Decreased Neural Response to Threat Differentiates Patients Who Have Attempted Suicide From Nonattempters With Current Ideation

Suicide prevention efforts have not slowed suicide rates, in part because of limited understanding of differences in risk for suicide ideation versus suicide attempts. Reduced fear of pain and death may be key to this distinction. In the present study we examine whether blunted neural response to threat of death, bodily harm, or illness, measured by the late positive potential (LPP), differentiates individuals who had previously attempted suicide from individuals who had never attempted suicide, controlling for current levels of suicidal ideation. We compared psychiatric outpatients with no history of suicide attempts (n = 152) and those with a history of suicide attempts (n = 83). Attempters exhibited a blunted threat-elicited LPP compared to patients with no history of attempts, regardless of current ideation. Findings suggest diminished neural response to threat can distinguish attempters from ideators and might be a target for future research on the transition from ideation to action.