Promising research may help to shape future interventions

Numerous risk factors for suicide are well known, including depression, anxiety, substance abuse, a history of self-harm, job loss, divorce, suffering from frantic hopelessness or a state of entrapment defined as being stuck in a life situation that is painful and intolerable, and a feeling that all routes of escape are blocked.

Additionally, affective disturbance (i.e., emotional pain, rapid spikes of negative emotions, extreme anxiety, anhedonia), loss of cognitive control (i.e., rumination, cognitive rigidity, ruminative flooding, failed thought suppression), overarousal (i.e., agitation, hypervigilance, irritability, insomnia), and social withdrawal (i.e., reduction in activity, evasive communication) are important factors to consider.

However, measuring suicide risk is always a challenge, in part because there are many other people who have the same risk factors but do not attempt suicide. Why do some people transition from suicidal ideation to planning to actually attempting suicide, and others do not?

The answers to this question are complex and defy neat categorization. However, a new study has shone light on at least one piece of the puzzle: the role of unusual connectivity in the brain.

The link between brain connectivity and suicide risk

In the study, researchers from Boston University and the VA Boston Healthcare System examined veterans who had a history of trauma and showed symptoms of depression and post-traumatic stress disorder. The participating veterans were given a resting functional MRI scan, which tracks communication between brain regions and networks to show how different areas interact.

The researchers then compared the brain connectivity in veterans who had reported at least one suicide attempt and in those who did not. To emphasize, these individuals had otherwise equivalent psychiatric symptoms; the only significant difference was the history of suicide attempts.

The MRI results showed significant differences in important connections in the brain between the veterans with a history of suicide attempts and the control group, both before and after the suicide attempts themselves, specifically in the right middle temporal gyrus (right MTG). Those differences affected cognitive control (adjusting behavior to fit a certain goal) and self-referential thought processing (reflecting on the past and thinking about what we need to do in the future).

Researchers also found abnormal connectivity in the right amygdala in veterans with a history of suicide attempts, but only after the attempts, making this finding less useful for predictive purposes. However, this is a significant clue when it comes to identifying why previous suicide attempts increase the risk of future attempts.

Identifying these brain changes could be a powerful suicide risk assessment method

According to the BU and VA researchers, these findings have the potential to transform suicide assessment by providing a measure of suicidality that does not require self-disclosure of suicidal thoughts. Most current suicide risk assessment methods are dependent on the suicidal person disclosing their thoughts and behaviors. (The Suicide Crisis Syndrome is an exception; it too is not dependent on a person disclosing suicide ideation). An objective measure of brain connectivity could help medical professionals identify at-risk patients who would otherwise be overlooked.

Researchers also noted that their findings could influence future treatments for suicidality. “This could also lead to new treatments that target these brain regions and their underlying functions,” said Audreyana Jagger-Rickels, a Boston University Chobanian & Avedisian School of Medicine assistant professor of psychiatry and lead author on the paper.

The study findings highlight the importance of suicide assessment and prevention

More research needs to be done to investigate the role of connections in the brain in determining suicide risk. These findings, however, speak to a larger truth that is well-known in the suicide prevention community: suicide risk can be identified and treated with prompt, appropriate interventions.

When medical professionals fail to meet standards of care and patients die by suicide, our law firm works to hold them accountable. If you have lost a loved one to suicide completion, contact the Law Offices of Skip Simpson today for a free and confidential consultation. Our firm represents families nationwide.