Decision-Making Under Stress, Biological Stress Responses, and Risk for Suicidal Behavior in Young Adults

Greater reductions in risky choices under stress over time were observed in young adults with recent suicide attempts (n=55) compared with healthy controls (n=48).

• Why it matters: Stress-linked changes in decision-making may be tied to vulnerability for suicidal behavior, but longitudinal evidence on risky choice and expected value sensitivity under stress has been limited.
• What they did: Across 233 young adults (18–30 years), hair cortisol concentration and inflammatory markers (CRP, IL-6, IL-10, IL-1ra, TNF-alpha) were measured alongside the Stressful Cups Task at baseline and 3-, 6-, and 12-month follow-ups.
• The result: Reductions in expected value (EV) sensitivity under stress predicted subsequent suicidal behavior, while CRP and IL-6 related to fewer risky choices and IL-10 related to greater stress-related reductions; hair cortisol showed no significant associations.

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