and a history of suicide attempts, though there is little consistent evidence for the relationship of emotion recognition and SI or behavior. On the other hand, better theory of mind ability was linked to SI and a history of suicide attempts. Furthermore, negative attributional bias was linked to current SI, but not a history of SI or attempt. Conclusions This review suggests mixed associations between social cognition, SI, and behavior in SMI. Future research should evaluate additional mediators and moderators of social cognition and suicide, employing prospective designs.
Collapse
Affiliation(s)
- Emma M Parrish
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Lisa Steenkamp
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Samantha A Chalker
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Raeanne C Moore
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Amy Pinkham
- Department of Psychology, The University of Texas at Dallas, Dallas, TX, USA
| | - Colin A Depp
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| |
Collapse
|
6
|
Senna S, Schwab B, Melo HM, Diaz AP, Schwarzbold ML. Social cognition and suicide-related behaviors in depression: a cross-sectional, exploratory study. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2022; 44:639-643. [PMID: 36709452 PMCID: PMC9851751 DOI: 10.47626/1516-4446-2021-2407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/18/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To explore the association between social cognition and previous suicide attempts and non-suicidal self-injurious behavior in adults with unipolar depressive disorders. METHODS Seventy-two patients undergoing outpatient treatment for unipolar depression were enrolled in this cross-sectional study. Theory of mind was assessed using the Hinting Task and the Revised Reading the Mind in the Eyes Test. Empathy was evaluated using the Interpersonal Reactivity Index. Lifetime suicide attempts and non-suicidal self-injurious behavior were assessed using the Columbia Suicide Risk Rating Scale. Participants with and without these suicide-related outcomes were compared in terms of social cognition. RESULTS Patients with previous suicide attempts performed worse on the Reading the Mind in the Eyes Test (p = 0.017). Patients with a history of non-suicidal self-injurious behavior were younger (p = 0.005), had a younger age at first depressive episode (p = 0.017), and scored higher on personal distress in the Interpersonal Reactivity Index (p = 0.027). Only personal distress remained independently associated with non-suicidal self-injurious behavior in multivariable analysis (p = 0.038). CONCLUSION Among patients with depression, those with previous suicide attempts or non-suicidal self-injurious behavior showed worse social cognition. These results encourage future research on social cognition deficits as clinical markers of suicide-related behaviors and as targets for interventions.
Collapse
Affiliation(s)
- Sofia Senna
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil,Instituto de Psiquiatria de Santa Catarina, São José, SC, Brazil,Correspondence: Sofia Senna Gonçalves, Av. Engelberto Koerich, 333, Colônia Santana, CEP 88123-300, São José, SC, Brazil. E-mail:
| | - Bianca Schwab
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Hiago M. Melo
- Programa de Pós-Graduação em Neurociências, UFSC, Florianópolis, SC, Brazil
| | - Alexandre P. Diaz
- Louis A. Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Marcelo L. Schwarzbold
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| |
Collapse
|