Social Emotion Recognition, Social Functioning, and Attempted Suicide in Late-Life Depression

Abstract

Objectives-Lack of feeling connected and poor social problem solving has been described in suicide attempters. However, cognitive substrates of this apparent social impairment in suicide attempters remain unknown. One possible deficit, the inability to recognize others' complex emotional states has been observed not only in disorders characterized by prominent social deficits (autism-spectrum disorders and frontotemporal dementia) but also in depression and normal aging. This study assessed the relationship between social emotion recognition, problem solving, social functioning, and attempted suicide in late-life depression.Design, Participants, Measurements-There were 90 participants: 24 older depressed suicide attempters, 38 non-suicidal depressed elders, and 28 comparison subjects with no psychiatric history. We compared performance on the Reading the Mind in the Eyes test and measures of social networks, social support, social problem solving, and chronic interpersonal difficulties in these three groups.Results-Suicide attempters committed significantly more errors in social emotion recognition and showed poorer global cognitive performance than elders with no psychiatric history. Attempters had restricted social networks: they were less likely to talk to their children, had fewer close friends, and did not engage in volunteer activities, compared to non-suicidal depressed elders and those with no psychiatric history. They also reported a pattern of struggle against others and hostility in relationships, felt a lack of social support, perceived social problems as impossible to resolve, and displayed a careless/ impulsive approach to problems.Conclusions-Suicide attempts in depressed elders were associated with poor social problemsolving, constricted social networks, and disruptive interpersonal relationships. Impaired social NIH Public Access Author ManuscriptAm J Geriatr Psychiatry. Author manuscript; available in PMC 2012 March 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript emotion recognition in the suicide attempter group was related to global cognitive decline, thus it is possible that cognitive decline is one of the risk factors for suicide attempt in late-life, interacting with social deficits and psychosocial factors. ObjectivesSuicide rates are the highest in old age in almost every country in the world. Yet, it is difficult to identify those at risk, since known risk factors, such as depression, pain, disability, or financial problems have limited predictive power (1-3). The role of deficits in cognitive abilities is a poorly understood part of the suicidal diathesis (4,5), especially in older adults (6). The failure to deal with social stressors may play a particularly important role in suicidal behavior, and indeed suicide attempters report difficulties resolving social problems in questionnaire-based studies (7,8). However, cognitive substrates of this apparent social incompetence in suicide attempters remain unknown. It is conceivable that a misperception...

Theory of Mind in Depressive Disorders: A Review of the Literature

“…These results call the attention to the fact that the degree of ToM impairment observed in psychiatric populations highly depends on the composition of the comparison groups. Other studies have described that certain clinical features of depression like suicidal behaviours [43] or anxiety [32] have a negative impact on RMET performance.…”

Binge Eating Disorder In Adolescence: The Role Of Alexithymia And Impulsivity

“…Previous literature has posited that alexithymia may have a mediating role between impulsivity and emotional-behavioral functioning (Szanto et al, 2012). However, no other studies to my best knowledge have specifically investigated the relationship between impulsivity and alexithymia in adolescents with BED and their influence on adolescents' emotional-behavioral functioning.…”

“…Loftis (2012) has studied the role of alexithymia and impulsivity in the suicidal behavior on young adults. The author found that when variables were included together in a regression model, only alexithymia remained statistically significant, suggesting that the presence of alexithymia was the stronger predictor of suicidal behaviors, connected to internalizing and externalizing problems (Szanto et al, 2012).…”

Characteristics and Comorbid Symptoms of Older Adults Reporting Death Ideation

“…One candidate measure is social emotion recognition, which has recently been shown to characterize older adult suicide attempters. 15 …”

“…If suicidal risk was indeed less pernicious in this group, then we anticipated that those with Low Distress/Death Ideation would also score low in a known correlate of suicide risk, social isolation. 1415 We also predicted the presence of another group endorsing a passive wish to die: this group would not endorse active suicidal ideation, but would be at elevated risk for suicide due to the presence of clinically significant depressive and anxiety symptoms and high scores on both functional impairment and social isolation (i.e., a “High Distress/Death Ideation” group).…”