Executive functioning in depression and suicide
The purpose of this study was to understand executive functioning tasks and their relationship to suicide through analysis of two such tasks in a sample of depressed patients. Past suicide Attempters and Non-Attempters were compared on two tests, the Wisconsin Card Sorting Test, a test that has a strong association with the dorsolateral prefrontal cortex, and the Object Alternation Test (OA), a test that is more sensitive to inferior prefrontal functioning. The Attempter group was more impaired on the Failure to Maintain Set index of the WCST, an index that is associated with inferior prefrontal functioning. However, the Non-Attempters showed selective impairment on all of the indices of the task designed to measure inferior prefrontal functioning (OA), contrary to the study hypotheses. Supplemental analyses comparing neuropsychological test performance with clinical measures of depression and suicide found that poorer performance on the Object Alternation Test was associated with hopelessness, as measured by the Beck Hopelessness Scale. Differences in demographic variables failed to explain the differences between the Attempter and Non-Attempter groups on OA. Analyses of the clinical variables indicate that the Non-Attempter group in this study may be at high risk for suicidal behavior. If the OA test is to be used in the future, its construct should be more clearly defined, and studies of the relationships between the OA indices and different measures of memory, attention, and executive functioning would be informative. Finally, gambling tests provide an alternative method of assessing the inferior prefrontal cortex, and should be explored in suicidal individuals.
Wyatt, Gwinne R, "Executive functioning in depression and suicide" (2004). ETD Collection for Fordham University. AAI3118192.