Research Roundup June 2025: 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…

• Theories about suicidal thoughts and behaviors apply to Black men and racism
• Individuals with first-episode psychosis experienced suicidal ideation
• Moment-to-moment research methods can be used ethically to study suicide, and
• We are deepening our understanding of biological research through genetic studies

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

The Interpersonal-Psychological Theory of Suicide (IPTS) is one of the most widely used frameworks for understanding why people consider or attempt suicide. It proposes that suicidal thoughts emerge when people feel like they don’t belong and believe they are a burden to others — and that suicide becomes more likely when they’ve also lost their fear of death. Most research using this theory has focused on White populations, raising questions about how well it applies to other ethnic and racial groups. For Black men in America, racism — whether structural, interpersonal, or internalized — may deeply shape these experiences of isolation, burdensomeness, and despair. Adapting suicide theories to better reflect the lived realities of marginalized groups is essential for equitable and effective suicide prevention efforts.

With her AFSP-funded grant, Dr. Leslie Adams explored how racism intersects with the Interpersonal-Psychological Theory of Suicide (IPTS) in the lives of 15 Black men with histories of suicidal thoughts and behaviors. Through in-depth interviews, participants described experiences of racism that contributed to feelings of social isolation (thwarted belongingness), emotional concealment (perceived burdensomeness), and emotional numbness (suicide capability). Thwarted belongingness emerged as the most prominent construct of the theory, followed by hopelessness, and suicide capability. Racism was experienced as a constant presence — shaping self-perception, safety, and mental health across personal, professional, and community settings. The findings highlight the need to expand suicide theories like IPTS to account for sociocultural and structural realities affecting marginalized populations.

Citation: Adams, L. B., DeVinney, A., Aljuboori, D., Brooks Stephens, J., Watts, T., Cook, B. L., Joe, S., Wilcox, H. C., & Thorpe, R. J., Jr (2025). Investigating the Role of Racism in Black Men's Suicide: Revisiting the Interpersonal-Psychological Theory of Suicide. Archives of suicide research : official journal of the International Academy for Suicide Research, 1–14. Advance online publication. https://doi.org/10.1080/13811118.2025.2462528        

Researcher: Heather Wastler, PhD
Institution: The Ohio State University
Grant Type: 2021 Young Investigator Grant – $88,800
Grant Title: Real Time Assessment of Emotion Regulation and Suicidal Ideation among Individuals with First-Episode Psychosis

Suicide is a major concern among people experiencing first-episode psychosis (FEP), with risk particularly high in the early years following diagnosis. While psychosis-related symptoms like hallucinations and delusions have long been studied as potential drivers of suicide risk, much less is known about what people with FEP themselves report as reasons for thinking about suicide. Understanding these patient perspectives can help refine existing theories and better tailor clinical interventions. It may also explain why research linking psychotic symptoms to suicide has produced mixed results — suggesting that risk is complex and deeply personal.

In Dr. Heather Wastler’s AFSP-funded study, 46 participants with FEP completed clinical interviews and 28 days of ecological momentary assessment (EMA), reporting in real time why they were thinking about suicide. Most frequently, participants cited emotional reasons — especially the desire to stop bad feelings or to escape distressing thoughts or emotions. Only a small proportion cited psychosis-specific symptoms like hallucinations as direct causes of suicidal thinking. These findings suggest that emotional distress and a sense of entrapment may be more immediate triggers than psychotic symptoms themselves. The authors call for greater attention to emotional regulation, isolation, and anxiety in suicide prevention efforts for people with psychosis, and recommend further research to understand when, how, and for whom psychotic symptoms contribute to suicide risk. Listening to the voices of people with lived experience can help guide better, more compassionate care.

Citation: Wastler, H. M., Manges, M., Thompson, E., & Bornheimer, L. A. (2025). Reasons for Thinking About Suicide Among Individuals With First-Episode Psychosis: An Ecological Momentary Assessment Study. Early intervention in psychiatry, 19(3), e13640. https://doi.org/10.1111/eip.13640      

Researcher: Sarah Victor, PhD
Institution: Texas Tech University
Grant Type: 2022 Early Career Research Grant – $90,000
Grant Title: Real-time Study of Psychotherapy, Suicide Risk, and Resilience in Transgender and Non-binary Adults

Non-suicidal self-injury (NSSI) is a common and serious behavior, linked to later suicidal thoughts and behaviors. Traditional methods of studying NSSI — such as surveys and interviews — often miss the rapid and fluctuating nature of these behaviors. Ecological Momentary Assessment (EMA), which uses real-time data collection through smartphone-based prompts, offers a promising alternative. However, EMA studies introduce new ethical challenges, including how researchers should respond to moments of high risk, protect participant autonomy, and ensure safety without interfering with the behavior being studied. As EMA use grows in mental health research, clearer guidance is needed to navigate these dilemmas responsibly.

Citing her AFSP-funded work, Dr. Sarah Victor reviewed current practices and proposes ethics-based recommendations for conducting EMA research on NSSI. The authors discuss how to design studies that avoid stigmatizing language, safeguard participant well-being, and manage risk appropriately – balancing participant safety with the goal of gathering authentic, real-time data. They emphasize the importance of informed consent, diverse participant inclusion, and clear crisis response protocols tailored to the level of risk. The paper calls for further research to establish empirically grounded best practices and highlights the need for ongoing collaboration with individuals who have lived experience of NSSI to shape future study design and ethics.

Citation: Hoelscher, E. C., Victor, S. E., Kiekens, G., & Ammerman, B. (2025). Ethical considerations for the use of ecological momentary assessment in non-suicidal self-injury research. Ethics & Behavior, 1–18. https://doi.org/10.1080/10508422.2025.2456714    

Researcher: Matthew Girgenti, PhD
Institution: Yale School of Medicine
Grant Type: 2021 Young Investigator Grant – $90,000
Grant Title: Understanding Suicide through Postmortem Targeted Brain Multi-omics

Understanding why some individuals are more vulnerable to suicide than others is a key challenge in prevention efforts — particularly in groups with higher rates like military service members. While research shows that suicidal behavior can run in families, much of the genetic work to date has focused on common genetic variants (genetic differences that are widespread) with small effects. Far less is known about the impact of rare, protein-altering mutations — especially in individuals from diverse backgrounds. Identifying these genetic signals (patterns in our DNA that may contribute to suicide risk) could offer new insights into the biology of suicide and inform future tools for prevention and care.

With the funds from his AFSP grant, Dr. Matthew Girgenti used whole-genome sequencing (a method that analyzes nearly every letter of a person’s DNA) in over 13,000 active-duty U.S. Army soldiers, including nearly 1,000 with a history of suicide attempt. They discovered 19 genes with rare, protein-altering changes that appeared more often in those who had attempted suicide. Several of these genes — such as RGS7BP, CIB2, and ACTR6 — have shown altered expression in brain tissue from individuals who died by suicide. These associations were observed across racial and ethnic groups. The findings deepen our understanding of the biological roots of suicide risk and point to new areas for study.

Citation: Wilkerson, M. D., Hupalo, D., Gray, J. C., Zhang, X., Wang, J., Girgenti, M. J., Alba, C., Sukumar, G., Lott, N. M., Naifeh, J. A., Aliaga, P., Kessler, R. C., Turner, C., Pollard, H. B., Dalgard, C. L., Ursano, R. J., & Stein, M. B. (2024). Uncommon Protein-Coding Variants Associated With Suicide Attempt in a Diverse Sample of U.S. Army Soldiers. Biological psychiatry, 96(1), 15–25. https://doi.org/10.1016/j.biopsych.2023.12.008     

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