Brain Evidence About Suicide Attempts and Youth

The fourth death by suicide this year occurred at North Carolina State University as of November. Universities across the nation have reported that the mental health of college students is in a state of crisis. The counseling centers on campuses have a backlog due to the demand for services from students. Recently at my own university, faculty and staff have received a request from the Assistant Dean of Students that we consider participating in You Are Not Alone (YANA) training in preparation for the Spring 2023 semester. Following completion of the training, faculty and staff will not be qualified to provide therapy or counseling but would be cleared to chat with students about difficulties with roommates, classes, being away from home, and other non-crisis personal issues or worries. This is but one example of efforts to help with the crisis.

Suicide is the second leading cause of death for young people between the ages of 15 and 29. Researchers are aware of this reality; so they remain busy providing new research to shed light on suicidal thoughts and behaviors (STBs) among young people. The more evidence that researchers acquire, it can be potentially used to assist with prevention and intervention efforts.

Mental health services are in demand by young adults on campuses.

Source: Monstera/Pexels

The Frontal Pole

A collective of researchers, the ENIGMA suicidal thoughts and behaviors consortium, pooled evidence from 21 international studies to analyze neuroimaging data across multiple sites (van Velzen, Dauvermann, Colic, et al. 2022). The dataset was large and allowed the researchers to assess common structural brain alterations across a variety of clinical conditions in young people. The purpose was to examine the brain structure and form potentially associated with suicidal thoughts and behaviors among youth aged 8-25.

The researchers studied a subsample of 577 highly clinically similar (major depression disorder, bipolar disorder) participants (aged 11-25) who all completed the Columbia–Suicide Severity Rating Scale (C-SSRS). This subsample was examined in one phase of the research. Significant findings were revealed about the youths' frontal pole area based on comparisons of those with a lifetime history of suicidal thoughts and attempts relative to those who don't have such a history (van Velzen, Dauvermann, Colic, et al., 2022).

Researchers found that the surface area of the frontal pole was lower in young people with mood disorders and a history of actual suicide attempts compared to those without a lifetime of suicide attempts. The frontal pole is the anterior-most portion of the cortex's frontal lobe. Overall, the frontal lobe governs humans' higher cognitive functions such as memory, emotions, impulse control, problem-solving, social interaction, and motor function.

Vulnerability

The cortical surface area is highly associated with heredity rather than linked to environmental factors across human development (van Velzen, Dauvermann, Colic, et al., 2022). Therefore the stress of life is not a primary contributing factor for suicidal attempts among persons who show lower cortical/frontal surface areas. Thus the explanation for a lower cortical surface area is different from explanations for shifts in cortical thickness. Change in cortical thickness is more relevant to environmental factors. Changes in frontal pole surface area as revealed in the consortium research may represent a pre-existing hereditary vulnerability for non-interrupted and non-aborted suicidal attempts in adolescents. The researchers concluded that more ongoing long-term research to regularly measure youths' brain changes is needed to understand the nature of any changes and how such changes may relate to suicide risk. Among families that have a history of suicide attempts, it appears that regularly imaging the frontal pole of the youth in the family might help with preventative efforts for suicidal behavior.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.