Patterns of Neural Activation and Functional Connectivity Predict Suicidal Ideation During the COVID-19 Pandemic

• In Event: Impact of the COVID-19 pandemic on adolescent development: Exploring sleep and mental health

Abstract

Introduction: Preliminary reports indicate that rates of SI in adolescents and young adults increased during the COVID-19 pandemic (Zhang et al., 2020; Czeisler et al., 2020). Adolescents with pre-existing disruptions in socio-affective processing may be especially susceptible to stress associated with the dramatic upheaval of the social environment during the pandemic, which may increase SI risk. Alterations in neural systems supporting processing social-evaluative threat or reward have been linked to SI in youth (Oppenheimer et al., 2019), but it is unclear whether such alterations confer SI risk during a time with heightened social stress. Here, we examined whether patterns of neural function implicated in processing social feedback and at rest increased SI risk during the pandemic in shy/fearful adolescent girls. We hypothesized that heightened amygdala activation and reduced fronto-amygdala functional connectivity and/or reduced cortico-striatal activation would predict higher SI during the pandemic.

Methods: Ninety-three girls ages 12-17 were recruited from a larger longitudinal study for a COVID-19 follow-up study during the initial stay-at-home orders in the study’s geographical region (April – May 2020). Approximately, two-thirds of the sample were recruited with high shy/fearful temperament. At baseline of the larger study, participants reported on their depressive symptoms and completed a) a Social Incentive Delay (SID) fMRI task in which they received performance-related social feedback from a virtual peer and b) a resting state session. For this study, participants were divided into matched groups based on SI (no SI; SI) assessed via the Suicidal Ideation Questionnaire – Junior Version (SIQ-JR; Reynolds, 1987) completed during COVID-19 follow-up. Analyses were performed on a subset of the participants who had useable fMRI and COVID-19 follow-up data. Parameter estimates for the task were extracted from the following anatomically-defined regions-of-interest: nucleus accumbens, caudate, putamen, insula, amygdala, ventromedial prefrontal cortex, subgenual anterior cingulate cortex) during social reward or punishment feedback (vs. neutral feedback). For resting state, time-series were extracted from the bilateral ventromedial prefrontal cortex and amygdala. Parameter estimates of neural activation and functional connectivity indices were entered in separate logistic regression models, controlling for age and depressive symptoms (at baseline).

Results: Blunted activation in the putamen and caudate to anticipation of social reward on the SID task was associated with an increased chance of SI during the pandemic (see Table 1). There were no significant associations with social punishment feedback. Additionally, reduced right amygdala - vmPFC functional connectivity during resting state was associated with an increased chance of SI (Standardized Log Odds: -1.113, SE = .52, p = .0352).

Conclusions: Girls with blunted striatal activation to anticipated social rewards and reduced fronto-amygdala functional connectivity during rest are at increased risk of SI during the pandemic. Undervaluing potential social rewards may decrease motivation to seek out opportunities for peer support and increase SI risk. This may be particularly detrimental during periods of heightened stress and social disruption among peers. These findings are an initial step toward identifying neurobiological risk factors for adolescent SI during periods of heightened social stress, such as the COVID-19 pandemic.

Authors

• Cecile D Ladouceur, University of Pittsburgh
  Presenting Author

• Emily Anne Hutchinson, University of Pittsburgh
  Non-Presenting Author

• Stefanie Sequeira, University of Pittsburgh
  Non-Presenting Author

• Teague Henry, University of Pittsburgh
  Non-Presenting Author

• Jennifer S. Silk, University of Pittsburgh
  Non-Presenting Author