Decision making, as quantitatively defined in the Iowa gambling task36 that compares choosing between disadvantageous choices for which a lot of money is won but even more is lost (resulting in a net loss) and advantageous choices where less is won but even less is lost (resulting in a net gain), shows associations with SB. A significantly higher tendency toward disadvantageous choices was found in patients with a history of SB compared with patients without any such history and to healthy controls.37 Patients were euthymic at the time of assessment, suggesting a trait, rather than state, finding. This impairment was not related to comorbid axis-I disorders.37 Similar alterations in suicide attempters were recently reported in patients suffering from major depressive disorder,38 bipolar disorder39, 40 and also in self-harming adolescents.41 Most recently, disadvantageous decision making was found deficient in elderly suicide attempters versus elderly suicide ideators, non-suicidal depressed and non-depressed subjects in a reward/punishment-based task.42 Although decision making has not been formally studied in relatives of suicide attempters/completers, one study reported decision-making alterations in unaffected relatives of alcoholics suggesting that this
