Elevated cognitive rumination and adverse life events are associated with lower cortical surface area and suicidal ideation in adolescents with major depressive disorder

Dauvermann, Maria R.; Schmaal, Lianne; Čolić, Lejla; Velzen, Laura S. van; Bellow, Sophie; Ford, Tamsin; Suckling, John; Goodyer, Ian; Blumberg, Hilary P.; Harmelen, Anne‐Laura van

doi:10.1016/j.jad.2022.12.087

Cited by 7 publications

(1 citation statement)

References 70 publications

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“…As mentioned in Methods, we conducted an additional updated search in May 2023, after the data synthesis had been performed and the brain model of suicidal behavior in youth had been built. The search resulted in 8 papers that met the inclusion criteria [58][59][60][61][62][63][64][65]. To preserve the order of the data synthesis-in which we begin with the systematic literature search first, without any specific model in mind, then perform a narrative synthesis, and finally propose a model-we did not include the 8 additional papers in the synthesis and instead compared the findings in these papers to our END model as to whether they support or contradict it.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of MRI Studies and the “Emotional paiN and social Disconnect (END)” Brain Model of Suicidal Behavior in Youth

Tymofiyeva,

Reeves,

Shaw

et al. 2023

Behavioural Neurology

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Introduction. Risk of suicidal ideation and suicidal behaviors greatly increases during adolescence, and rates have risen dramatically over the past two decades. However, few risk factors or biomarkers predictive of suicidal ideation or attempted suicide have been identified in adolescents. Neuroimaging correlates hold potential for early identification of adolescents at increased risk of suicidality and risk stratification for those at high risk of suicide attempt. Methods. In this systematic review, we evaluated neural regions and networks associated with suicidal ideation and suicide attempt in adolescents derived from magnetic resonance imaging (MRI) studies. A total of 28 articles were included in this review. Results. After descriptively synthesizing the literature, we propose the Emotional paiN and social Disconnect (END) model of adolescent suicidality and present two key neural circuits: (1) the emotional/mental pain circuit and (2) the social disconnect/distortion circuit. In the END model, the emotional pain circuit—consisting of the cerebellum, amygdala, and hippocampus—shows similar aberrations in adolescents with suicidal ideation as in those with a history of a suicide attempt (but to a smaller degree). The social disconnect circuit is unique to adolescent suicide attempters and includes the lateral orbitofrontal cortex (OFC), the temporal gyri, and the connections between them. Conclusion. Our proposed END brain model of suicidal behavior in youth, if confirmed by future prospective studies, can have implications for clinical goals of early detection, risk stratification, and intervention development. Treatments that target emotional pain and social disconnect may be ideal interventions for reducing suicidality in adolescents.

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