One third to one half of psychiatrically hospitalized youth is readmitted, with highest readmission risk 15-30 days post discharge and more than 80% readmitted within three months. The proposed study involves in vivo characterization of naturalistic phenomena associated with suicide risk after discharge adolescents using ecological methods and devices that allow acoustic capture of an individual's social environment and self-reports of experienced affect. We propose that social context and experienced affect are reciprocally reinforcing and that a reactive style involving close coupling of stressful social context (isolation, conflictual or high affect interactions) with affect reactivity (rapidly changig, intense affect, with slow return to baseline) increases risk for suicidal thoughts and behaviors. We also examine childhood maltreatment and epigenetic markers as predictors of post-discharge reactivity. Two hundred youth hospitalized for suicidal thoughts and behaviors will be followed prospectively using ecological methods and devices for three weeks following psychiatric discharge; suicidal thoughts and behaviors will be reassessed at 6 months. The present study further innovates through the incorporation of affect reactivity biomarkers (in-hospital blood samples for assessment of DNA/DNAm/expression). The proposed study merges multiple fields of study and permits an innovative and thorough characterization of the real-world interplay of affect and social context. Results of this investigation will inform a number of intervention approaches including family therapy, EMA-based adjunctive intervention, and pharmacological approaches.

Public Health Relevance

Adolescents hospitalized for suicidal thoughts and behaviors are at high risk for rehospitalization and suicide attempts during initial weeks following discharge. The present study involves a rich characterization of adolescents' emotions and social interactions in the weeks following psychiatric hospitalization discharge using the combination of self-reporting on mobile devices and audio capture of social environment. The study also examines the ways that early life maltreatment may impact the emotional and social processes experienced by discharged adolescents.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
Project #
Application #
Study Section
Social Psychology, Personality and Interpersonal Processes Study Section (SPIP)
Program Officer
Murphy, Eric Rousseau
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Rhode Island Hospital
United States
Zip Code
Sheerin, Christina M; Lind, Mackenzie J; Bountress, Kaitlin et al. (2017) The Genetics and Epigenetics of PTSD: Overview, Recent Advances, and Future Directions. Curr Opin Psychol 14:5-11
Lind, Mackenzie J; Marraccini, Marisa E; Sheerin, Christina M et al. (2017) Association of Posttraumatic Stress Disorder With rs2267735 in the ADCYAP1R1 Gene: A Meta-Analysis. J Trauma Stress 30:389-398
Barker, David H; Nugent, Nicole R; Delgado, Jeanne R et al. (2017) A genetic marker of risk in HIV-infected individuals with a history of hazardous drinking. AIDS Care 29:1186-1191
Mehl, Matthias R (2017) The Electronically Activated Recorder (EAR): A Method for the Naturalistic Observation of Daily Social Behavior. Curr Dir Psychol Sci 26:184-190
Marraccini, Marisa E; Brier, Zoe M F (2017) School connectedness and suicidal thoughts and behaviors: A systematic meta-analysis. Sch Psychol Q 32:5-21
Marraccini, Marisa E; Weyandt, Lisa L; Rossi, Joseph S et al. (2016) Neurocognitive enhancement or impairment? A systematic meta-analysis of prescription stimulant effects on processing speed, decision-making, planning, and cognitive perseveration. Exp Clin Psychopharmacol 24:269-84
Nugent, Nicole R; Goldberg, Amy; Uddin, Monica (2016) Topical Review: The Emerging Field of Epigenetics: Informing Models of Pediatric Trauma and Physical Health. J Pediatr Psychol 41:55-64