Suicide is the third leading cause of death among youth. Although considerable progress has been made in recent decades in identifying risk factors for suicidal behaviors, improvements in clinical intervention programs have been comparatively modest. These modest gains in clinical effectiveness reflect, in part, the fact that, although we know many of the risk factors for suicidal behaviors, we know little about how they confer heightened risk. Indeed, a history of self-injurious behavior (i.e., suicide attempts and non-suicidal self-injury [NSSI]) has been consistently found to be the strongest predictor of future suicide attempts. Yet, studies on the pathways and processes explaining the link between past and future suicidal behaviors have been lacking. Although both life stressors and impulsivity have been widely studied in relation to suicidal behaviors, and feature prominently in several theoretical models of suicidal behaviors, no studies have examined how they interrelate to predict future suicidal behaviors. This New Investigator application will address these critical gaps in current knowledge by integrating and extending findings from the separate lines of research on these risk factors for suicidal behavior. Specifically, it will examine how life stressors, different neurocognitive/neurobehavioral dimensions of impulsivity (encompassing two RDoC constructs, """"""""reward valuation"""""""" and """"""""response selection, inhibition or suppression""""""""), and loss-related experiences, consistent with the RDoC construct of loss, may explain how past suicide attempts increase risk for future recurrences in a multiwave longitudinal study with a sample of 150 adolescent inpatients. Adolescents 14-16 years old will complete a state-of-the-art life stress interview and a multi-method and multi-dimensional assessment of impulsivity at the time of an inpatient psychiatric admission, and at 3-months, 6-months, 12-months, and 18- months post-hospital discharge. The central hypothesis is that adolescents with a history of suicide attempts will (a) experience greater dependent stressors (i.e., those that are influenced by their own behaviors), and (b) this increased rate of dependent stressors, in turn, increases their risk for future suicide attempts. We also hypothesize that behavioral impulsivity will similarly predict future suicide attempts by generating greater dependent stressors. We will also examine whether NSSI predicts dependent stressors, which in turn predicts future suicide attempts. Findings from this study have the potential to advance clinical intervention strategies. The types of stressors found to be most relevant to suicide risk may speak to the promise of different clinical approaches (e.g., behavioral modification in the case of dependent stressors and coping skills for independent stressors). The public health relevance of this application is evident as it addresses Healthy People 2020 Objective MHMD HP 2020- 2: """"""""Reduce suicide attempts by adolescents"""""""". This application is also consistent with NIMH's Strategic Plan, which highlights the need for research on biomarkers and behavioral indicators related to psychopathology, and for research based on dimensions of observable behavior and neurobehavioral methodologies.

Public Health Relevance

of this application is evident as it addresses Healthy People 2020 Objective MHMD HP 2020- 2: Reduce suicide attempts by adolescents. This application is also consistent with NIMH's Strategic Plan, which highlights the need for research on biomarkers and behavioral indicators related to psychopathology, and for research based on dimensions of observable behavior and neurobehavioral methodologies. PUBLIC HEALTH RELEVANCE: The purpose of this application is to examine how stressful life events and impulsivity may explain why past self-injurious behavior (i.e., suicide attempts and non-suicidal self-injury [NSSI]) is so strongly linked with future suicidal risk in adolescents The aims of this application are clinically significant because very little is currently known abou why adolescents who previously attempted suicide are at much greater risk for attempting again in the future, and current suicide prevention strategies are only modestly effective.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH101138-01A1
Application #
8644370
Study Section
Psychosocial Development, Risk and Prevention Study Section (PDRP)
Program Officer
Garriock, Holly A
Project Start
2014-02-01
Project End
2019-01-31
Budget Start
2014-02-01
Budget End
2015-01-31
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Emma Pendleton Bradley Hospital
Department
Type
DUNS #
City
East Providence
State
RI
Country
United States
Zip Code
02915
Liu, Richard T (2017) Characterizing the course of non-suicidal self-injury: A cognitive neuroscience perspective. Neurosci Biobehav Rev 80:159-165
Liu, Richard T (2017) The microbiome as a novel paradigm in studying stress and mental health. Am Psychol 72:655-667
Liu, Richard T; Burke, Taylor A; Abramson, Lyn Y et al. (2017) The Behavioral Approach System (BAS) Model of Vulnerability to Bipolar Disorder: Evidence of a Continuum in BAS Sensitivity across Adolescence. J Abnorm Child Psychol :
Trout, Zoë M; Hernandez, Evelyn M; Kleiman, Evan M et al. (2017) Prospective prediction of first lifetime suicide attempts in a multi-site study of substance users. J Psychiatr Res 84:35-40
Liu, Richard T; Trout, Zoë M; Hernandez, Evelyn M et al. (2017) A behavioral and cognitive neuroscience perspective on impulsivity, suicide, and non-suicidal self-injury: Meta-analysis and recommendations for future research. Neurosci Biobehav Rev 83:440-450
Liu, Richard T (2017) Childhood Adversities and Depression in Adulthood: Current Findings and Future Directions. Clin Psychol (New York) 24:140-153
Liu, R T (2016) Taxometric evidence of a dimensional latent structure for depression in an epidemiological sample of children and adolescents. Psychol Med 46:1265-75
Nestor, Bridget A; Cheek, Shayna M; Liu, Richard T (2016) Ethnic and racial differences in mental health service utilization for suicidal ideation and behavior in a nationally representative sample of adolescents. J Affect Disord 202:197-202
Cheek, Shayna M; Nestor, Bridget A; Liu, Richard T (2016) SUBSTANCE USE AND SUICIDALITY: SPECIFICITY OF SUBSTANCE USE BY INJECTION TO SUICIDE ATTEMPTS IN A NATIONALLY REPRESENTATIVE SAMPLE OF ADULTS WITH MAJOR DEPRESSION. Depress Anxiety 33:541-8
Liu, Richard T; Jones, Richard N; Spirito, Anthony (2015) Is Adolescent Suicidal Ideation Continuous or Categorical? A Taxometric Analysis. J Abnorm Child Psychol 43:1459-66

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