The Choice of a Violent Suicidal Means: a MRI Study with Computational Modeling of Decision-making
- Conditions
- Suicide, Attempted
- Interventions
- Other: Algometer testOther: functional MRI
- Registration Number
- NCT05230043
- Lead Sponsor
- Centre Hospitalier Universitaire de Nīmes
- Brief Summary
The study authors hypothesize a combination of cognitive, brain structural, brain functional and brain connectivity impairments in Suicide Attempters compared to Patient Controls and Healthy Controls, with deficits more marked in suicide attempters using violent suicidal means including:
1. Impaired choices at the reversal learning task with responses influenced by immediate outcome. This deficit would be correlated with brain activity in ventromedial Prefrontal Cortex during resting state and with several peripheral markers of the 5HT-system.
2. Reduced loss aversion. These deficits would be related to altered dynamics of Blood-Oxygen Level Dependent signal in the dorsal and ventral striatum as well as in ventral Prefrontal Cortex/ orbitofrontal cortex during the loss aversion task. These deficits would also be correlated with several peripheral markers of the 5HT-system.
3. Increased pain tolerance facilitating the execution of a violent and possibly painful act. These deficits measured with the algometer would be correlated with several peripheral markers of the 5HT-system.
4. Reduced behavioral inhibition in aversive context at the orthogonalized GoNoGo task facilitating the choice of a violent means. These deficits would be associated with altered Blood-Oxygen Level Dependent signal in ventral Prefrontal Cortex/ orbitofrontal cortex and parietal cortex during the resting state and correlated with several peripheral markers of the 5HT-system.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 40
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Right-handed (as assessed with the Edinburgh Handedness Scale).
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Agreement to participate and sign the informed consent form.
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Is insured or beneficiary of a health insurance plan.
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Speaks French.
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Suicide Attempters using Violent Means group:
- a personal history of mood disorder (bipolar disorder or depressive disorders according to DSM-5 criteria measured with the MINI 7.0);
- at least one suicidal act committed with a violent means within the last 5 years.
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Suicide Attempters using Non-Violent Means group:
- a personal history of mood disorder (bipolar disorder or depressive disorders according to DSM-5 criteria measured with the MINI 7.0);
- at least one suicidal act conducted within the last 5 years;
- no lifetime history of suicidal act with a violent means.
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Patient Control group:
- a personal history of mood disorder (bipolar disorder or depressive disorders according to DSM-5 criteria measured with the MINI 7.0);
- never attempted suicide in their lifetime;
- no family history of suicidal behavior up to the second biological degree.
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Healthy Control group:
- no personal history of major mental disorder according to the MINI 7.0;
- never attempted suicide in their lifetime;
- no family history of suicidal behavior up to the second biological degree.
- Current participation or in the exclusion period of another research protocol in a category 1 RIPH
- Currently under judicial protection, or under adult guardianship.
- Refusal to participate.
- Is pregnant or breast feeding.
- The suicide attempt may have impacted the brain functioning (e.g. following hanging, asphyxia by drowning, head trauma following jumping from height, bullet impact, etc). This criteria will be assessed clinically by the investigator.
- Mental retardation (known or observed during the interview).
- Current psychotic disorder (according to the MINI 7.0).
- Current hypomanic episode (according to the MINI 7.0).
- Current manic, mixed, rapid cycling episodes (according to the MINI 7.0).
- Alcohol or substance disorder within last 3 months (according to the MINI 7.0).
- Past major brain trauma (with loss of consciousness > 1 minute).
- Contra-indication to MRI (metal in body (including due to suicidal act), claustrophobia, impossibility to lie still on the back during one hour).
- Electroconvulsive therapy within the last three months.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Suicide Attempters not using Violent Means Algometer test - Healthy Controls Algometer test - Patient Control functional MRI - Healthy Controls functional MRI - Suicide Attempters using Violent Means Algometer test A violent suicidal act is any suicidal act conducted with any means except for medication overdose or superficial wrist cutting. Patient Control Algometer test - Suicide Attempters using Violent Means functional MRI A violent suicidal act is any suicidal act conducted with any means except for medication overdose or superficial wrist cutting. Suicide Attempters not using Violent Means functional MRI -
- Primary Outcome Measures
Name Time Method Brain activity between groups Day 0 Magnetic Resonance Imaging signal during the resting state and loss aversion task Blood-Oxygen Level Dependent sequences.
- Secondary Outcome Measures
Name Time Method Pain tolerance between groups Day 0 Pressure pain tolerance threshold (mean of 3 consecutive trials) measured by algometer
Impaired reversal learning between groups Day 0 Proportion of participants in each group reaching the learning criterion of the Reversal learning task (8 consecutive correct trials) in each stage (acquisition and reversal).
Loss aversion between groups Day 1 Level of acceptance/reject rate according to the size of the potential gain and loss in each trial of the Loss aversion task
Behavioral inhibition in aversive context between groups Day 0 Response latencies in the reward-only condition vs. the reward+punishment condition in the inforced categorization task
Trial Locations
- Locations (1)
CHU de Nimes
🇫🇷Nîmes, France