Posttraumatic stress disorder (PTSD) is associated with suicidal thoughts and behaviours. Decision-making processes and risk-taking are prominent for coping in both, but the implications for guaranteed and probabilistic reward discounting, important components in behavioural decision-making processes, are unclear. This study explored the relationships between PTSD and suicide risk with tendencies towards devaluing guaranteed rewards that are larger but delayed (i.e., delay discounting; DD) and devaluing larger but uncertain rewards (i.e., probability discounting; PD) for immediate but smaller rewards. The current study evaluated 498 participants (majority male [51.4%] and white [63.8%]; 33.3% screening positive for probable PTSD; 19.2% with lifetime suicide attempts; 30.8% with recent suicide ideation) on both delayed discounting and PD tasks. Provisional PTSD diagnosis, but not suicide attempts or ideation, was associated with increased PD (i.e., more devaluation of uncertain rewards). Conversely, PTSD interacted with both attempt history and ideation to predict increased delayed discounting (i.e., more devaluing of greater but delayed rewards). These results highlight how those with PTSD symptoms assign valuations to rewards, as well as how the addition of suicide risk interacts to impact these decision-making processes. While further research is needed, this suggests potential implications for treatment as they may benefit from structuring progress in smaller, more immediate goals.

中文翻译：

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创伤后应激障碍症状、自杀意念、自杀企图和奖励折扣之间的关联

创伤后应激障碍（PTSD）与自杀想法和行为有关。决策过程和冒险对于应对这两种情况都很重要，但对行为决策过程中重要组成部分的保证和概率奖励贴现的影响尚不清楚。本研究探讨了 PTSD 和自杀风险之间的关系，倾向于贬低较大但延迟的有保证的奖励（即延迟折扣；DD），以及贬低较大但不确定的奖励（即概率折扣；PD）以获得即时但较小的奖励。目前的研究评估了 498 名参与者（大多数为男性 [51.4%] 和白人 [63.8%]；33.3% 的可能 PTSD 筛查呈阳性；19.2% 有终生自杀企图；30.8% 有近期自杀意念）的延迟贴现和 PD 任务。临时 PTSD 诊断（而非自杀企图或意念）与 PD 增加相关（即不确定奖励的贬值程度更高）。相反，PTSD 与尝试历史和意念相互作用，以预测延迟折扣的增加（即，更大但延迟的奖励的贬值幅度更大）。这些结果强调了患有创伤后应激障碍症状的人如何对奖励进行评估，以及自杀风险的增加如何相互作用影响这些决策过程。虽然还需要进一步的研究，但这表明对治疗的潜在影响，因为它们可能受益于在更小、更直接的目标中取得进展。