冲动性
心理学
自杀未遂
强化学习
认知
萧条(经济学)
临床心理学
毒物控制
爱荷华赌博任务
行为激活
钢筋
自杀预防
发展心理学
精神科
医学
社会心理学
医疗急救
宏观经济学
人工智能
经济
计算机科学
作者
Alexandre Y. Dombrovski,Michael N. Hallquist,Vanessa M. Brown,Jonathan Wilson,Katalin Szanto
标识
DOI:10.1016/j.biopsych.2018.10.006
摘要
Background Suicidal behavior is associated with impaired decision making in contexts of uncertainty. Existing studies, however, do not definitively address whether suidice attempers have 1) impairment in learning from experience or 2) impairment in choice based on comparison of estimated option values. Our reinforcement learning model–based behavioral study tested these hypotheses directly in middle-aged and older suicide attempters representative of those who die by suicide. Methods Two samples (sample 1, n = 135; sample 2, n = 125) of suicide attempters with depression (nattempters = 54 and 39, respectively), suicide ideators, nonsuicidal patients with depression, and healthy control participants completed a probabilistic three-choice decision-making task. A second experiment in sample 2 experimentally dissociated long-term learned value from reward magnitude. Analyses combined computational reinforcement learning and mixed-effects models of decision times and choices. Results With regard to learning, suicide attempters (vs. all comparison groups) were less sensitive to one-back reinforcement, as indicated by a reduced effect on both choices and decision times. Learning deficits scaled with attempt lethality and were partially explained by poor cognitive control. With regard to value-based choice, suicide attempters (vs. all comparison groups) displayed abnormally long decision times when choosing between similarly valued options and were less able to distinguish between the best and second-best options. Group differences in value-based choice were robust to controlling for cognitive performance, comorbidities, impulsivity, psychotropic exposure, and possible brain damage from attempts. Conclusions Serious suicidal behavior is associated with impaired reward learning, likely undermining the search for alternative solutions. Attempted suicide is associated with impaired value comparison during the choice process, potentially interfering with the consideration of deterrents and alternatives in a crisis.
科研通智能强力驱动
Strongly Powered by AbleSci AI