Suicidal thoughts and behaviors are associated with an increased decision-making bias for active responses to escape aversive states.

Suicide is a leading cause of death worldwide. Despite decades of clinical and theoretical accounts that suggest that suicidal thoughts and behaviors are efforts to escape painful emotions, little prior research has examined decision making involved in escaping aversive states. We compared the performance of 85 suicidal participants to 44 nonsuicidal psychiatric patients on a novel reinforcement learning task with choices to make either active...