Grants

Saving Lives: Constructing a Nationwide Cohort With Multi-modal Data to Improve Precision in Prediction and Prevention of Suicide

Suicide is difficult to predict and prevent. The goal of this research program is to utilize Sweden’s unique national databases to improve prediction of suicide by integrating the many environmental factors captured by national registers and genetic information using multi-modal modeling. A large national suicide biobank will be created with the aim to make useful predictive models that combine different types of data and use new analytic approaches to best make use of those data. The goal is to increase our understanding of suicidal behavior.

HAVEN: A Multi-generational Suicide Prevention Program Embedded in African American Churches

The HAVEN (Helping to Alleviate Valley Experiences Now) Connect program is a depression and suicide prevention program for Black youth ages 13-19 in 12 churches across New York State. HAVEN-Connect builds on natural cohesive networks, enhances positive coping skills, and promotes help-seeking acceptance through its Youth Connect program and reinforces these protective factors through sermons, Bible study, and Sunday school activities.

HEAR Plus MINDBODYSTRONG: A Mental Health Resiliency Intervention for Nurses

Nurses have a higher suicide rate than the general population. They also experience high rates of burnout and depression that adversely impact health care quality and safety. This study will test a combination of an interactive, anonymous suicide screening program developed by AFSP along with a digitized version of a cognitive behavioral skills-building program previously shown to reduce emotional distress in clinicians. If effective, this intervention could be used to reduce depression and suicide risk throughout the nursing profession and serve as a model for other health care professions.

Identifying and Understanding Suicides That Take Place During Encounters With Police

Hundreds of people in the U.S. die by suicide during interactions with police, and little is known about how often and under what circumstances these suicide deaths occur. Using data from the National Violent Death Reporting System (NVDRS), 2015-2019, suicides that take place during encounters with police, i.e., “suicide police encounters” (SPEs), will be identified and studied by applying Natural Language Processing (NLP) techniques to over 100,000 NVDRS incident narratives to improve understanding of these events. The goal is to inform efforts to reduce suicides during police encounters and improve public safety responses to those at risk of suicide.

Cohort Survey-CMS Data Linkage for Multi-level Modeling and Novel Risk Prediction of Suicide in Diverse Older Adults

Midlife and older adults have the highest rates of suicide in the U.S., and these rates vary widely by race and ethnicity. Complex social, behavioral, and health factors can either increase suicide risk or enhance resilience. These factors also vary by race and ethnicity, but existing suicide prediction models do not perform equally across all groups. We can improve suicide prevention efforts by developing more sophisticated risk frameworks and creating new machine-learning-based prediction models applicable to diverse older adults.

Adaptation of Meaning-Centered Grief Therapy for Parents Bereaved by Suicide

Parents bereaved by suicide often struggle to finding meaning in their loss and their lives. This study will adapt Meaning-Centered Grief Therapy (MCGT) using expert feedback from 12 bereaved parents and mental health providers to maximize the sensitivity and impact of MCGT for survivors of suicide loss (MCGT-SSL). Next, a small open trial of MCGT-SSL with 10 parents bereaved by suicide will be conducted to determine the preliminary feasibility, acceptability, and efficacy of MCGT-SSL.

Sorting Out Self-harm From Suicide Risk: A Novel Assessment

Young adults are at high risk for suicide and self-injury, but the pathways leading up to self-harm are not well understood. This study will use a card-sort task to determine which factors lead up to self-harm behavior and how close in proximity they occur to self-harm behavior. Understanding pathways to self-harm, as well as evaluating the card-sort task as a clinical tool, will aid in personalizing safety and treatment planning for people with suicide risk.

Suicidal Behavior and Neuroinflammation: A Pilot Study

Inflammation in the brain has been implicated as playing a role in suicidal behavior. The aim of this study is to conduct a pilot positron emission tomography (PET) neuroimaging study of Translocation Protein (TSPO), which is a marker of neuroinflammation in the brain. The study will be conducted in adults with current unipolar major depressive disorder (MDD) who have been hospitalized for a recent suicide attempt. The results of this study will be compared to those of similar patients who have MDD but no life history of a suicide attempt. Research results may indicate that reducing neuroinflammation using therapies that are anti-inflammatory in nature may be effective.

A DBT Intervention to Support Parents of Teens at Risk for Suicide in the Transition From Inpatient to Outpatient Care

The transition from inpatient to outpatient care for youth with self-injurious thoughts and behaviors is a high-risk period for suicide attempts and death by suicide. Parents play a critical role in keeping teens safe at home during this transition but are often lacking in the necessary skills and support to do so effectively. This study will examine the effectiveness of a new parent-support intervention for parents of youth hospitalized for suicidal thoughts and behaviors.

Machine Learning Approaches to Identify and Predict the Presence and Severity of Suicidal Thoughts and Behaviors by Integrating Online Activity and Clinical Information

Suicide is one of the leading causes of death, yet suicide prevention remains difficult. Suicide risk is known to be associated with an individual’s social environment, as well as their affective and cognitive states. Given the continual adoption of online technologies, this research will integrate rich repositories of online and clinical data, via machine learning and natural language analysis, to identify novel predictors of suicidal thoughts and behaviors and to inform treatment and intervention research.

Life After Self-harm in Sri Lanka

Reducing repeat self-harm is a major target for suicide prevention — 16% of people who self-harm will repeat this behaviour within a year. In South Asia the risk of repeat self-harm is much lower (3%), but we don’t know why. Using clinical data from over 5,500 people who have self-harmed, and additional in-depth interviews, this study aims to understand what contributes to this lower rate in Sri Lanka. This will help better manage and prevent future suicidal behaviour globally.

Encouraging Firearm Access Disclosure: Suicide Prevention in Health Care

Firearms are the most common means of suicide death in the U.S. Health care providers have valuable opportunities to intervene with people at risk of firearm suicide, because many people have contact with a health care provider in the months leading up to a suicide attempt. This project will draw on experiences by those providing and receiving health care in order to improve routine questions about firearm access during health care encounters to support suicide prevention.

The Impact of AMPA Receptor Blockade on Ketamine’s Anti-suicidal Effects

Initial evidence indicates that ketamine, which is an effective, rapid antidepressant, reduces suicidal thoughts. This research probes whether this effect depends on stimulating a particular brain receptor called the AMPA receptor (AMPAR). It tests a key hypothesis regarding the mechanism behind ketamine treatment for suicidal ideation and depression. It may help produce a new generation of medications that could rapidly reduce suicidal thoughts and behaviors through drugs that enhance AMPAR function, potentially saving many lives.

Evaluating the Impact of Teen-to-teen Crisis Lines

Crisis lines are one of the oldest suicide prevention approaches in the U.S. and are viewed as a national “safety net” during a mental health crisis. Teen-to-teen (t2t) crisis lines are a special type of crisis service where youth volunteers help their peers. This project is the first to examine the impact of t2t crisis line work for youth volunteers in collaboration with two of the largest t2t lines in the U.S.: Teen Line and Youth Line.

Pilot Study of a Modified Safety Planning Intervention for Elementary School-aged Children

Suicide rates among children have been rising, emphasizing the need for evidence-based suicide prevention practices appropriate for children. The present study will finalize a treatment protocol for a child version of the Safety Planning Intervention (C-SPI). This will be achieved through an in-depth exploration of suicide crises among children aged 6-12, an evaluation of the intervention’s feasibility and acceptability among children and their caretakers, and an assessment of its effectiveness in reducing suicide risk.

A Mobile Intervention to Reduce Suicidality During the Partial Hospital to Outpatient Transition

Partial hospital programs can help to reduce suicidal thoughts and behaviors, but many people may need additional support after leaving these programs. My Values Program is a mobile app intervention that will be developed and tested to provide personalized, skills-based guidance through identifying values and daily activities to increase meaning and purpose in life in the months after partial hospital treatment. Studied outcomes will include reduced suicidal thoughts and behaviors, reduced depression, and improved quality of life.

Feasibility of Inhaled Nitrous Oxide Versus Intravenous Ketamine in TRD with Suicidal Ideation: A Pilot RCT

The proposed study is a randomized trial to compare a course of repeated nitrous oxide (N2O) inhalations to a course of repeated intravenous ketamine infusions for treatment- resistant depression with suicidal ideation. This will be an important step to identify the characteristics distinguishing the two treatments with some potential shared mechanism of action for patients at imminent risk of suicide. This study will provide feasibility, tolerability, and preliminary efficacy estimates to aid the design of more definitive studies.

Developing a Medication Safety Planning Intervention for Health Care Settings to Prevent Intentional Poisoning

This project will develop and test a brief “medication safety plan” that is easily completed in collaboration with any type of health care provider (e.g., primary care nurse, pharmacist, or mental health clinician) to reduce the risk of intentional poisoning. The medication safety plan will involve increasing awareness of warning signs, so patients know when to enact the plan, followed by identification of specific actions to decrease access to medications.

In Vivo Investigation of the Relationship Between Kappa Opioid Receptor and Suicidal Behavior in PTSD

The relationship between the kappa opioid receptor (KOR), post-traumatic stress disorder (PTSD) symptoms, and suicidal behavior will be studied using positron emission tomography (PET) brain imaging. Other factors such as pain tolerance, impulsivity, and neuropsychological behavior will be evaluated. Findings have the potential to inform development of KOR-targeted medications to reduce suicide risk in PTSD.

Development and Preliminary Testing of a “Papageno” Story Interview Intervention

Filmed interviews of individuals who came close to suicide, yet did not make an attempt will be created. Such narratives are often described as having a “Papageno” or suicide protective effect. Videos which have high levels of acceptability and stakeholder identification with the interviewee will be put forth for further testing among young adults (ages 18-24) with past-month history of suicidal ideation to determine potential suicide protective effects of the videos.

Modulation of Brain Plasticity in the Development of Suicidal Behaviors

Early developmental periods have profound effects on the organization and function of our brains, and adversity during childhood is a significant risk factor for suicide later in life. Perineural nets (PNNs) are malleable structures that impact the developing brain by stabilizing connections between cells. Changes to PNNs have been associated with suicidal behaviors, so identifying the source of PNN components and their susceptibility to childhood adversity can help us understand this relationship.

Predicting Post-discharge Suicidal Behavior in Bipolar Disorders Using Passive Sensing and Pattern Recognition

Up to 60% of bipolar disorder patients attempt suicide at least once in their lifetime. As a result, several interventions for suicide prevention have been developed. This study aims to analyze high-dimensional, multi-modal objective (sleep, activity), subjective (mood, anxiety, energy, sleep), and physiological data (heart rate variability) using wearable sensors and mathematical modeling to extract and interpret individual patterns suggestive of future suicidal behavior. Developing the capacity to detect and predict relapses and suicidal behaviors may improve prevention.

Racial Discrimination, Emotion Reactivity and Dysregulation, and Suicide Risk in a Clinical Sample of Black and Latinx Adolescents

In recent years, suicide and suicidal behaviors have disproportionately increased among ethnoracially underrepresented youth populations in the U.S. To address the racial and ethnic disparity in youth suicidal behaviors, this study will use behavioral tasks and inflammation-related biomarkers to explore potential pathways through which experiences of racism may increase suicide-related risk among Black and Latinx adolescents from an under-resourced community. Findings from this study will help improve the cultural responsiveness of suicide prevention strategies.

Real-time Study of Psychotherapy, Suicide Risk, and Resilience in Transgender and Non-binary Adults

Few studies have examined protective factors that reduce the risk of suicide among transgender and non-binary (TNB) people, such as community connectedness, identity pride, and psychotherapy. This study will use ecological momentary assessment to gather information on the experiences of TNB adults to understand what factors decrease risk of suicide over short periods of time in daily life. Results will inform development of affirming suicide prevention strategies for TNB people.

Characterizing the Role of tRNA Expression and Methylation in Proteomics Shifts of the Suicide Brain

Transfer (t)RNAs are clover-leaf shaped molecules that are crucial in translating the genetic code into functional proteins, and recent work suggests that dynamic chemical modifications to tRNAs may alter psychiatric outcomes. By identifying changes to these regulatory molecules in the brains of people who died by suicide and those by other causes, the goal is to make strides in clarifying a novel biological marker and later consequences for psychiatric outcomes, potentially leading to predictors of suicidal behavior or better treatment options.

Estimating the Population Prevalence and Risk of Suicide for the LGBTQ+ Population in the United States

While a higher rate of suicidal ideation and attempts for LGBTQ+ people has been well documented, the rate of death by suicide remains unknown. Given the known differences between ideation, attempts, and deaths, there is a pressing need to better understand the risk and protective factors for death by suicide among the LGBTQ+ population. This study integrates suicide cases into the general population of living individuals through pioneering data harmonization to provide initial estimates of risk and protective factors associated with suicide for LGBTQ+ individuals.

Self-harm Presentations That Encounter the Emergency Department in Youth (the SPEEDY Study): Rapid Risk Stratification to Inform Clinical Management

Adolescents who present to the emergency department with self-harm are at high risk of suicide, but it is not known if the method of self-harm impacts risk of future suicide. This study will compare the risk of suicide among youth after they have a first emergency visit for self-harm, according to the method of self-harm. The findings will inform clinical decision-making in emergency rooms and guide the allocation of services to youth most at risk.

The Interplay Between Risk and Protective Factors and Suicidal Thoughts: Examining Momentary Fluctuations to Improve Suicide Risk Detection

This project seeks to improve prediction of momentary suicidal ideation by using multiple daily surveys to capture risk and protective factors that precede suicidal thoughts. Young adults ages 18–25 years old who recently visited the emergency department due to suicide risk will be recruited for this study. Nonlinear dynamic statistical modeling using the cusp catastrophe model will be used to identify the compounding effect of multiple factors measured over time to improve suicide risk prediction.

Suicide-associated Loci Regulating Molecular Traits and Their Interaction With Environmental Factors

Several genetic variants have been associated with higher suicide risk. However, we do not know the exact mechanisms by which these genetic variants might increase suicide risk. This study aims to characterize the function of genetic variants associated with suicidal behavior and evaluate their interaction with other factors associated with suicide, i.e., environmental factors. The results will improve the understanding of the mechanisms involved in the genetic predisposition to suicidal behavior.

A Multi-modal Integration of Neurobiological and Ecological Measures of Emotion Regulation in Suicidal Individuals

Difficulty regulating negative emotions can cause vulnerability that contributes to suicidal behavior. This multi-method study combines neural, physiological, and real-time monitoring of emotion, stress, and coping to characterize impairments in emotion regulation (ER) associated with suicide risk. A machine-learning-based approach will be applied to derive a neural signature for ER-related brain activity and used to predict physiological reactivity to stress and spontaneous use of coping strategies in real-world settings. Findings may ultimately inform clinical interventions for suicide risk.

Inflammatory and Insulinemic Potential of Diet and Risk of Suicide Among Midlife and Older U.S. Adults

Inflammation and impaired glucose metabolism are key biological pathways linked to an increased risk of suicide. Limited evidence exists to inform how diet, a modifiable lifestyle factor, reduces suicide mortality by modifying key pathways relevant to suicide risk. This study will relate inflammatory and insulinemic diet scores with subsequent risk of suicide among approximately 2,000,000 midlife and older adults. Secondarily, this study will examine the mediator role of depression in inflammatory and insulinemic diet-suicide risk associations.

Interpersonal Physiological Synchrony in Prediction of Patient Suicidality in Clinician-patient Dyads

Interpersonal physiological synchrony refers to the degree to which physiological processes (e.g., heart rate) in the human body “synchronize” among people and allow people to “feel” another’s emotions. Such degree of synchrony in patient-clinician dyads may capture the emotional and interpersonal difficulties experienced by suicidal patients. Interpersonal physiological synchrony in clinician-patient dyads will be investigated as a novel predictor of patient suicidal thoughts and behaviors, as well as the feasibility and acceptability of its use.

A Mixed-method Study of Fluctuations in Suicide Risk and Resilience in Native American Young Adults

We know very little about how suicidal ideation and behavior change over time for Native American young people, who are at heightened risk. This study will use quantitative and qualitative approaches to examine whether certain traits, like impulsivity, and week-by-week experiences, like life stress, impact Native American young people’s thoughts of suicide over time. Additionally, the hope is to discover ways in which Native American young people garner protective factors, like social or cultural connectedness, to diminish suicide risk.

Investigation of the Neural Correlates of the Acquired Capability for Suicide in Child and Adult Brains

Most people who think about suicide do not make an attempt. It is unclear whether there are differences in the brain between these individuals. Identifying any differences in the brain may increase our understanding of the development of suicidal behaviors. Using brain scans from children and young adolescents, this study will examine how the brain changes in individuals who go on to make a suicide attempt as compared with those who do not.