(PS9-D93) Attentional Variability Differentiates Suicide Attempts from Ideation in a Veteran Sample

Suicide is an urgent public health crisis with recent reports showing that 6261 veterans died by suicide in 2019 (VA 2021 Suicide Prevention Report). Reports of suicidal ideation are common with 9% of veterans reporting current suicidal ideation (Nichter et al., 2021).Therefore, understanding neurocognitive factors that differentiate veterans who make suicide attempts from those who experience ideation may inform novel methods for risk assessment and intervention. One distinguishing factor may be attention, a multifaceted cognitive process that has been linked to suicide and psychological distress (Huber et al., 2019). The present study aims to evaluate the association between different aspects of attention measured with the Conners’ Continuous Performance Test (CPT-II; Conners, 2000) and lifetime risk for suicidal ideation and behavior in veterans. We hypothesized that there would be attentional differences between veterans with a history of suicide attempt compared to veterans with a history of ideation and veterans without a history of ideation or attempts. The present sample comprised of 71 veterans in the Salt Lake City area who completed a battery of mental health questionnaires and neurocognitive testing. Veterans were M_age = 36.96 (SD = 9.34), 81.8% male, and 81.8% White. Veterans were classified into three discrete groups based on their reports on the Columbia-Suicide Severity Rating Scale (C-SSRS): lifetime suicide attempt (+SA; n = 13); lifetime suicide ideation without attempt (+SI; n = 34); or no lifetime suicide ideation or attempt (No SI/SA; n = 24). Attention was indexed using omission errors, commission errors, hit rate, and hit rate variability (measured via standard error) scores from the CPT-II, which is a computerized task that requires participants to press a spacebar in response to an x on the screen, and to inhibit the response when a letter other than x appears. Four one-way between group ANOVAs were completed with CPT omission errors, commission errors, hit rate, and hit rate standard error as respective dependent variables and group membership (+SA, +SI, or No SI/SA) as the independent between-group measure.  Significant group differences were observed for CPT hit rate variability, F(2,68) = 5.23, p = .008. Post-hoc contrasts indicated that veterans in the +SA group exhibited greater hit rate variability (M = 8.36, SD = 5.77) than the +SI group (M = 5.72, SD = 2.48; F(1,68) = 6.83, p = .011) and veterans with No SI/SA (M = 4.97, SD = 1.49; F(1,68) = 10.10, p = .002). These results remained significant after multiple test correction. Results from the current study suggest that attentional control may be an important neurocognitive marker for different types of suicide behavior (i.e., attempts versus ideation and no suicidality). Specifically, veterans with a history of suicide attempts exhibited more variation in attention compared to the other groups. This is particularly relevant to treatment, as those with a history of suicide attempt may struggle to consistently attend to therapeutic discussions or have challenges practicing intervention skills such as mindfulness. Future work should be conducted to determine neural mechanisms related to attentional variability in individuals with suicidal behavior.