INS NYC 2024 Program

Poster	Poster Session 05 Program Schedule 02/15/2024 02:30 pm - 03:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 05: Neuropsychiatry \| Addiction/Dependence \| Stress/Coping \| Emotional/Social Processes Final Abstract #21 Subjective Cognitive Complaints and Neuropsychological Performance in Suicide Attempters with PTSD Mary Clark, Columbia University/New York State Psychiatric Institute, New York, United States John Keilp, Columbia University/New York State Psychiatric Institute, New York, United States Marianne Gorlyn, Columbia University/New York State Psychiatric Institute, New York, United States Ainsley Burke, Columbia University/New York State Psychiatric Institute, New York, United States J. Mann, Columbia University/New York State Psychiatric Institute, New York, United States Category: Psychiatric Disorders Keyword 1: post-traumatic stress disorder Keyword 2: cognitive functioning Keyword 3: neuropsychological assessment Objective: Among individuals with Post-Traumatic Stress Disorder (PTSD), elevated levels of subjective cognitive complaint have been associated with an increased risk of suicide attempt. It is unclear, though, if these subjective cognitive complaints are associated with actual, objective neurocognitive deficits, that can increase the potential for suicidal behavior in this high-risk group. Participants and Methods: In this study, 74 participants in a major depressive episode (MDE) with lifetime comorbid PTSD were assessed. All participants were unmedicated at the time of assessment as part of their participation in associated biological assessments. PTSD participant groups with past suicide attempt (n=38) and without past suicidal behavior (n=36) were compared on a range of demographic, clinical, and neuropsychological variables. Groups were comparable in age, sex distribution, race, ethnicity, education, and estimated ability level. Approximately three-quarters of each group were female, and 80.0% or more of each had experienced past physical and/or sexual abuse. Participants completed an assessment of subjective cognitive complaints (Cognitive Failures Questionnaire) and received an objective, comprehensive neuropsychological performance battery that included measures of reaction time, processing speed, attention, cognitive control, memory, working memory, abstraction, language fluency, and impulse control. Results: PTSD participants with past suicidal attempts were, as expected, found to have greater a level of subjective cognitive complaint (p = .051). Though PTSD attempters and non-attempters were comparable in depression severity on an objective clinician-rated measure (Hamilton Depression Scale, p = .10), PTSD attempters exhibited a higher degree of subjective depression (Beck Depression Inventory, p < .001), hopelessness (Beck Hopelessness Inventory, p = 0.004), and poorer overall level of functioning (Global Assessment Scale, p < .001). On neuropsychological tasks, PTSD attempters exhibited poorer sustained attention (Continuous Performance Test, p = .011), attention control (computerized Stroop task, p = .051), verbal memory (Buschke Selective Reminding Test, p = .005), abstraction (Wisconsin Card Sort, p = .051), and reasoning speed (A, Not B Time Reasoning task, p = .027). When severity of subjective depression was controlled, however, differences in level of subjective cognitive complaint was no longer significant (p=.554). Poorer neuropsychological performance on measures of sustained attention (Continuous Performance Test, p=.044) and abstraction (Wisconsin Card Sort, p=.055) were, however, maintained after covariance adjustment for subjective depression severity. Conclusions: PTSD is a risk factor for suicidal behavior, but neurocognitive factors contribute to the risk for suicidal behavior in those with this disorder. Results of here suggest that subjective cognitive complaints are elevated in those with past suicidal behavior, but that these complaints may simply reflect a heightened level of subjective depression severity, known to be associated with increased suicidal behavior risk. Objective neuropsychological deficits, however, are evident even after controlling for subjective depression severity. In assessing suicidal behavior risk in those with PTSD, then, assessments of cognitive complaints, subjective depression severity, and objective neuropsychological performance are likely to be useful in identifying those at greatest risk for self-harm behaviors.

Poster

02/15/2024
02:30 pm - 03:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes

Final Abstract #21

Subjective Cognitive Complaints and Neuropsychological Performance in Suicide Attempters with PTSD

Mary Clark, Columbia University/New York State Psychiatric Institute, New York, United States
John Keilp, Columbia University/New York State Psychiatric Institute, New York, United States
Marianne Gorlyn, Columbia University/New York State Psychiatric Institute, New York, United States
Ainsley Burke, Columbia University/New York State Psychiatric Institute, New York, United States
J. Mann, Columbia University/New York State Psychiatric Institute, New York, United States

Category: Psychiatric Disorders

Keyword 1: post-traumatic stress disorder
Keyword 2: cognitive functioning
Keyword 3: neuropsychological assessment

Objective:

Among individuals with Post-Traumatic Stress Disorder (PTSD), elevated levels of subjective cognitive complaint have been associated with an increased risk of suicide attempt. It is unclear, though, if these subjective cognitive complaints are associated with actual, objective neurocognitive deficits, that can increase the potential for suicidal behavior in this high-risk group.

Participants and Methods:

In this study, 74 participants in a major depressive episode (MDE) with lifetime comorbid PTSD were assessed. All participants were unmedicated at the time of assessment as part of their participation in associated biological assessments. PTSD participant groups with past suicide attempt (n=38) and without past suicidal behavior (n=36) were compared on a range of demographic, clinical, and neuropsychological variables. Groups were comparable in age, sex distribution, race, ethnicity, education, and estimated ability level. Approximately three-quarters of each group were female, and 80.0% or more of each had experienced past physical and/or sexual abuse. Participants completed an assessment of subjective cognitive complaints (Cognitive Failures Questionnaire) and received an objective, comprehensive neuropsychological performance battery that included measures of reaction time, processing speed, attention, cognitive control, memory, working memory, abstraction, language fluency, and impulse control.

Results:

PTSD participants with past suicidal attempts were, as expected, found to have greater a level of subjective cognitive complaint (p = .051). Though PTSD attempters and non-attempters were comparable in depression severity on an objective clinician-rated measure (Hamilton Depression Scale, p = .10), PTSD attempters exhibited a higher degree of subjective depression (Beck Depression Inventory, p < .001), hopelessness (Beck Hopelessness Inventory, p = 0.004), and poorer overall level of functioning (Global Assessment Scale, p < .001). On neuropsychological tasks, PTSD attempters exhibited poorer sustained attention (Continuous Performance Test, p = .011), attention control (computerized Stroop task, p = .051), verbal memory (Buschke Selective Reminding Test, p = .005), abstraction (Wisconsin Card Sort, p = .051), and reasoning speed (A, Not B Time Reasoning task, p = .027). When severity of subjective depression was controlled, however, differences in level of subjective cognitive complaint was no longer significant (p=.554). Poorer neuropsychological performance on measures of sustained attention (Continuous Performance Test, p=.044) and abstraction (Wisconsin Card Sort, p=.055) were, however, maintained after covariance adjustment for subjective depression severity.

Conclusions:

PTSD is a risk factor for suicidal behavior, but neurocognitive factors contribute to the risk for suicidal behavior in those with this disorder. Results of here suggest that subjective cognitive complaints are elevated in those with past suicidal behavior, but that these complaints may simply reflect a heightened level of subjective depression severity, known to be associated with increased suicidal behavior risk. Objective neuropsychological deficits, however, are evident even after controlling for subjective depression severity. In assessing suicidal behavior risk in those with PTSD, then, assessments of cognitive complaints, subjective depression severity, and objective neuropsychological performance are likely to be useful in identifying those at greatest risk for self-harm behaviors.