Attentional Bias Deficits in Adolescent Suicide Attempters During an Emotional Stroop Task: An ERP Study

Abstract

There is increasing evidence that, in adolescence, attentional bias plays a critical role in the vulnerability for suicidal behaviour. No studies to date have investigated the neurophysiological correlates of attentional bias in adolescent suicidality. The present study uses event-related potentials (ERPs) to investigate such processing in inpatient adolescents admitted for an acute suicide crisis using an Emotional Stroop Task (EST). In this task, participants are asked to name the colour of words varying in emotional valence (positive, negative, neutral, suicide-related). Suicidal individuals are hypothesised to be more preoccupied by the context of the suicide-related stimuli, which may interfere with their ability to perform the colour naming task. Seventeen adolescents with acute suicidal behaviour and 17 age- and gender-matched healthy controls performed an EST while ERPs were recorded. Suicide attempters showed increased reaction times to suicide-related words compared to other emotion categories, while the controls did not. The amplitude of the early posterior negativity (EPN) was not significantly different across groups or emotional valence. A double peak P3 (early-P3 and late-P3) was observed in both groups. Both the early- and late-P3 were significantly reduced in amplitude in the suicide attempter group compared to the control group, regardless of emotional valence. The late-P3 latency was also significantly delayed in the suicide attempters compared to controls. The behavioural findings support the attentional bias theories of suicide attempters and extend these findings to adolescents. Furthermore, large early- and late-P3 provide evidence that cognitive strategies employed by two groups did markedly differ.

Adaptation of an Emotional Stroop Test for Screening of Suicidal Ideation in Portugal

“…Our findings corroborate previous studies that demonstrated that the Emotional Stroop Test is an important tool for the assessment of suicidal ideation, as it fills gaps in commonly used self-report scales [ 10 , 29 , 30 ]. In fact, this test will be beneficial for the field of psychological assessment in Portugal, as it considers specific criteria and characteristics related to suicidal ideation that other measures are not prepared to assess.…”

The role of cognitive flexibility in self-injurious thoughts and behaviors: A systematic review.

“…Yet, more recent studies indicate that the SST has poor concurrent validity and cannot effectively differentiate persons with versus without SA history (Niu et al, 2021;Wilson et al, 2019). Overall, attentional bias to suicide-related words is not robustly associated with SITB (Becker et al, 1999;Cha et al, 2017Cha et al, , 2018Chung & Jeglic, 2016Niu et al, 2021;Stewart et al, 2017;Tavakoli et al, 2021;Williams & Broadbent, 1986;Yin et al, 2021), and does not account for unique variance in SA history when controlling for depressive symptoms (Chung & Jeglic, 2016. Thus, SST is not a robust predictor of suicide risk.…”

The enhanced emotional negativity bias in parents of atypically developing children: Evidence from an event‐related potentials study

“…The N2 component was a negative wave over fronto-central scalp sites at around 200-300 ms, which has been thought to reflect the recruitment of cognitive and attentional control processes in EST (Folstein & Van Petten, 2008;Thai et al, 2016). Following the N2, the late P3 component was also extensively reported in the EST, and typically suggested a larger P3 for negative stimuli than positive or neutral stimuli (Bertsch et al, 2009;Tavakoli et al, 2021;Thomas et al, 2007). This may represent a phase of sustained attentive processing and elaborate evaluation of the significance of negative stimuli (Hajcak & Foti, 2020).…”

“…Except for the behavioral measure, to examine the time course of attentional bias in EST, scalp electrical activity was also generally recorded by previous studies via the ERPs (e.g., Bertsch et al., 2009; González‐Villar et al., 2014; Tavakoli et al., 2021; Thomas et al., 2007). Due to its extremely high temporal resolution (Hillyard & Anllo‐Vento, 1998), ERPs are very suitable for investigating the sub‐processes of attention.…”