Neurocognition and the Suicidal Process.

Early thinking about cognitive process and suicidal behaviors tended to focus on the immediate situation surrounding the individual - typically the underlying psychiatric condition that was seen as leading to his or her distress. However, we now know that the cognitive processes involved in a range of suicidal thoughts and behaviors can exert a significant impact on the expression or development of these behaviors, even without an environmental stressor or psychiatric condition. In this chapter, we summarize theoretical perspectives that led to this realization and explore the current understanding of the link between cognition and suicide from recent research and clinical findings. We present these findings first by psychiatric disorder, then by cognitive domains, and finally by specific suicidal construct in order to highlight the importance of these factors in determining the role of cognition in the suicidal process.Within and across psychiatric disorders, certain cognitive processes - negativistic thinking, impulsivity, cognitive rigidity, and altered emotional processing - are frequently found to be linked to suicidal thoughts and behaviors. Overall cognitive performance, decreased processing speed, executive dysfunction, and negative biases in memory and attention have also been linked to suicidal thoughts and behaviors. However, these findings do not hold true for all populations. There seems to be a role both for cognitive distortions (such as hopelessness) and neurocognitive deficits (such as poor overall cognitive performance, slower processing speed, and executive dysfunction) in the suicidal process, which warrant further exploration both separately and together.

Severe childhood trauma and clinical and neurocognitive features in schizotypal personality disorder.

OBJECTIVE: Literature suggests that childhood trauma increases vulnerability for schizophrenia-spectrum disorders, including schizotypal personality disorder (SPD). Yet, it remains unexplored whether childhood trauma predicts symptom load and the level of neurocognitive functioning in SPD. METHOD: We included 225 individuals with SPD and 127 healthy controls. Childhood trauma was evaluated using the Childhood Trauma Questionnaire, and schizotypal traits were assessed using the Schizotypal Personality Questionnaire. Standard neurocognitive assessments covered six cognitive domains. RESULTS: All types of reported childhood trauma were significantly associated with SPD, in a linear fashion. Severe sexual abuse showed the greatest magnitude of association with higher cognitive-perceptual load (e.g., ideas of reference, odd belief or magical thinking); severe emotional neglect was associated with interpersonal scores (e.g., excessive social anxiety, constricted affect) within the SPD group. SPD individuals who reported severe trauma showed worse cognitive functioning (i.e., working memory, verbal/visual learning and memory, as well as verbal fluency). CONCLUSIONS: Particular severe childhood trauma types were associated with higher cognitive-perceptual and interpersonal symptoms in SPD, along with worse cognitive functioning. These findings highlight the need for clinicians to enquire about childhood trauma in SPD patients, since unaddressed early adverse experiences may carry long-term negative consequences.