Decision making and implicit suicidality in schizophrenia spectrum disorders

Abstract

Introduction

Research shows that mental illnesses increase suicidal risk. Studies have found that suicidal risk is associated with impaired decision-making.

Objectives

To analyze decision making based on emotional learning in implicit suicidality.

Methods

56 male patients with schizophrenia spectrum disorder (F20) and denied presence of suicidal ideation were involved into the study (mean age 23±2.7),. Methods: Iowa gambling task (IGT) - integral indicators were used: the prevalence of “good” choices over “bad” ones, total score; and an indicator reflecting the ignorance of consequences of one’s choice - the subject remains on a “bad deck” after a loss. The Rorschach test (Rorschach Comprehensive system) was administered: Suicide Constellation «S-CON» and its components were used.

Results

According to the analysis, prevalence of “good” choices (IGT) negatively correlates with «S-CON» (Spearman’s correlation -0.328*, hereinafter significance level: ~ - p<0.1; * - p<0.05). A decrease in the total IGT score is associated with the following cognitive indicators: disregard for social conventions, non-conformism («P») (Spearman’s, 0.337*); a tendency to react defensively to a problem situation, blocking activity in terms of making decisions («R») (0.308*). Ignoring the consequences of one’s choice (IGT) correlates with such emotional factors as emotional incontinence, superficiality of emotions, emotional lability («FC:CF+C») (-.0382*), ambivalence of emotions («Blcol-shd») (statistical tendency, 0.277~), expressed dissatisfaction with the existing situation, internal tension and dysphoria («S») (0.291~).

Conclusions

The relationship of implicit suicidality with decision-making was found to be similar to the relationship of pronounced suicidality with decision-making. Suicidality is associated with impaired ability to make decisions based on emotional learning.

Disclosure

No significant relationships.