Adolescent Suicide Behaviors are Associated with Accelerated Reductions in Cortical Gray Matter Volume and Maintenance of Behavioral Activation System Sensitivity

Abstract

Abstract Distinguishing those at risk of making a suicide attempt from those who experience only suicidal ideations remains a significant clinical challenge. Longitudinal studies during early adolescence may provide insight into altered brain and behavioral developmental trajectories among those who develop suicide behaviors (SB). Here, we applied linear mixed effects regression models to several global brain volumes and psychiatric/behavioral measures from the Adolescent Brain Cognitive Development Study®. We analyzed data from baseline up until the two-year follow-up, when participants were roughly 10 to 12 years of age. What distinguished those reporting SB from other groups was that they exhibited the greatest reductions in cortical gray brain matter volume. Those who developed SB also exhibited the greatest increase in DSM5-depression scores and were the only group that maintained their levels of Behavioral Activation System (BAS) Fun-Seeking behaviors. Finally, we applied a Cross-Lagged Panel Modelling approach and found evidence for a potential causal relationship between total cortical gray brain matter volume and BAS Fun-Seeking behaviors. Our results suggest that changes in cortical gray matter structure may impact behavioral approach systems which in turn increase the risk of suicide attempt during early adolescence.