Research Roundup October 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…

• Parents of at-risk youth preferred certain firearm and medication locking devices to others
• An inability to sustain cognitive effort may relate to suicide attempts
• Different coping strategies work for different people dealing with suicidal urges, and
• A new approach to integrating genetic and brain imaging research can deepen our understanding of suicide biology

Researcher: Matthew Miller, ScD, MPH, Carol Runyan, PhD, Catherine Barber, MPA
Institution: Northeastern University, Harvard University, University of Colorado
Grant Type: 2016 Focus Grant - $1,478,266
Grant Title: An ED-based Randomized Clinical Trial of Lethal Means Counseling for Parents of At-Risk Youth

Suicide is the second leading cause of death among youth ages 10-17, and the methods youth use to attempt suicide typically come from home. Therefore, restricting access to highly lethal methods within the home (e.g., firearms and dangerous medications) provides an immense opportunity for parents and caregivers to protect their children. A central component of lethal means restriction is locking firearms and medication, but a need has been identified for more research to evaluate the effectiveness of the storage devices themselves in order to guide the selection from both safety and consumer preference perspectives.

As part of a large, AFSP-funded, clinical intervention trial (the SAFETY Study) to test the effectiveness of lethal means counseling for parents of youth at risk for suicide, Drs. Matthew Miller, Carol Runyan, and Catherine Barber evaluated feedback on the use and acceptability of different locking devices received from behavioral health clinicians while their children were treated in the emergency department for suicide-related problems. They found a large increase in the use of both medication and firearm locking devices compared to use at the beginning of the study, and that parents preferred some devices (firearm lockboxes vs. cable locks) to others. These results suggest the need for more research on what parents prefer to ensure these vital devices are actually used.

Citation: Barber, C., Azrael, D., Berrigan, J., Betz, M. E., Brandspigel, S., Runyan, C., Salhi, C., Vriniotis, M., & Miller, M. (2022). Selection and Use of Firearm and Medication Locking Devices in a Lethal Means Counseling Intervention. Crisis, 0(0), null, http://dx.doi.org/10.1027/0227-5910/a000855   

Researcher: James Bjork, PhD
Institution: Virginia Commonwealth University
Grant Type: 2017 Pilot Research Grant – $24, 916
Grant Title: Deployment Experiences: Relationships with Cognition in Veterans

Understanding what differentiates people who attempt suicide from those who do not is critical for developing better methods of detection and treatment. Research has shown the brain function in people who have attempted suicide tends to process information quickly but without reflection, as if things are “black or white,” and with less flexibility. More recent research has suggested there may be a common denominator underlying these cognitive processes, facilitating the mental states that could lead to an attempt – an inability to sustain cognitive effort, despite individual’s awareness of potential rewards to be gained.

To explore this cognitive marker further, Dr. James Bjork and his team recruited 48 Veterans receiving care for mood disorders and divided the sample into two groups – one group with a history of at least one suicide attempt, and one group without any suicide attempts – to compare difficulties in sustaining cognitive effort. Dr. Bjork administered cognitive tests that let the Veterans decide between tasks that varied in complexity and monetary reward. Results showed that Veterans who had previously attempted suicide opted out of earning higher monetary reward if earning it required slightly increased cognitive demand than Veterans with no history of suicide attempts. These results could inform future suicide risk detection, and importantly, the development of cognitive interventions.

Citation: Bjork, J. M., Sawyers, C. K., Straub, L. K., Garavito, D. M. N., & Westbrook, A. (2022). Cognitive effort avoidance in veterans with suicide attempt histories. Acta Psychologica, 231, 103788, http://dx.doi.org/10.1016/j.actpsy.2022.103788

Researcher: Ewa Czyz, PhD
Institution: University of Michigan
Grant Type: 2015 Postdoctoral Fellowship – $104,000
Grant Title: Safety Planning with Motivational Interviewing for Healthy Coping (MI-SafeCope)

Most suicide research treats the pathway to suicide as if it’s the same for everyone. However, people respond in their own ways to suicidal urges by using different coping strategies. These strategies can be both internal (e.g., trying to relax or comfort oneself, distracting oneself, thinking about reasons for living) and external (e.g., talking to a family member, friend, or mental health professional, contacting a crisis line), and the selection of a strategy can vary greatly depending on the intensity of the suicidal urge for each person.

To illustrate this, Dr. Ewa Czyz tracked the daily urges and coping behaviors of three adolescents with frequent suicidal thoughts and behaviors after discharge from psychiatric care following a suicide attempt. Dr. Czyz found that the relationship between the intensity of suicidal urges and use of coping strategies varied significantly within and across the three individuals. These results show that a better understanding is needed of each person’s strategies for coping when they have suicidal urges. Tailored treatment can aim to maximize the effectiveness of coping strategies before reaching the point of a suicidal crisis.

Citation: Kuehn, K. S., Foster, K. T., Czyz, E. K., & King, C. A. (2022). Identifying person-specific coping responses to suicidal urges: A case series analysis and illustration of the idiographic method. Suicide and Life-Threatening Behavior, 52(3), 490-499, http://dx.doi.org/10.1111/sltb.12841

Researcher: Ramiro Salas, PhD
Institution: Baylor College of Medicine  
Grant Type: 2015 Standard Research Grant - $90,000
Grant Title: The Role of the Reward System in Suicidal Ideation and Behavior

Brain imaging and genetics are two separate areas in the field of biological suicide prevention research that have accumulated valuable information in the pursuit of understanding what leads to suicide, and what we can do to prevent it. While acquiring more information is important, more integration between the two fields is needed to better understand the underlying biology relative to suicide prevention.

With this in mind, Dr. Ramiro Salas and his team developed ProcessGeneLists (PGL), a novel approach that integrates genetic and brain imaging data. By applying PGL to previously published genetics studies that compared individuals who had attempted suicide to individuals who had not attempted suicide, Dr. Salas identified eight regions of the brain that may be different in suicide attempters. Then, brain imaging was conducted on a separate group of psychiatric inpatients (one group with a history of at least one suicide attempt, and the other with no attempts) to see if there were differences in the PGL-identified regions. Based on the genes mapped onto the brain by PGL, Dr. Salas found similar differences in brain functioning between the two groups.

Citation: Poblete, G., Nguyen, T., Gosnell, S., Sofela, O., Patriquin, M., Mathew, S. J., Swann, A., Nielsen, D. A., Kosten, T. R., & Salas, R. (2022). A Novel Approach to Link Genetics and Human MRI Identifies AKAP7-Dependent Subicular/Prefrontal Functional Connectivity as Altered in Suicidality. Chronic Stress, 6, 24705470221083700, http://dx.doi.org/10.1177/24705470221083700

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