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Suicide and the social brain: the psychobiology of risk and protective factors
Heeringen, Kees van
Although many divergent approaches to the study of suicidal behaviour have resulted in the identification of social, biological and psychological risk factors, a comprehensive framework, in which ...these factors and their mutual relationships can be described, is currently lacking. In this chapter such a framework will be proposed, based on the "social brain" concept. The social brain, or basolateral circuit, consists of two subsystems, i.e. the temporal cortex in conjunction with the hippocampal structures, mediated by the serotonin (5-HT)1a and noradrenergic neurotransmission systems and modulating resilience to (mainly interpersonal) stress, and the prefrontal cortex and itsfeedback loop involving the amygdala, mediated by the 5-HT2a and dopamine neurotransmission systems and modulating approach/avoidance behaviours. This chapter will describe the increasing evidence that a dysfunction of the two subsystems is involved in the development of suicidal behaviour. For example, with regard to the first component we have demonstrated that increased cortisol production among attempted suicide patients correlates significantly with the temperamental characteristic that mediates sensitivity to interpersonal events. Regarding the second component, suicidal behaviour has been shown to be associated with interrelated disturbed 5-HT28 functions and increased hopelessness. There appears to be a considerable overlap between findings from cognitive psychological and biological studies, thus justifying a psychobiological approach to our understanding of suicidal behaviour.
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