Research Roundup June 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…

• Researchers codesigned an online victimization intervention with suicidal LGBTQ youth
• Experiencing bullying victimization in childhood may impact risk for suicide later in life
• The therapeutic bond between client and crisis counselor affects session outcomes, and
• Specific genes, and the expression of them in the brain, may be unique to individuals who die by suicide

Researcher: Candice Biernesser, PhD
Institution: University of Pittsburgh
Grant Type: 2021 Young Investigator Grant – $79,821
Grant Title: Development and Feasibility Testing of a Suicide Prevention Intervention for Sexual and Gender Minority Youth

With the increase in youth having access to online platforms in recent years, online victimization (OV) is a growing issue that has been linked to suicide risk for adolescents. OV can take the form of disparaging remarks, images, or behaviors that cause harm. Experiences of OV have disproportionately impacted LGBTQ youth, who are three times as likely to attempt suicide as non-LGBTQ youth. While social media can provide important benefits for youth through connection and affirming resources, current interventions and services contain gaps in supporting LGBTQ youth who experience OV.

With this in mind, Dr. Candice Biernesser and her team developed Flourish, a digital suicide prevention intervention for LGBTQ youth who have faced online victimization. To codesign Flourish, Dr. Biernesser conducted qualitative interviews with 20 LGBTQ youth with a history of experiencing OV and suicidal thoughts and behaviors along with 11 of their parents, and 10 LGBTQ-focused professionals. After identifying priorities for the service based on feedback, the team developed a partially automated, text message intervention leveraging web-based content to create a safe space for LGBTQ youth to seek support for OV through education, coping skills, and help-seeking resources. The team then conducted prototype testing with a different group of 10 LGBTQ adolescents which yielded excellent usability ratings. The next step for Dr. Biernesser and her team is to test the feasibility and efficacy of Flourish in a larger sample.

Citation: Biernesser, C., Win, E., Escobar-Viera, C., Farzan, R., Rose, M., & Goldstein, T. (2023). Development and codesign of flourish: A digital suicide prevention intervention for LGBTQ+ youth who have experienced online victimization. Internet interventions, 34, 100663. https://doi.org/10.1016/j.invent.2023.100663

Researcher: Marie-Claude Geoffroy, PhD
Institution: McGill University
Grant Type: 2018 Young Investigator Grant – $83,080
Grant Title: Peer Bullying, Epigenetics, and Suicidal Risk: Prospective Associations

Peer and bullying victimization refer to the repeated experience of being the target of aggressive behavior, such as being pushed or hit, called names, made fun of, or being excluded from a group. It is often characterized by an imbalance of power between the perpetrator and the victim. Research has shown that bullying victimization in childhood has been linked with an increased risk for suicidal thoughts and behaviors, but no study has yet explored the possibility of an increased risk of dying by suicide.

To explore this gap, Dr. Marie-Claude Geoffroy and her team conducted a 50-year nationwide cohort study using data from the 1958 British Birth Cohort, which is an ongoing longitudinal study of 17,638 individuals born within one week of each other in March 1958. Dr. Geoffroy conducted analyses on 14,946 individuals whose mothers reported bullying victimization for their children at ages 7 and 11. Of the subgroup, 55 people had died by suicide between the ages of 18-52 years old. Though the effect was small, having been bullied was associated with death by suicide when other factors weren’t considered. It’s unclear if this effect would hold with more information, but the importance of implementing suicide prevention efforts in childhood is supported by these findings.

Citation: Geoffroy, M. C., Arseneault, L., Girard, A., Ouellet-Morin, I., & Power, C. (2023). Association of childhood bullying victimisation with suicide deaths: findings from a 50-year nationwide cohort study. Psychological medicine, 53(9), 4152–4159. https://doi.org/10.1017/S0033291722000836

Researcher: Daniel Cox, PhD
Institution: University of British Columbia
Grant Type: 2017 Young Investigator Grant – $82,986
Grant Title: What Reduces Suicide Ideation in Online Crisis Chats? A Study of Crisis Counselor & Client Processes

When people experience suicidal crises, they often struggle with relationships, which can contribute to difficulties in forming a therapeutic bond with clinicians. Even though research has shown that building a strong relationship between clinician and client is crucial for effective outcomes in therapy, especially for those thinking about suicide, we don’t know much about how relationship struggles show up in therapy sessions. We also don’t know much about how relationship struggles can impact one-time crisis therapy sessions.

With this is mind, Dr. Daniel Cox and his team looked at how the relationship between crisis counselor and client affects the client's desire to die by suicide and examined the outcomes of one-time, 30-minute online crisis therapy sessions. Dr. Cox analyzed 354 sessions with clients who were actively suicidal and using an online crisis service for the first time. The team measured suicidal desire, the strength of the therapeutic relationship throughout the sessions, and the outcomes (e.g., acceptance of referral to external services and acceptance of crisis-center follow-up). The results indicated that a strong relationship between crisis counselor and client helped reduce suicidal desire and led to better outcomes. These results highlight the importance of training therapists on how to build strong relationships with clients who are in acute suicidal crises.

Citation: Cox, D. W., Deptuck, H. M., Fischer, O., & Wojcik, K. D. (2024). The role of the therapeutic bond when working with clients in suicidal crisis. Journal of counseling psychology, 71(2), 115–125. https://doi.org/10.1037/cou0000724

Researcher: Virginia Willour, PhD
Institution: University of Iowa  
Grant Type: 2019 Focus Grant – $1,488,788
Grant Title: An Integrated Approach to Understanding the Biology of Suicidal Behavior

In the field of suicide prevention research, some scientists have focused on finding genetic differences that are specifically active for people who die by suicide. This search is complicated by both the biological and methodological challenges of conducting genetic research. While some genetic markers have been found before, many are still unknown, especially those affecting how genes work in the brain.

Dr. Virginia Willour and her team looked at the genetic data from specific brain areas of people who died by suicide to see how gene activity might relate to suicide risk. They studied data from 986 suicide cases and 415 non-suicide controls, using information collected from several genetic databases. The team found differences in one specific genetic marker (rs926308) that is linked to lower activity of a gene (RFPL3S) important for brain development and arousal. They also identified 20 other genes that could potentially be related to suicide risk. Ten of these genes are also linked to mental health disorders like schizophrenia and autism, which can be associated with suicide. This study provides new insights into the genetic and biological mechanisms that might lead to suicide. Further study of the functions these genes serve is needed.

Citation: Han, S., DiBlasi, E., Monson, E. T., Shabalin, A., Ferris, E., Chen, D., Fraser, A., Yu, Z., Staley, M., Callor, W. B., Christensen, E. D., Crockett, D. K., Li, Q. S., Willour, V., Bakian, A. V., Keeshin, B., Docherty, A. R., Eilbeck, K., & Coon, H. (2023). Whole-genome sequencing analysis of suicide deaths integrating brain-regulatory eQTLs data to identify risk loci and genes. Molecular psychiatry, 28(9), 3909–3919. https://doi.org/10.1038/s41380-023-02282-x

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