A Potential Neural Pathway for Explaining Suicidal Behaviour: Does it Exist?

Abstract

Suicide is a major health problem, with a lack of decline in suicide rates over the past few decades suggesting existing treatment methods are not effective enough in dealing with suicidal behaviour. A review of the existing neuroimaging literature on suicidal behaviour suggests that a core, “skeleton” neural pathway exists in that a majority of suicidal individuals tend to have structural and functional alterations in the ACC, PFC (more specifically the OFC) and insular cortex. This proposed pathway is able to explain the two main cognitive-behavioural characteristics observed in suicidal individuals: increased impulsivity and impaired decision-making, and emotional dysregulation. Abnormalities in other brain regions may exist in suicidal individuals depending on certain characteristics; most notably, the presence of a comorbid mental disorder may be correlated with impairments of specific brain structures depending on the disorder that is present. Future neuroscientific and psychological research should aim to increase the replicability of neuroimaging studies, determine the extent of the impact a comorbid mental disorder has on the observed location of neural abnormalities in the brain, and to unify the definitions of terminology used in the study of suicide to increase validity and compatibility across suicidology research.