Understanding the suicidal brain

Brain regions shown to be involved in suicidal behaviour constitute what may be called the ‘suicidal brain’. [...]the current state of knowledge of neuropsychological and cognitive psychological aspects of suicidal behaviour allows for a description of the roles of these areas in the development of suicidal ideation and behaviour, and more particularly for a dissociation of the social cognitive processes and the behavioural expression of these processes. By using a modified fluency test it was recently demonstrated that participants who had attempted suicide were less fluent in coming up with positive events that might happen in the future. [...]hopelessness – which is a core psychopathological characteristic in association with suicidal behaviour – was found to correlate significantly with the lack of generating future positive events and not with an excessive anticipation of negative things in the future (Williams & Pollock, 2001). Using a split-dose activation paradigm with the Verbal Fluency Test we recently showed a blunted increase in prefrontal blood flow in the brains of people who had attempted suicide when compared with a healthy control group (Audenaert et al, 2002). [...]research is needed to study the relevance of such findings to the understanding of the suicidal brain. [...]the effects of state-dependent conditions (such as those associated with the increased stress response or with excessive alcohol intake) on serotonergic neural activity requires further study, because of their potential influence on the course of the suicidal process (Van Heeringen, 2001).