Research Roundup April 2024: Recently Published Findings From AFSP-Funded Studies

The Research Roundup is a regular update of recently published findings in suicide prevention research. AFSP-funded studies included in this roundup examined how…

• A media engagement initiative in Canada affected suicide reporting quality and suicide rates
• Ethnic identity in Black adolescents may play a role in suicidal thoughts and behaviors
• Different treatments for opioid use disorder impact suicide mortality rates, and
• Using real-time smartphone monitoring may help predict suicide risk

Researcher: Mark Sinyor, MD, FRCPC
Institution: University of Toronto/Sunnybrook Research Institute (Canada)
Grant Type: 2020 Standard Research Grant – $99,993
Grant Title: Impact of a National Media Engagement Strategy in Canada on Suicide-related Media Reporting, Social Media Content and Suicide Rates

Using responsible media reporting strategies when sharing suicide-related stories (e.g., including how people in crisis can receive help and avoiding reporting details of suicide methods) is an accepted suicide prevention method. In 2015, suicide prevention experts in Canada launched a media engagement initiative aimed at improving suicide-related reporting from major publications in the Greater Toronto Area (GTA) media market. The initiative included dissemination of media guidelines using a variety of methods. Since prior research has demonstrated a link between media reporting and suicide deaths, there has been a question as to whether this initiative impacted media reporting quality and suicide deaths in the GTA following its implementation.

To explore this, Dr. Mark Sinyor and his team analyzed changes in 900 suicide-related stories published before and after the initiative in major GTA publications. They found a widespread improvement in reporting quality, with significant reductions in harmful practices and increases in protective content. However, there was only a slight decrease in suicide deaths during the same period. The study also highlighted a need for more articles featuring hopeful stories, suggesting a potential focus for future initiatives aiming to have a greater impact on reducing suicide rates.

Citation:  Sinyor, M., Ekstein, D., Prabaharan, N., Fiksenbaum, L., Vandermeer, et. al.,(2024) Changes in Media Reporting Quality and Suicides Following National Media Engagement on Responsible Reporting of Suicide in Canada. Canadian journal of psychiatry. Revue canadienne de psychiatrie, Advance online publication. https://doi.org/10.1177/07067437231223334

Researcher: Leslie Adams, PhD, MPH
Institution: Johns Hopkins Bloomberg School of Public Health
Grant Type: 2020 Young Investigator Grant – $90,000
Grant Title: Real-time assessments of suicidality among Black men: a mixed methods approach

Understanding the role ethnic group identity (i.e., the meaning and significance individuals attribute to their racialized social status) plays in relation to suicidal thoughts and behaviors (STBs) is an understudied area. In populations like Black adolescents, who have seen a recent increase in suicide rates and are underrepresented in research, ethnic identity may be relevant to both understanding risk factors and designing prevention strategies. Key dimensions of ethnic identity that could be significant for Black adolescents include centrality (how much they identify with their Black ethnic group), private regard (their feelings about being Black), and public regard (how positively they perceive others view Black people).

Dr. Leslie Adams examined data from 1,170 African American and Caribbean Black adolescents and identified three patterns of ethnic identity based on these dimensions: Undifferentiated (a cohesive sense of ethnic identity across all dimensions), Low Ethnic Identification (below-average public regard and significantly low centrality and private regard), and Alienated (significantly low scores on all three dimensions). The Undifferentiated group constituted 84% of the sample. In relation to STBs, 8% of the total sample reported suicidal thoughts and behaviors, with 75% of those with ideation and 71% of attempters in the Undifferentiated group. Further research is needed to fully grasp the relationship between ethnic identity and STBs.

Citation:  Bernard, D. L., Adams, L. B., Lateef, H. A., Azasu, E., & Joe, S., (2023) Investigating the Role of Suicidality and Ethnic Identity among Black Adolescents: A Latent Profile Analysis. Archives of suicide research : official journal of the International Academy for Suicide Research, 27(4), 1261–1277. https://doi.org/10.1080/13811118.2022.2114868

Researcher: Bradley Watts, MD, MPH
Institution: Dartmouth College
Grant Type: 2019 Standard Research Grant – $99,468
Grant Title: Medication Assisted Treatment for Opioid Dependence to Reduce the Risk of Death by Suicide

Treating opioid use disorder (OUD) with opioid agonist treatments that work to prevent withdrawal and reduce cravings, such as methadone and buprenorphine, has been shown to be an effective approach in reducing mortality from all causes, overdose mortality, and suicide mortality. However, due to differences in requirements for getting treatment –– methadone requires daily visits to a dispensing facility while buprenorphine can be received with weekly or monthly prescriptions –– there has been a push to compare these two treatment approaches.

To look at potential differences between these two approaches, Dr. Bradley Watts collected data from 61,997 US Department of Veteran Affairs patients with a diagnosis of OUD who received opioid agonist treatment between 2010 and 2019. After analyzing the data, Dr. Watts found significantly lower all-cause mortality and suicide mortality rates for patients who received buprenorphine treatment compared to methadone. These results support the less restrictive prescribing practices of buprenorphine treatment for OUD.

Citation: Gottlieb, D. J., Shiner, B., Hoyt, J. E., Riblet, N. B., Peltzman, T., Teja, N., & Watts, B. V. (2023). A comparison of mortality rates for buprenorphine versus methadone treatments for opioid use disorder. Acta psychiatrica Scandinavica, 147(1), 6–15. https://doi.org/10.1111/acps.13477

Researcher: Enrique Baca-Garcia, MD, PhD
Institution: Fundación Jimenez Diaz (Spain)  
Grant Type: 2017 Linked Standard Research Grant – $299,394
Grant Title:

Advancements in technology offer the field of suicide prevention many promising opportunities when it comes to predicting when risk will occur and intervening when it does. One way these opportunities are manifesting is with real-time smartphone monitoring. By collecting data from willing participants, researchers are given the chance to construct predictive models based on patterns in behavior and changes in these patterns over time. These changes are considered critical periods, and their relationship with suicide-risk events has been in need of further study.  

Aside from studying sleep and appetite, Dr. Enrique Baca-Garcia and his colleagues recruited 225 patients with a history of suicidal thoughts and behaviors and passively tracked data from their smartphones (e.g., distance walked, steps taken, time spent at home, and app usage) for six months to test the predictive capacities of real-time smartphone monitoring. Using an algorithm that constructed daily activity profiles for participants according to the data, Dr. Baca-Garcia was able to detect changes in behavior patterns of the participants. By the end of the study period, 18 (8%) of participants had attempted suicide and 14 (6.2%) presented to the emergency department for psychiatric care. After assessing the data, Dr. Baca-Garcia found that the behavioral changes detected by the algorithm (such as those mentioned above, like steps taken and app usage) predicted increased risk for suicidal ideation and behavior in a time frame of one week, indicating strong accuracy. Early detection of risk is a critical feature of intervening to save lives.

Citation: Barrigon, M. L., Romero-Medrano, L., Moreno-Muñoz, P., Porras-Segovia, A., Lopez-Castroman, J., Courtet, P., Artés-Rodríguez, A., & Baca-Garcia, E. (2023). One-Week Suicide Risk Prediction Using Real-Time Smartphone Monitoring: Prospective Cohort Study. Journal of medical Internet research, 25, e43719. https://doi.org/10.2196/43719   

Learn more about the AFSP research grants featured in this monthly roundup, as well as others, here.