Research Roundup November 2023: 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…

• Certain personal factors in adolescents aligned with distinct patterns in suicidal thoughts and behaviors
• Different subgroups of firearm owners vary in their risk for suicidal thoughts and behaviors
• Specific stressful life events are associated with suicidal thoughts and behaviors, and
• The field of suicide research is taking steps towards understanding the genetics of suicide

Researcher: Arielle Sheftall, PhD
Institution: The Abigail Wexner Research Institute at Nationwide Children's Hospital
Grant Type: 2020 Young Investigator Grant — $90,000
Grant Title: Suicidal Behavior in Elementary School-Aged Youth: Assessment of Familial Factors and Neurocognitive Functioning

Suicidal thoughts, plans, and attempts manifest in several distinct ways within adolescents. Some adolescents may only have suicidal thoughts, while never making a plan or attempt. Others may have suicidal thoughts and a plan, but never make an attempt. Suicide attempts may occur in some adolescents who had suicidal thoughts and a plan, and others who had neither. It’s important to research these distinct patterns to understand more about the factors that could be associated with each. Knowledge about these factors could help clinicians while screening adolescents for risk of suicidal behaviors and provide cues for intervention.

In her research, Dr. Arielle Sheftall examined the demographic, psychological, social, and substance use factors associated with past-year suicidal thoughts, plans, and attempts from 7,491 high school-aged adolescents. Dr. Sheftall found that 24% of the adolescents had suicidal thoughts only in the past year, 38% had suicidal thoughts and a plan and did not attempt suicide, 35% attempted suicide after having thoughts and a plan, and 3% made a suicide attempt with no previous thoughts or plans. She also found that all substance use and psychosocial factors (e.g., being bullied at school or online, feeling sad or hopeless, and having a history of sexual violence victimization) were associated more with adolescents who attempted suicide. The groups that were most likely to have no suicidal thoughts or plans before an attempt were male or Black. Since the goal of this study was to identify patterns, the next step will be to understand the differences between them to inform suicide prevention screening.

Citation: Romanelli, M., Sheftall, A. H., Irsheid, S. B., Lindsey, M. A., & Grogan, T. M. (2022). Factors Associated with Distinct Patterns of Suicidal Thoughts, Suicide Plans, and Suicide Attempts Among US Adolescents. Prevention Science, 23(1), 73-84, http://dx.doi.org/10.1007/s11121-021-01295-8

Researcher: Craig Ross, PhD, Alisa Lincoln, PhD, MPH
Institution: Northeastern University, Boston University
Grant Type: 2018 Linked Standard Research Grant — $299,986
Grant Title: Developing Firearm Suicide Prevention Programs Tailored to Gun Owner Population Subgroups

Firearm owners are a large, diverse population with many subgroups that require unique considerations when devising suicide prevention efforts. At the time of this study, it was estimated that 22% of Americans owned at least one firearm, and one in three Americans lived in a household with a firearm. Lethal-means counseling can be an effective suicide prevention resource for firearm owners, but it has been found to be underutilized. There is a need for lethal means counseling to be adapted to different audiences to reach the many subgroups of firearm owners.

To learn more about risk in firearm owners and potential subgroups within this population, Drs. Alisa Lincoln and Craig Ross conducted a nationally representative survey of 2,646 firearm owners to assess  individuals’ experience with suicidal ideation and behavior, presence of factors that contribute to suicide (e.g., mental health conditions, family history, head injury), and demographic characteristics. They found that almost one in 10 firearm owners were at increased risk for suicide with 25% reporting suicide ideation, 6.6% reporting suicide planning, and 1.8% reporting a previous suicide attempt. After analyzing demographic characteristics, Drs. Lincoln and Ross also identified three unique subgroups of firearm owners with higher-than-average suicide risk: affluent firearm owners with a history of adverse experiences and mental health challenges, male veterans with high levels of alcohol consumption, and non-heterosexual women who have experienced trauma. These findings provide valuable information for designing interventions tailored more specifically to each subgroup of firearm owners identified to be at risk for suicide.

Citation: Ross, C. S., Gradus, J. L., Siegel, M. B., Alcorn, T., Garverich, S., & Lincoln, A. (2022). Distinct groups of firearm owners with differential risk for suicide in the United States: A latent class analysis. Preventive Medicine, 107185, http://dx.doi.org/10.1016/j.ypmed.2022.107185  

Researcher: Igor Galynker, MD
Institution: Icahn School of Medicine at Mount Sinai
Grant Type: 2015 Focus Grant — $1,298,476
Grant Title: Modular Assessment of Risk for Imminent Suicide: A Novel Tool for Suicide Prediction

There has long been an association between stressful life events (SLEs) and suicidal thoughts and behaviors. However, many of the studies that established this association have contained considerable gaps, rarely looking at psychiatric inpatients and lacking specificity in terms of what types of SLEs were connected to suicidal thoughts and behaviors. More research has been needed on SLEs in order to help direct clinicians’ attention when certain stressful live events occur to individuals they are treating.

To address this, Dr. Igor Galynker and his team assessed 1,058 psychiatric patients (both inpatient and outpatient) for 22 separate stressful live events and suicidal thoughts and behaviors in the past three months. Dr. Galynker found that SLEs were common, with almost 65% of individuals reporting them. He also found an association between three specific SLEs and both recent and prospective suicidal thoughts and behaviors: interpersonal rejection and loss, homelessness, and academic failure. This is a signal to clinicians, family, and friends to check in if someone they are treating or know is experiencing stressful events.

Citation: Cohen, L. J., Hernandez, M., Mokhtar, R., Richards, J., Bloch-Elkouby, S., Rogers, M. L., & Galynker, I. (2023). Stressful Life Events and Near-term Suicidal Risk in a Clinical Population. The Psychiatric quarterly, 94(3), 467–482. https://doi.org/10.1007/s11126-023-10038-7

Researcher: Gabriel Fries, PhD
Institution: University of Texas, Houston  
Grant Type: 2021 Young Investigator Grant — $90,000
Grant Title: The Neuronal Transcriptome of Suicide in Bipolar Disorder

The field of biological suicide research has produced a large basis of knowledge in genetics and epigenetics, which is the way genes function in our lives. We now know that suicidal behavior is heritable, or transmissible from parent to child, which means that specific genetic components in DNA may be able to indicate risk for suicidal thoughts and behaviors. Identifying these components could offer valuable markers that would help detect whether certain individuals are at risk for suicidal behavior. However, there has been a lack of attention to determining common findings between studies, potentially leaving much to be gained from revisiting the research to reappraise what’s been found.

To assess the status of the genetic understanding of suicidal behavior in the field, Dr. Gabriel Fries and his team conducted a systematic review by pulling together 577 genetic and epigenetic studies related to suicide. The results of their search suggest that a significant amount of progress has been made in mapping out the basic genetic and biological patterns associated with suicidal behavior, but many of the initial findings need to be validated by further research. Dr. Fries’s review also identified a number of methodological limitations, specifically that many studies use different measures when collecting data. He makes the case for the use of more standardized measurement and methods in order to build a cohesive biological framework of suicidal behavior.

Citation: Mirza, S., Docherty, A. R., Bakian, A., Coon, H., Soares, J. C., Walss‐Bass, C., & Fries, G. R. (2022). Genetics and epigenetics of self‐injurious thoughts and behaviors: Systematic review of the suicide literature and methodological considerations. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 189(7–8), 221–246. https://doi.org/10.1002/ajmg.b.32917

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