The relationship between poor performance on attention tasks and increased suicidal ideation in adolescents

Circadian misalignment alters resting-state functional connectivity of the salience network in rotating shift workers

STUDY OBJECTIVES

This study compared resting-state functional connectivity (rsFC) of the salience network (SN) between rotating shift workers (RSWs) and controls. Furthermore, we examined whether rsFC of the SN was correlated with sleep, emotion, cognition, and attention.

METHODS

The 60 RSWs and 57 controls enrolled in this study completed self-report questionnaires and sleep diaries to assess subjective sleep quality, and polysomnography and actigraphy to evaluate objective sleep and 24-hour rest-activity rhythm parameters. The participants also underwent resting-state functional magnetic resonance imaging and structural T1 scans. We performed a seed-based rsFC analysis of the SN using the anterior cingulate cortex (ACC) and anterior insula (AI) as seed regions. Furthermore, AI and ACC rsFC were compared in RSWs and controls, and we analyzed correlations between rsFC and variables of interest showing significant group differences.

RESULTS

Compared with controls, RSWs showed reduced rsFC between the ACC and right insula, and increased rsFC of the ACC with the left occipital lobe and right superior frontal gyrus extending to the supplementary motor area (SFG/SMA). Moreover, RSWs showed reduced rsFC between the right AI and right superior parietal lobule (SPL). Finally, rsFC between the ACC and right AI was correlated with 24-hour rest-activity rhythmicity.

CONCLUSIONS

Although RSWs did not show sleep disturbance, emotional distress, cognitive impairment, or attention deficits, alterations of right insula, left occipital lobe, right SFG/SMA, and right SPL rsFC in the SN indicate that impairments in salience detection and top-down attentional control may emerge in shift workers over time.

Abnormal attentional bias in individuals with suicidal ideation during an emotional Stroop task: an event-related potential study

Introduction

There is increasing evidence that suicidal individuals exhibit an attentional bias toward negative or suicide-related stimuli, but the underlying neural mechanism remains unclear. This study aimed to investigate the neural mechanism of attentional bias toward emotional stimuli using a modified emotional Stroop task (EST) and to further explore the influencing factor of abnormal attention processing by identifying whether mental disorders or suicidal ideation contributes to attention processing disruptions.

Methods

Fourteen students with suicidal ideation and mental disorders (SIMDs), sixteen students with suicidal ideation but no mental disorders (SINMDs), and fourteen sex- and age-matched healthy controls (HCs) were recruited. Moreover, 64-channel electroencephalography (EEG) data and behavioral responses were recorded simultaneously during the EST. Participants were instructed to respond to the ink color for various types of words (positive, neutral, negative, and suicide) while ignoring their meanings. Event-related potentials (ERPs) were analyzed to evaluate attention to the stimuli. Spearman correlations between clinical psychological assessment scales and ERP signatures were analyzed to determine the risk factors for suicide.

Results

The results showed that the SIMD group exhibited longer early posterior negativity (EPN) latency compared to the SINMD and HC groups, indicating that early attention processing was affected during the EST, and the automatic and rapid processing of emotional information decreased. Furthermore, P300 latency for positive words was positively correlated with current suicidal ideation in the SINMD group, suggesting that delayed responses or additional processing to positive information may lead individuals with suicidal ideation to an incorrect interpretation of external events.

Conclusions

Generally, our findings suggest that the neural characteristics of the SIMD group differed from those of the SINMD and HC groups. EPN latency and P300 latency during the EST may be suicide-related neurophysiological indicators. These results provide neurophysiological signatures of suicidal behavior.

Inflammation, cognitive dysfunction, and suicidal ideation among patients with major depression

BACKGROUND

Dysregulated proinflammatory cytokines have been shown to be associated with suicidal behavior. Cognitive deficits in working memory and inhibitory control have been demonstrated in depressed patients and people with suicidal ideation (SI). However, the association between proinflammatory cytokines, SI, and cognitive deficits in patients with major depressive disorder (MDD) remains unclear.

METHODS

A total of 77 patients with MDD and age-/sex-matched 60 healthy individuals were recruited. MDD patients were divided into two groups: with SI (n = 36) and no SI (n = 41). SI was defined by a score of ≥2 in item 3 of the 17-item Hamilton Rating Scale for Depression. Levels of proinflammatory cytokines, including soluble interleukin-6 receptor, soluble tumor necrosis factor-α receptor type 1, and C-reactive protein (CRP), were measured, and cognitive function was assessed using 2-back task and Go/No-Go task.

RESULTS

Patients with SI had higher levels of CRP than those without SI and controls (P = .007). CRP was positively associated with SI (β = 0.21, P = .037), independent of cognitive function and depressive symptoms. Furthermore, SI was associated with cognitive deficits in working memory and inhibitory control after adjusting for confounding factors (P < .05).

CONCLUSION

Our findings suggest that higher levels of serum CRP and deficits in working memory and inhibitory control may be associated with higher SI among patients with MDD.

The relationship between schizotypal personality features and mind wandering among college students during COVID-19 pandemic: A moderator of depression

INTRODUCTION

Although the impact of the COVID-19 pandemic on people's mental health has been well documented in many studies, the schizotypal personality features in the general population have not received sufficient attention.

METHODS

Study 1 is a longitudinal study tracking changes in schizotypal personality features among college students during the COVID-19 pandemic. A total of 153 Chinese college students were assessed using the Schizotypal Personality Questionnaire. Study 2 explored the relationship between schizotypal personality features, mind wandering, and depression. A total of 557 college students completed the Schizotypal Personality Questionnaire, the Beck Depression Inventory, and the Mind-Wandering Questionnaire during the COVID-19 pandemic.

RESULTS

Study 1 results showed that the scores from later stages in the pandemic were significantly higher than those from the initial stages on each dimension of schizotypal personality, which means that the schizotypal personality features became more obvious during the COVID-19 pandemic. Study 2 results showed that there was a positive correlation between schizotypal personality features, depression, and mind wandering.

DISCUSSION

Depression played a moderating role in the relationship between schizotypal personality features and mind wandering. The schizotypal personality features of college students increase during COVID-19; it has a positive relationship with mind wandering; depression moderates the relationship. We discussed these findings and provided some suggestions about future research.

Attention-deficit/ hyperactivity disorder symptoms and suicidal ideation among college students: A structural equation modeling approach

OBJECTIVE

Suicidal ideation (SI) among college students is frequently reported. However, the mediating roles of depressive and anxiety symptoms between attention-deficit/hyperactivity disorder (ADHD) symptoms and SI has yet to be explored among college students.

METHOD

A cross-sectional survey of college freshmen in China was conducted between October 2018 and December 2018. Standardized questionnaires were used to collect information on basic sociodemographic characteristics, including SI, ADHD symptoms, and anxiety and depressive symptoms. A structural equation model (SEM) was then constructed.

RESULTS

A total of 904 college freshmen were included in the analysis. The prevalence of ADHD symptoms and lifetime SI were 11.9% (95% CI: 9.9%-14.2%) and 29.2% (95% CI: 26.3%-32.2%), respectively. The SEM revealed that there were no direct paths from inattention, executive dysfunction, and hyperactivity to SI. Under the mediating role of anxiety and depressive symptoms, executive dysfunction (β = 0.011, p < 0.05) and hyperactivity (β = 0.015, p < 0.05) had indirect relationships with the risk of SI, and the role of inattention was not identified. Depressive and anxiety symptoms had direct influences on increasing SI. There also were indirect effects from anxiety symptoms to SI, which were mediated by depressive symptoms (β = 0.023, p < 0.001).

CONCLUSIONS

The current study indicated the indirect relationships between ADHD symptoms and SI among college freshmen. The findings could provide useful clues for clinical treatment and school-based prevention that aims to improve college students' mental well-being.

The Relationship between Performance of Attention Task and Suicidal Ideation in Korean Patients with Mood Disorders

OBJECTIVE

We examined the performance of attention tests related to suicidal ideation in mood disorder patients and to explain the difference of attention test performance in relation to suicidal ideation after controlling clinical and psychological variables of mood disorder patients.

METHODS

Seventy-three in- and outpatients with major depressive disorder (n=41) or bipolar disorder (n=32) completed a self-rating questionnaire assessing socio-demographic characteristics, and clinical and psychological variables. Comprehensive Attention Test (CAT) also was conducted.

RESULTS

Thirty-three patients were the high-suicidal ideation (SI) group, and forty patients were the low-SI group. The errors of commission (CEs) of visual sustained attention in the high-SI group was 6.3 times higher on average than that of the low-SI group. After controlling for sex, age, and diagnosis, a higher number of CEs on visual sustained attention tasks predicted higher SI score. However, after controlling for sex, age, diagnosis, and depressive mood, this predictive ability was no longer observed.

CONCLUSION

This study showed that CE on the visual sustained attention task seems to influence suicidal ideation as a result of interaction with depressive symptoms.

A qualitative systematic review of suicide behavior using the cognitive systems domain of the research domain criteria (RDoC) framework

Neurocognitive deficits are associated with both suicide behavior (SB) and psychiatric disorders. Application of a transdiagnostic framework to identify neurocognitive commonalities of SB may clarify important risk factors of SB across psychiatric disorders. The aim of this study was to conduct a qualitative systematic literature review of SB using the Research Domain Criteria (RDoC) Cognitive Systems framework to determine if cognitive deficits exist independently of psychiatric disorders in SB. The following six constructs that encompass the Cognitive Systems domain were assessed: 1) Attention, 2) Cognitive Control, 3) Declarative Memory, 4) Language, 5) Perception, and 6) Working Memory. A total of 1386 abstracts were identified and 74 studies met the inclusion criteria for this review. The majority of studies reviewed (65%) had significant differences in cognition between individuals with and without SB. Seventy-nine percent of studies with a patient control group showed significant cognitive deficits in SB groups. Deficits in cognitive control were associated with SB and had the greatest percentage of studies with significant main findings. Use of the RDoC cognitive systems framework to evaluate SB revealed that cognitive deficits may be a transdiagnostic risk factor for SB, especially alterations in cognitive control.

Paying attention to attention in depression

Attention is the gate through which sensory information enters our conscious experiences. Oftentimes, patients with major depressive disorder (MDD) complain of concentration difficulties that negatively impact their day-to-day function, and these attention problems are not alleviated by current first-line treatments. In spite of attention's influence on many aspects of cognitive and emotional functioning, and the inclusion of concentration difficulties in the diagnostic criteria for MDD, the focus of depression as a disease is typically on mood features, with attentional features considered less of an imperative for investigation. Here, we summarize the breadth and depth of findings from the cognitive neurosciences regarding the neural mechanisms supporting goal-directed attention in order to better understand how these might go awry in depression. First, we characterize behavioral impairments in selective, sustained, and divided attention in depressed individuals. We then discuss interactions between goal-directed attention and other aspects of cognition (cognitive control, perception, and decision-making) and emotional functioning (negative biases, internally-focused attention, and interactions of mood and attention). We then review evidence for neurobiological mechanisms supporting attention, including the organization of large-scale neural networks and electrophysiological synchrony. Finally, we discuss the failure of current first-line treatments to alleviate attention impairments in MDD and review evidence for more targeted pharmacological, brain stimulation, and behavioral interventions. By synthesizing findings across disciplines and delineating avenues for future research, we aim to provide a clearer outline of how attention impairments may arise in the context of MDD and how, mechanistically, they may negatively impact daily functioning across various domains.

Attention-deficit hyperactivity disorder and suicidality: The mediating effects of psychiatric comorbidities and family function

OBJECTIVE

To explore the association between Attention-Deficit Hyperactivity Disorder ("ADHD") and suicidality in children. Mediating effects of family function and psychiatric co-morbidities were also explored.

METHODS

This is a national representative cross-sectional survey of school-based sample of 4739 children aged 7-15. Logistic regression was used to assess the excess risks of suicidality (i.e., suicidal ideation, suicide plan, and suicide attempts) in 412 children with ADHD. Serial multiple mediator models were conducted to assess the mediating effects of family function and psychiatric comorbidities.

RESULTS

The prevalence of suicidality in children with ADHD was approximately 20% in Taiwan. After adjusting for potential confounders, the risk of suicidality among children with ADHD was approximately four times higher than among non-ADHD children [(adjusted Odds Ratio ["OR"] = 3.82, 95% Confidence Interval ("CI") (2.73, 5.34)] for suicidal ideation, adjusted OR = 4.18, 95% CI (2.57, 6.80) for suicide plan and adjusted OR = 4.45, 95% CI (1.99, 9.93) for suicide attempts. The mediating effects of anxiety/depression and conduct problems were about 20% and 8%, respectively, across all suicide outcomes. The mediating effects of family function were around 6-7% for suicidal ideation and 16-18% for suicide plan and suicide attempts. The effects of ADHD on suicidality, in general, remained after considering the mediating roles of family function and psychiatric comorbid conditions.

CONCLUSIONS

Children with ADHD are at a high risk of suicide. Although the family function and psychiatric co-morbidities partially mediate this association, ADHD in itself is a potent suicide risk factor and should be an important target for suicide prevention.

Association between socioeconomic attainments and suicidal ideation by age groups in Korea

BACKGROUND:

Suicidal ideation is a strong antecedent of suicidal behavior, associated with increased likelihood of suicide. Thus, suicidal ideation serves to identify which groups are at more risk of suicide and has policy implications for targeting groups to prevent suicide.

AIMS:

A substantial body of research has addressed potential determinants of suicide ideation in Korea. Little attention has been paid, however, to analyzing the extent to which socioeconomic attainments (education, household income, and employment status) are associated with risk of suicidal ideation, drawing on nationally representative data.

METHODS:

Data were drawn from the 2012 Korea Welfare Panel Study (KOWEPS). Among the 12,606 respondents, the findings are based on 1,500 young adults (age 18-35) and 3,469 middle-aged adults (age 36-55) who answered a question about suicidal ideation.

RESULTS:

For young adults, respondents from 2-year and 4-year colleges and higher had lower probabilities of suicidal ideation compared with respondents from high school. People out of the labor force also exhibited an elevated risk of suicidal ideation compared with those in waged employment. Middle-aged adults displayed different patterns. Middle-aged respondents from 4-year colleges or higher had an increased likelihood of suicidal ideation. The likelihood of reporting suicidal ideation was predicted to decrease as household income increased only for middle-aged adults.

CONCLUSIONS:

The information about suicidal ideation was obtained from only one question of self-response, which limits the validity of the suicidal ideation measurement. The cross-sectional setting of the data prevents us from estimating causal relationships. Nevertheless, the findings imply that age-specific policy should be implemented to ameliorate differential risk for suicidal ideation and benefit public mental health in the long run.

Effects of Psychiatric Symptoms on Attention in North Korean Refugees

OBJECTIVE

We investigated the performance of North Korean refugees on attention tasks, and the relationship between that performance and psychiatric symptoms.

METHODS

Sustained and divided attention was assessed using the computerized Comprehensive Attention Test in North Korean refugees and in South Koreans. All participants also completed the Beck Depression Inventory, the Beck Anxiety Inventory, the Impact of Event Scale-Revised and the Dissociative Experiences Scale-II (DES-II).

RESULTS

The North Korean refugees showed slower reaction times (RTs) on the visual sustained attention task compared to the South Koreans after controlling for age and sex. North Korean refugees had a greater number of omission errors (OEs) on the divided attention task and a higher standard deviation (SD) of RT. Total DES-II scores of the North Korean refugees were associated with the number of OEs and the SD of RT on the sustained attention task, and with the number of OEs on the divided attention task.

CONCLUSION

North Korean refugees showed poorer performance on computerized attention tasks. In addition, attention deficit among North Korean refugees was associated with their dissociative experiences. Our results suggest that refugees may have attention deficits, which may be related to their psychiatric symptoms, particularly dissociation.