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Suicidal Ideation Among Anxious Youth: A Preliminary Investigation of the Role of Neural Processing of Social Rejection in Interaction with Real World Negative Social Experiences

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Abstract

Suicidal ideation increases in adolescence, especially for anxious youth, and is a frequent precursor to suicide. This study examined whether neural processing of social rejection interacted with negative social experiences to predict suicidal ideation. Thus, to our knowledge this is the first study to examine how brain function may interact with the environment to contribute to suicidal ideation in youth, consistent with a developmental psychopathology perspective. Thirty-six anxious youth (ages 11 to 16) completed diagnostic interviews and questionnaires, an ecological momentary assessment (EMA) protocol, and a functional magnetic resonance imaging paradigm. Results showed that youth experienced greater severity of suicidal ideation when they exhibited heightened activation to social rejection in the right anterior insula and also experienced high levels of peer victimization or EMA-measured daily negative social experiences. Findings provide preliminary evidence that alterations in neural processing of social rejection interacts with exposure to negative social experiences to contribute to suicidal ideation.

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References

  1. Centers for Disease Control and Prevention NCfIPaC (2013) Web-based Injury Statistics Query and Reporting System. Retrieved December 1, 2018 from http://webappa.cdc.gov

  2. Nock MK (2016) Recent and needed advances in the understanding, prediction, and prevention of suicidal behavior. Depress Anxiety 33:460–463

    Article  PubMed  Google Scholar 

  3. Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM et al (2013) Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry 70:300–310

    Article  PubMed  Google Scholar 

  4. Baumeister RF (1990) Suicide as escape from self. Psychol Rev 97:90

    Article  PubMed  Google Scholar 

  5. Shneidman ES (1993) Commentary: suicide as psychache. J Nerv Ment Dis 181:145–147

    Article  PubMed  Google Scholar 

  6. Van Orden KA, Witte TK, Cukrowicz KC, Braithwaite SR, Selby EA, Joiner TE Jr (2010) The interpersonal theory of suicide. Psychol Rev 117:575

    Article  PubMed  PubMed Central  Google Scholar 

  7. Nock MK, Prinstein MJ, Sterba SK (2009) Revealing the form and function of self-injurious thoughts and behaviors: a real-time ecological assessment study among adolescents and young adults. J Abnorm Psychol 118:816

    Article  PubMed  PubMed Central  Google Scholar 

  8. Victor SE, Scott LN, Stepp SD, Goldstein TR (2018) I want you to want me: interpersonal stress and affective experiences as within-person predictors of nonsuicidal self-injury and suicide urges in daily life. Suicide Life Threat Behav. https://doi.org/10.1111/sltb.12513

    Article  PubMed  PubMed Central  Google Scholar 

  9. Cicchetti D, Rogosch FA (2002) A developmental psychopathology perspective on adolescence. J Consult Clin Psychol 70:6

    Article  PubMed  Google Scholar 

  10. Hankin BL, Mermelstein R, Roesch L (2007) Sex differences in adolescent depression: stress exposure and reactivity models. Child Dev 78:279–295

    Article  PubMed  Google Scholar 

  11. Guyer AE, Silk JS, Nelson EE (2016) The neurobiology of the emotional adolescent: from the inside out. Neurosci Biobehav Rev 70:74–85

    Article  PubMed  PubMed Central  Google Scholar 

  12. Eisenberger NI (2012) The pain of social disconnection: examining the shared neural underpinnings of physical and social pain. Nat Rev Neurosci 13:421–434

    Article  PubMed  Google Scholar 

  13. O’Neil KA, Puleo CM, Benjamin CL, Podell JL, Kendall PC (2012) Suicidal ideation in anxiety-disordered youth. Suicide Life Threat Behav 42:305–317

    Article  PubMed  Google Scholar 

  14. Gallagher M, Prinstein MJ, Simon V, Spirito A (2014) Social anxiety symptoms and suicidal ideation in a clinical sample of early adolescents: examining loneliness and social support as longitudinal mediators. J Abnorm Child Psychol 42:871–883

    Article  PubMed  PubMed Central  Google Scholar 

  15. Silk JS, Davis S, McMakin DL, Dahl RE, Forbes EE (2012) Why do anxious children become depressed teenagers? The role of social evaluative threat and reward processing. Psychol Med 42:2095–2107

    Article  PubMed  PubMed Central  Google Scholar 

  16. Eisenberger NI (2012) The neural bases of social pain: evidence for shared representations with physical pain. Psychosom Med 74:126

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kumar P, Waiter GD, Dubois M, Milders M, Reid I, Steele JD (2017) Increased neural response to social rejection in major depression. Depress Anxiety 34:1049–1056

    Article  PubMed  Google Scholar 

  18. Giletta M, Hastings PD, Rudolph KD, Bauer DJ, Nock MK, Prinstein MJ (2017) Suicide ideation among high-risk adolescent females: examining the interplay between parasympathetic regulation and friendship support. Dev Psychopathol 29:1161–1175

    Article  PubMed  Google Scholar 

  19. Silk JS, Siegle GJ, Lee KH, Nelson EE, Stroud LR, Dahl RE (2013) Increased neural response to peer rejection associated with adolescent depression and pubertal development. Soc Cognit Affect Neurosci 9(11):1798–1807

    Article  Google Scholar 

  20. Hsu D, Yttredahl A, Sankar A 2018 66. Neuroimaging Evidence for Targeting Abnormal Responses to the Social Environment in Major Depressive Disorder. Biological Psychiatry 83:S27

  21. Johnston JA, Wang F, Liu J, Blond BN, Wallace A, Liu J et al (2017) Multimodal neuroimaging of frontolimbic structure and function associated with suicide attempts in adolescents and young adults with bipolar disorder. Am J Psychiatry 174:667–675

    Article  PubMed  PubMed Central  Google Scholar 

  22. Miller AB, McLaughlin KA, Busso DS, Brueck S, Peverill M, Sheridan MA (2018) Neural correlates of emotion regulation and adolescent suicidal ideation. Biol Psychiatry 3:125–132

    Google Scholar 

  23. Pan L, Hassel S, Segreti A, Nau S, Brent D, Phillips M (2013) Differential patterns of activity and functional connectivity in emotion processing neural circuitry to angry and happy faces in adolescents with and without suicide attempt. Psychol Med 43:2129–2142

    Article  PubMed  Google Scholar 

  24. Quevedo K, Ng R, Scott H, Martin J, Smyda G, Keener M et al (2016) The neurobiology of self-face recognition in depressed adolescents with low or high suicidality. J Abnorm Psychol 125:1185

    Article  PubMed  PubMed Central  Google Scholar 

  25. Groschwitz RC, Plener PL, Groen G, Bonenberger M, Abler B (2016) Differential neural processing of social exclusion in adolescents with non-suicidal self-injury: an fMRI study. Psychiatry Res 255:43–49

    Article  Google Scholar 

  26. Brown RC, Plener PL, Groen G, Neff D, Bonenberger M, Abler B (2017) Differential neural processing of social exclusion and inclusion in adolescents with non-suicidal self-injury and young adults with borderline personality disorder. Front Psychiatry 8:267

    Article  PubMed  PubMed Central  Google Scholar 

  27. Olié E, Jollant F, Deverdun J, de Champfleur NM, Cyprien F, Le Bars E et al (2017) The experience of social exclusion in women with a history of suicidal acts: a neuroimaging study. Sci Rep 7:89

    Article  PubMed  PubMed Central  Google Scholar 

  28. Liu RT, Miller I (2014) Life events and suicidal ideation and behavior: a systematic review. Clin Psychol Rev 34:181–192

    Article  PubMed  Google Scholar 

  29. Heilbron N, Prinstein MJ (2010) Adolescent peer victimization, peer status, suicidal ideation, and nonsuicidal self-injury: examining concurrent and longitudinal associations. Merrill-Palmer Q 56:388–419

    Article  Google Scholar 

  30. Giletta M, Calhoun CD, Hastings PD, Rudolph KD, Nock MK, Prinstein MJ (2014) Multi-level risk factors for suicidal ideation among at-risk adolescent females: the role of hypothalamic-pituitary-adrenal axis responses to stress. J Abnorm Child Psychol 43(5):807–820

    Article  Google Scholar 

  31. King CA, Merchant CR (2008) Social and interpersonal factors relating to adolescent suicidality: a review of the literature. Arch Suicide Res 12:181–196

    Article  PubMed  PubMed Central  Google Scholar 

  32. Holt MK, Kaufman Kantor G, Finkelhor D (2008) Parent/child concordance about bullying involvement and family characteristics related to bullying and peer victimization. J Sch Violence 8:42–63

    Article  Google Scholar 

  33. Oppenheimer CW, Ladouceur CD, Waller JM, Ryan ND, Allen KB, Sheeber L et al (2016) Emotion socialization in anxious youth: parenting buffers emotional reactivity to peer negative events. J Abnorm Child Psychol 44:1267–1278

    Article  PubMed  PubMed Central  Google Scholar 

  34. Smyth JM, Stone AA (2003) Ecological momentary assessment research in behavioral medicine. J Happiness Stud 4:35–52

    Article  Google Scholar 

  35. Olino TM, Silk JS, Osterritter C, Forbes EE (2015) Social reward in youth at risk for depression: a preliminary investigation of subjective and neural differences. J Child Adolesc Psychopharmacol 25:711–721

    Article  PubMed  PubMed Central  Google Scholar 

  36. Williams KD, Jarvis B (2006) Cyberball: a program for use in research on interpersonal ostracism and acceptance. Behav Res Methods 38:174–180

    Article  PubMed  Google Scholar 

  37. Silk JS, Tan PZ, Ladouceur CD, Meller S, Siegle GJ, McMakin DL et al (2018) A randomized clinical trial comparing individual cognitive behavioral therapy and child-centered therapy for child anxiety disorders. J Clin Child Adolesc Psychol 47:542–554

    Article  PubMed  Google Scholar 

  38. Kaufman J, Birmaher B, Brent D, Rao UM, Flynn C, Moreci P, Williamson D, Ryan N (1997) Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Psy 36(7):980–988

    Article  Google Scholar 

  39. Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S, Baugher M (1999) Psychometric properties of the screen for child anxiety related emotional disorders (SCARED): a replication study. J Am Acad Child Adolesc Psychiatry 38:1230–1236

    Article  PubMed  Google Scholar 

  40. Caporino NE, Sakolsky D, Brodman DM, McGuire JF, Piacentini J, Peris TS et al (2017) Establishing clinical cutoffs for response and remission on the screen for child anxiety related emotional disorders (SCARED). J Am Acad Child Adolesc Psychiatry 56:696–702

    Article  PubMed  PubMed Central  Google Scholar 

  41. Wechsler D (1999) Manual for the Wechsler abbreviated intelligence scale (WASI). The Psychological Corporation, San Antonio

    Google Scholar 

  42. Hammerton G, Zammit S, Potter R, Thapar A, Collishaw S (2014) Validation of a composite of suicide items from the mood and feelings questionnaire (MFQ) in offspring of recurrently depressed parents. Psychiatry Res 216:82–88

    Article  PubMed  Google Scholar 

  43. Poznanski EO, Mokros HB (1996) Children’s depression rating scale, revised (CDRS-R). Western Psychological Services, Los Angeles

    Google Scholar 

  44. Mayes TL, Bernstein IH, Haley CL, Kennard BD, Emslie GJ (2010) Psychometric properties of the children’s depression rating scale-revised in adolescents. J Child Adolesc Psychopharmacol 20:513–516

    Article  PubMed  PubMed Central  Google Scholar 

  45. Rigby K, Slee PT (1993) Dimensions of interpersonal relation among Australian children and implications for psychological well-being. J Soc Psychol 133:33–42

    Article  PubMed  Google Scholar 

  46. Silk JS, Forbes EE, Whalen DJ, Jakubcak JL, Thompson WK, Ryan ND et al (2011) Daily emotional dynamics in depressed youth: a cell phone ecological momentary assessment study. J Exp Child Psychol 110:241–257

    Article  PubMed  Google Scholar 

  47. Schneider W, Eschman A, Zuccolotto A (2002) E-prime: user’s guide. Psychology Software Incorporated, Pittsburg

    Google Scholar 

  48. Ashburner J, Barnes G, Chen C, Daunizeau J, Flandin G, Friston K et al (2014) SPM12 manual. Wellcome Trust Centre for Neuroimaging, London

    Google Scholar 

  49. Whitfield-Gabrieli S, Nieto-Castanon A, Ghosh S (2011) Artifact detection tools (ART). Camb, Ma Release Version 7:11

    Google Scholar 

  50. Mazaika PK, Hoeft F, Glover GH, Reiss AL (2009) Methods and software for fMRI analysis of clinical subjects. Neuroimage 47:S58

    Article  Google Scholar 

  51. Tzourio-Mazoyer N, Landeau B, Papathanassiou D, Crivello F, Etard O, Delcroix N et al (2002) Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. Neuroimage 15:273–289

    Article  PubMed  Google Scholar 

  52. Brett M, Anton J-L, Valabregue R, Poline J-B (eds) (2002) Region of interest analysis using an SPM toolbox. 8th international conference on functional mapping of the human brain, Sendai

  53. Bolin JH (2014) Hayes, Andrew F.(2013). Introduction to mediation, moderation, and conditional process analysis: a regression‐based approach. New York, NY: The Guilford Press. J Educ Meas 51:335–337

    Article  Google Scholar 

  54. Critchley HD, Wiens S, Rotshtein P, Öhman A, Dolan RJ (2004) Neural systems supporting interoceptive awareness. Nat Neurosci 7:189

    Article  PubMed  Google Scholar 

  55. Wiech K, Lin C-s, Brodersen KH, Bingel U, Ploner M, Tracey I (2010) Anterior insula integrates information about salience into perceptual decisions about pain. J Neurosci 30:16324–16331

    Article  PubMed  PubMed Central  Google Scholar 

  56. MacDonald G, Leary MR (2005) Why does social exclusion hurt? The relationship between social and physical pain. Psychol Bull 131:202

    Article  PubMed  Google Scholar 

  57. Hooley JM, Franklin JC, Nock MK (2014) Chronic pain and suicide: understanding the association. Curr Pain Headache Rep 18:1–6

    Article  Google Scholar 

  58. Li D, Zucker NL, Kragel PA, Covington VE, LaBar KS (2017) Adolescent development of insula-dependent interoceptive regulation. Dev Sci 20:e12438

    Article  Google Scholar 

  59. Giletta M, Prinstein MJ, Abela JR, Gibb BE, Barrocas AL, Hankin BL (2015) Trajectories of suicide ideation and nonsuicidal self-injury among adolescents in mainland China: peer predictors, joint development, and risk for suicide attempts. J Consult Clin Psychol 83:265

    Article  PubMed  Google Scholar 

  60. Craig AD, Craig A (2009) How do you feel–now? The anterior insula and human awareness. Nat Rev Neurosci 10(1):59–70

    Article  PubMed  Google Scholar 

  61. Paulus MP, Stein MB (2006) An insular view of anxiety. Biol Psychiatry 60:383–387

    Article  PubMed  Google Scholar 

  62. Emmert K, Breimhorst M, Bauermann T, Birklein F, Van De Ville D, Haller S (2014) Comparison of anterior cingulate vs. insular cortex as targets for real-time fMRI regulation during pain stimulation. Front Behav Neurosci 8:350

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Caroline W. Oppenheimer, Jennifer S. Silk, Erika Forbes, Neal Ryan & Cecile D. Ladouceur

  2. School of Public Health, University of California, Berkeley, CA, USA

    Ronald E. Dahl

  3. Department of Psychology, University of Pittsburgh, 210 S. Bouquet St., Pittsburgh, PA, USA

    Jennifer S. Silk & Erika Forbes

  4. Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 0308, Republic of Korea

    Kyung Hwa Lee

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  1. Caroline W. Oppenheimer
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  2. Jennifer S. Silk
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  3. Kyung Hwa Lee
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  4. Ronald E. Dahl
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  6. Neal Ryan
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  7. Cecile D. Ladouceur
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Correspondence to Caroline W. Oppenheimer.

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Oppenheimer, C.W., Silk, J.S., Lee, K.H. et al. Suicidal Ideation Among Anxious Youth: A Preliminary Investigation of the Role of Neural Processing of Social Rejection in Interaction with Real World Negative Social Experiences. Child Psychiatry Hum Dev 51, 163–173 (2020). https://doi.org/10.1007/s10578-019-00920-6

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