Event-Related Potential Markers of Suicidality in Adolescents

Deniz Doruk Camsari; Charles P Lewis; Ayse Irem Sonmez; Can Ozger; Parmis Fatih; Deniz Yuruk; Julia Shekunov; Jennifer L Vande Voort; Paul E Croarkin

doi:10.1093/ijnp/pyad039

Event-Related Potential Markers of Suicidality in Adolescents

Int J Neuropsychopharmacol. 2023 Aug 29;26(8):566-575. doi: 10.1093/ijnp/pyad039.

Authors

Deniz Doruk Camsari¹, Charles P Lewis^{1

2}, Ayse Irem Sonmez^{1

2}, Can Ozger¹, Parmis Fatih^{1

3}, Deniz Yuruk¹, Julia Shekunov¹, Jennifer L Vande Voort¹, Paul E Croarkin¹

Affiliations

¹ Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
² Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA.
³ Department of Psychiatry, Rush University, Chicago, Illinois, USA.

Abstract

Background: Implicit cognitive markers may assist with the prediction of suicidality beyond clinical risk factors. The aim of this study was to investigate neural correlates associated with the Death/Suicide Implicit Association Test (DS-IAT) via event-related potentials (ERP) in suicidal adolescents.

Methods: Thirty inpatient adolescents with suicidal ideations and behaviors (SIBS) and 30 healthy controls from the community were recruited. All participants underwent 64-channel electroencephalography, DS-IAT, and clinical assessments. Hierarchical generalized linear models with spatiotemporal clustering were used to identify significant ERPs associated with the behavioral outcome of DS-IAT (D scores) and group differences.

Results: Behavioral results (D scores) showed that the adolescents with SIBS had stronger implicit associations between "death" and "self" than the healthy group (P = .02). Within adolescents with SIBS, participants with stronger implicit associations between "death" and "self" reported more difficulty in controllability of suicidal ideation in the past 2 weeks based on the Columbia-Suicide Severity Rating Scale (P = .03). For the ERP data, the D scores and N100 component over the left parieto-occipital cortex had significant correlations. Significant group differences without behavioral correlation were observed for a second N100 cluster (P = .01), P200 (P = .02), and late positive potential (5 clusters, all P ≤ .02). Exploratory predictive models combining both neurophysiological and clinical measures distinguished adolescents with SIBS from healthy adolescents.

Conclusions: Our results suggest that N100 may be a marker of attentional resources involved in the distinction of stimuli that are congruent or incongruent to associations between death and self. Combined clinical and ERP measures may have utility in future refinements of assessment and treatment approaches for adolescents with suicidality.

Keywords: ERP; N100; death/suicide IAT; suicidality.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Electroencephalography
Evoked Potentials
Humans
Risk Factors
Suicidal Ideation*
Suicide* / psychology

Abstract

Publication types

MeSH terms

Grants and funding