Executive Function and Self-Injurious Thoughts and Behaviors: A Systematic Review and Meta-Analysis.
Shayna M Cheek, Rachel F L Walsh, Sarah E Barnes et al.
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In 30 seconds
This systematic review and meta-analysis examined associations between core executive functions—inhibitory control, cognitive flexibility, and working memory—and self-injurious thoughts and behaviors. Across 127 studies, deficits in all three functions were associated with suicidal ideation (Hedges’ gs = |0.15|-|0.23|) and suicide attempts (gs = |0.21|-|0.28|). For nonsuicidal self-injury, pooled effects were medium for cognitive flexibility (g = 0.52, 95% CI [0.10 to 0.93]) and working memory (g = -0.69, 95% CI [-1.00 to -0.38]). The authors identify executive-function deficits as candidate mechanisms, while noting that prognostic value requires longitudinal study.
Key findings
- Deficits in inhibitory control, cognitive flexibility, and working memory were associated with suicidal ideation (gs = |0.15|-|0.23|).
- The same executive-function deficits were associated with suicide attempts (gs = |0.21|-|0.28|).
- For nonsuicidal self-injury, pooled effects were g = 0.52 for cognitive flexibility and g = -0.69 for working memory.
- Sensitivity analyses linked task switching and response inhibition to suicidal ideation, and working memory and attentional control to suicide attempts.
Why it matters
The findings suggest that executive-function deficits may be relevant across suicidal thoughts, suicide attempts, and nonsuicidal self-injury, while some components may relate differently to thoughts and behaviors. This distinction could help shape research into mechanisms and potential targets, but the reported associations do not establish causation or show that executive-function measures can predict individual outcomes.
What to keep in mind
The meta-analysis synthesizes associations across studies; the abstract notes that longitudinal work is still needed to establish prognostic value.