Integrating Phenomenological and Neurobiological Models to Enhance Prediction of Adult Psychopathology and Suicidality

In recent years, there have been substantial advancements in research describing the neurobiological underpinnings of mental disorders and suicidality. The goal of this article is to assimilate the prevailing genetic markers, molecular signatures, neurochemical substrates, and patterns of brain activation to rectify current theoretical models of suicidal behavior. Using data from the Epidemiologic Catchment Area Study (U.S. Dept. of Health and Human Services, National Institute of Mental Health), we identified the most prevalent mental and physical health common factors reported by those that expressed suicide attempts or suicidal ideation. Specific processes were extrapolated and used as a basis for the analysis of biomarkers found in studies of suicide victims. Of those that expressed suicide attempts or suicidal ideation, common factors included depression (59.1%), irrational guilt (59.1%), worthlessness (77.3%), self-doubt (68.2%), impaired attention (86.4%), and rumination about death (81.8%). Of those that attempted suicide, the common triggering cause was loss of a loved one or chronic physical pain. Framing the neurobiological findings in studies of suicide victims with these mental states reveal pathways implicated in the contemporary theoretical models of suicidality. Thus, advances in the neurobiology of suicidality complements phenomenological hypotheses of suicide. Alterations in these mechanisms may present measurable phenotypes that can be used to identify diathesis, predisposition, and diagnosis.

Significance. Current methods of screening are based on self-reports, which are not completely accurate, but by supplementing with biological markers, clinicians can more efficiently test for predisposing biochemical/molecular traits.