Can Neurocognitive Functioning Tests Help Predict Future Suicide Attempts?

Can Neurocognitive Functioning Tests Help Predict Future Suicide Attempts? 1024 683 Mary Bates, PhD
Sad black teenage girl

Researchers identify sex-specific deficits in measures of working memory and affective processing associated with suicidal behavior in youth with depression.

To prevent youth suicide, researchers are working to identify factors associated with suicide attempts in adolescents at elevated risk for suicidal behavior.

In a new study, researchers from Nationwide Children’s examined neurocognitive functioning in suicidal and non-suicidal youth with a history of major depressive disorder and explored whether neurocognitive dysfunction predicted future suicide attempts.

The researchers administered a battery of psychiatric and neurocognitive tests to three groups of adolescents aged 12-15 years with a lifetime history of major depressive disorder:

  • Those with a history of suicide attempt
  • Those with a history of suicidal ideation but no history of a suicide attempt
  • Those with no history of suicidal ideation or suicide attempt

The results showed sex-specific deficits in neurocognitive functioning that differentiate suicidal and non-suicidal youth.

“In females, neurocognitive domains associated with affective bias, which refers to how emotions can impact cognitive processes, were found to be significantly different based on past suicidal ideation and attempts,” says Donna Ruch, PhD, a research scientist in the Center for Suicide Prevention and Research at the Abigail Wexner Research Institute at Nationwide Children’s Hospital and the study’s lead author.

“Similar results were found on tests for spatial working memory in males, where more errors occurred among those who had suicide ideation and attempts compared to never-suicidal subjects,” she says.

Prospective analyses also showed that deficits in these same domains predicted future suicide attempts. Females who made a future attempt made more errors in response to happy words on a test of affective processing compared to those with no future attempts.

Among males, less efficient strategies on the spatial working memory test predicted future suicide attempts. “This is a critical first step in identifying potential targets for future risk evaluation and treatment,” says Dr. Ruch.

“Findings from these exploratory analyses suggest that cognitive vulnerabilities in adolescents may predict future suicide attempts over and above the presence of major depressive disorder and attempt history.”

Knowledge of how neurocognitive impairments may distinguish youth at risk for suicide could help inform the development of clinically feasible neurocognitive evaluations and preventive intervention strategies to target specific risk factors for suicide in youth with depression.

“Future research should examine longer term follow-up data to better identify unique facets of neurocognitive functioning that most strongly predict youth suicidal behavior, including important sex differences,” says Dr. Ruch. “This can enable clinicians to more effectively intervene as early as possible and, ideally, respond with methods that target unique vulnerabilities of individual patients.”

This article was published in the 2021 Spring/Summer print issue. Download the full issue. 


Ruch D, Sheftall AH, Heck K, McBee-Strayer SM, Tissue J, Reynolds B, Ackerman J, Brent DA, Campo JV, Bridge JA. Neurocognitive vulnerability to youth suicidal behavior. Journal of Psychiatric Research. 2020;131:119-126.

Image credit: Adobe Stock

About the author

Mary a freelance science writer and blogger based in Boston. Her favorite topics include biology, psychology, neuroscience, ecology, and animal behavior. She has a BA in Biology-Psychology with a minor in English from Skidmore College in Saratoga Springs, NY, and a PhD from Brown University, where she researched bat echolocation and bullfrog chorusing.