Friends of the Behavioral Economics Club, this week we present the paper “Search for solutions, learning, simulation, and choice processes in suicidal behavior” by Dombrovski, A. and Hallquist, M. H. (2021), in which authors make a revision about the decision making process and the solutions to the suicidal behavior considering the point of view of behavioral economics.
Suicide is one of the most important and significant causes of death in recent years, especially among young population. Every day thousands of people decide to carry out suicidal behaviors and, sadly, end their lives, which is an irreparable loss.
From the scientific point of view of behavioral economics, this can be seen as an unfortunate result in decision-making processes.
But before commenting the article, we think it is convenient to explain what suicide is. It would be the act deliberately initiated and carried out by a particular person, with full knowledge of its fatal outcome.
There is a series of risk factors, such as being male, suffering from pathologies (depression, psychosis, personality disorders or addictions), having a family history of suicidal behavior, having suffered childhood trauma, physical illnesses and cognitive deficits.
From a psychological point of view, many explanations have been given for this behavior. For example, the trap and escape frameworks, the interpersonal theory, the motivational-volitional theory, or the three-step theory. They all share a vision of suicide as an escape from intolerable emotional states.
However, most of the factors involved in all theories are specific constructs of suicide or depression and there is a lack of an external explanatory framework. In other words, explanations of the mechanisms underlying the suicidal process are lacking and, therefore, new perspectives are needed.
That is why authors propose in the article that formal learning theory and decision neuroscience can help us to understand the cognitive and decision processes that are involved in this behavior.
Within the suicide risk mechanisms, two personality characteristics appear: neuroticism and impulsivity. Neuroticism would be a tendency to experience frequent negative emotions such as anger, sadness or anxiety, symptoms that are called “internalizing”. On the other hand, impulsivity is an important component of the “externalizing” spectrum, which includes symptoms such as substance abuse or violence.
Studies on the subject are almost always based on self-report methods, such as dimensional surveys. The challenge is that internalizing and externalizing are broad and heterogeneous constructs that, when evaluated in this way, provide information that is not too relevant.
It would be more interesting to know about the personality of the individual so that it can tell us something about how he will respond to circumstances that could be part of the progression towards a suicidal behavior.
Authors are interested in studying cognitive limitations because they could explain people’s inability to consider the alternatives and consequences of suicide, due to cognitive control influences decision making.
For example, those who attempt suicide show deficits in autobiographical and long-term memory, but not short-term. This may jeopardize the generation of alternative choices and the memory-based simulations that evaluate them.
In summary, people who engage in suicidal behaviors may show deficits in global cognitive performance, memory, and cognitive control beyond what is expected in psychopathology, but the stages of the suicidal process to which these deficits may contribute remain unclear.
On the other hand, the suicidal process can be seen from the decision theory. People do not normally admit suicide as an option when they face life’s challenges. But then, the person experiences a great crisis that threatens her /his objectives and generates uncertainty, a crisis that generates a sense of urgency to solve immediately the problems.
But how can suicide be selected over the alternatives in a crisis? When it comes about choosing in suicidal behavior, most people cannot accurately predict how the crisis will unfold, and their estimates of the relative value of suicide versus alternatives end up being inconsistent with their interests.
Furthermore, escape theories emphasize intense negative affective states, which make a challenging situation feel catastrophic.
The suicidal crisis is marked by a sense of temporary pressure, triggered by imminent threats. Since the number of items selected in the set of considerations is limited by time and cognitive resources, fewer alternatives are included, because the person is under urgent pressure. And it may even be because his/her cognitive ability is being diminished.
Besides, there is the aspect of cognitive overload in suicidal crises. Patients generally feel lost, and the crisis intensifies when the cognitive demands exceed the capacity of each person to manage it. The need of evaluating many options at once due to uncertainty, degrades the quality of decision making.
Therefore, the authors note that it would be interesting for future studies to examine how people vulnerable to suicidal behavior deal with information overload and limitations such as time pressure.
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