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Decision making and implicit suicidality in schizophrenia spectrum disorders

Published online by Cambridge University Press:  13 August 2021

O. Vorontsova ,
T. Medvedeva ,
S. Enikolopov ,
O. Boyko  and
G. Rupchev
O. Vorontsova
Affiliation:
Clinical Psychology, Federal State Budgetary Scientific institution “Mental health research center”, Moscow, Russian Federation
T. Medvedeva
Affiliation:
Clinical Psychology, Federal State Budgetary Scientific institution “Mental health research center”, Moscow, Russian Federation
S. Enikolopov
Affiliation:
Clinical Psychology, Federal State Budgetary Scientific institution “Mental health research center”, Moscow, Russian Federation
O. Boyko*
Affiliation:
Clinical Psychology, Federal State Budgetary Scientific institution “Mental health research center”, Moscow, Russian Federation
G. Rupchev
Affiliation:
Laboratory Of Psychopharmacology, FSBSI Mental Health Research Center, Moscow, Russian Federation
*
*Corresponding author.

Abstract

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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.

Keywords

Rorschach testIowa gambling taskschizophréniaimplicit suicidality
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S807
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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