Research Roundup September 2025: Recently Published Findings From AFSP-Funded Studies
September 1, 2025 – 6 min read
By AFSP
The Research Roundup is a regular update of recently published findings in suicide prevention research. AFSP-funded studies included in this roundup examined how…
- Existing suicide prevention interventions can be tailored for transgender individuals
- Insecure attachment style and emotion dysregulation may play a part in youth suicidal behavior
- College enrollment may not be a protective factor against suicidal behavior for all students, and
- Alterations in brain structure may play a part in suicidal behavior
Researcher: David Tolin, PhD
Institution: Institute of Living/Hartford Hospital
Grant Type: 2019 Focus Grant — $1,049,024
Grant Title: Inpatient Cognitive-Behavioral Therapy to Reduce Suicide Risk Post-Discharge
Transgender individuals face disproportionately high rates of suicidal thoughts and behavior. The minority stress model offers a framework for understanding how identity-based stressors, such as discrimination, rejection, and internalized stigma, can elevate suicide risk, while protective factors like social support and gender affirmation can foster resilience. However, most suicide prevention treatments were not developed with the unique experiences of transgender people in mind. There is a pressing need to ensure that suicide-focused interventions are not only evidence-based but also affirming, inclusive, and responsive to the needs of gender-diverse individuals.
To address this, Dr. David Tolin used his AFSP grant funds to analyze six inpatient therapy sessions with transgender adults participating in Brief Cognitive Behavioral Therapy for Suicide Prevention (BCBT-I). Dr. Tolin examined how themes of gender minority stress and resilience surfaced during treatment. All participants discussed experiences of social disconnection and connection that were often linked to their gender identity. The participants also shared complex relationships with coping and support. Less frequently discussed, but still present, were themes like gender dysphoria, discrimination, and barriers to gender-affirming care. Clinicians rarely prompted discussions of identity-related strengths or vulnerabilities, but such themes emerged naturally. The findings suggest that established suicide prevention therapies like BCBT-I can incorporate minority stress factors without altering their core structure, highlighting the importance of training clinicians to proactively and sensitively address identity in ways that affirm and support transgender clients.
Citation: Stubbing, J., Everhardt, K., Rice, T. B., Saunders, L. M. I., Tolin, D. F., Rudd, M. D., & Diefenbach, G. J. (2025). Gender minority stress themes and suicide prevention for adult transgender inpatients: A content analysis of brief cognitive-behavioral therapy. Psychology of Sexual Orientation and Gender Diversity. Advance online publication. https://doi.org/10.1037/sgd0000830
Researcher: Shira Barzilay, PhD
Institution: Schneider Children’s Medical Center (Israel)
Grant Type: 2021 Young Investigator Grant — $89,950
Grant Title: Multi-Informant Assessment of the Suicide Crisis Syndrome in Adolescents Presenting to an Emergency Department
It is thought that children’s ability to regulate their emotions is shaped in large part by the relationships they form with caregivers. When those relationships are insecure (i.e., marked by fear, unpredictability, or emotional unavailability) children may struggle to understand and manage their feelings. Two common insecure attachment styles are anxious attachment and avoidant attachment. Children with anxious attachment may become hypervigilant to signs of rejection or abandonment, leading to intense emotional reactions and difficulty soothing themselves. In contrast, children with avoidant attachment may downplay or suppress emotional needs, often appearing distant or overly self-reliant, even when distressed. It is unclear if emotional dysregulation, especially when paired with insecure attachment, may increase a child’s risk of engaging in suicidal behaviors. As suicide rates among children rise, there’s a need to explore how these early relational and emotional patterns contribute to suicide risk.
With her AFSP-funded grant, Dr. Shira Barzilay examined if there was a potential link between emotional dysregulation, insecure attachment styles, and suicidal thoughts and behaviors (STB). Using validated self-report measures with 111 children, ages 7–12, who were admitted to a pediatric emergency department due to recent suicidal ideation or behavior, Dr. Barzilay assessed two forms of insecure attachment (anxious and avoidant), difficulties in emotional regulation, and suicide risk. She found that emotional dysregulation played a role in the relationship between anxious attachment and suicidal behavior, but not suicidal thoughts. No significant pathway emerged between avoidant attachment and either outcome. These findings suggest that children with anxious attachment may be particularly vulnerable to emotional overwhelm that can contribute to suicidal actions. The results also underscore the importance of early interventions that focus on strengthening emotion regulation and healing parent–child relationships as a strategy for reducing suicide risk in young children.
Citation: Cohen-Bausi, O., Shahnovsky, O., Haruvi-Catalan, L., Benaroya-Milshtein, N., Fennig, S., & Barzilay, S. (2025). The Mediating Role of Emotional Dysregulation in the Relationship Between Anxious Attachment and Suicidal Behavior in Children Admitted to an Emergency Department. Child psychiatry and human development, 10.1007/s10578-025-01844-0. Advance online publication. https://doi.org/10.1007/s10578-025-01844-0
Researcher: James Aluri, MD
Institution: Johns Hopkins University
Grant Type: 2025 Early Career Researcher Grant — $137,797
Grant Title: Identifying Mechanisms and Predictors of Suicide Contagion and Exploring Postvention at US Colleges
College enrollment has been viewed as a sign of reduced suicide risk in young adulthood. Yet, that assumption may not hold true for all students. Suicide attempts among college students have been rising, and recent research has shown that students of color report higher rates of suicidal thoughts than their White peers. While the college environment may offer certain supports that buffer against suicide risk, those benefits might not be equitably distributed. In addition, risk for suicide may have developed prior to entering college and lower rates may not be attributable to the college environment. Understanding how college enrollment interacts with race and ethnicity is critical to designing suicide prevention strategies that serve all students effectively.
To explore this further, Dr. James Aluri analyzed data from over 12,000 U.S. young adults ages 18–22 to examine whether the relationship between full-time college enrollment and past-year suicide attempts (PYSA) differed by race and ethnicity. White students had lower odds of having a suicide attempt in the past year when compared with nonenrolled White individuals. For Black/African American and multiracial individuals, college enrollment was associated with a higher prevalence of past-year suicide attempt compared to those who were unenrolled and White students. The results underscore that structural and cultural factors such as discrimination, underrepresentation, or lack of culturally responsive support may contribute to suicidal behavior for Black and multiracial students enrolled in college.
Citation: Witmer, A. M., Deng, Y., Mojtabai, R., Wilcox, H. C., & Aluri, J. (2025). The Association Between College Enrollment and Suicide Attempts by Race and Ethnicity. Prevention science : the official journal of the Society for Prevention Research, 26(1), 25–30. https://doi.org/10.1007/s11121-025-01771-5
Researcher: Hilary Blumberg, MD
Institution: Yale University
Grant Type: 2011 Standard Research Grant — $75,000
Grant Title: The Neural Circuitry of Suicidality in Adolescent Depression
Alterations in brain structure may help explain why some individuals are more vulnerable to suicidal thoughts and behaviors (STBs), but past studies have often been too small or inconsistent to provide clear answers. White matter, which is the tissue that connects different brain regions, has been a focus of research, with some studies suggesting it may function differently in people with a history of suicide attempt. However, it's been difficult to tell whether these brain differences are linked to suicide risk itself or to mental illness more broadly. Larger, better-coordinated studies are needed to identify patterns in white matter that may play a role in STBs, and to determine whether they offer potential targets for prevention or intervention.
As part of the ENIGMA-STB consortium, Dr. Hilary Blumberg analyzed brain imaging data from over 6,000 individuals across 40 international cohorts. Dr. Blumberg compared white matter microstructure in people with and without a psychiatric diagnosis, focusing on those with a history of suicide attempt or recent suicidal ideation. Subtle but significant differences in white matter structure were found in individuals with a history of suicide attempt, even after accounting for psychiatric diagnosis. These effects were most evident in tracts linked to emotional regulation, attention, and cognitive control, including the corona radiata, corpus callosum, and superior longitudinal fasciculus. No significant differences were found for suicidal ideation alone or for severity of ideation. While the effects were small and not clinically predictive on their own, these findings suggest that white matter alterations may be one piece of the complex puzzle of risk for suicidal behavior and highlight the importance of future longitudinal studies to determine their role as potential risk markers.
Citation: van Velzen, L. S., Colic, L., Ceja, Z., Dauvermann, M. R., Villa, L. M., Savage, H. S., Toenders, Y. J., Dehestani, N., Zhu, A. H., Campos, A. I., Salminen, L. E., Agartz, I., Alexander, N., Ayesa-Arriola, R., Ballard, E. D., Banaj, N., Barkhau, C., Başgöze, Z., Bauer, J., Benedetti, F., … Schmaal, L. (2024). Transdiagnostic alterations in white matter microstructure associated with suicidal thoughts and behaviours in the ENIGMA Suicidal Thoughts and Behaviours consortium. medRxiv : the preprint server for health sciences, 2024.11.07.24316876. https://doi.org/10.1101/2024.11.07.24316876
Learn more about the AFSP research grants featured in this monthly roundup, as well as others, here.