Research Grants
Since 2008, the AFSP Research Grants Committee has recommended 53 new projects for funding. Collectively, these grants represent a commitment of $3.9 million:
DISTINGUISHED INVESTIGATOR GRANTS
Annette Beautrais, Ph.D.
Yale University
Tailoring Technology for Suicide Prevention. $100,000
The goal of this project is to add a cell phone text messaging service as part of the follow-up clinical care for participants seen in the emergency department for suicidal ideation/attempts as an intervention that will improve safety, engagement, self-management and adherence behaviors after discharge from the ED. Daily text messages asking for a mood rating will be sent, then based on the rating returned, messages will be sent regarding safety planning, symptom management or wellness promotion. The primary hypothesis is that the experimental group will be less likely to report SI/SA and endorse symptoms of depression than usual care group. Exploratory hypotheses are that the experimental group: 1) will be more likely to take meds, keep out-patient department appointments, use positive coping strategies than usual care group; 2) will report high levels of satisfaction with program; and 3) minority female participants, aged less than 30 will be early adopters of the program.
Emil F. Coccaro, M.D.
University of Chicago
Diffusion Tensor Imaging Studies of Suicidal Behavior. $100,000
This research will be the first to examine white matter integrity in patients with borderline personality disorder (BPD) with a history of suicidal behavior compared with healthy controls. White matter integrity will be examined through Diffusion Tensor Imaging (DTI). DTI is a magnetic resonance imaging technique that can examine the integrity of white matter tracts and map white matter tracts in vivo. In preliminary data with non-suicidal impulsively aggressive individuals these investigators have found DTI abnormalities in white matter and white matter tracts associated with corticolimbic pathways. Accordingly, this study will determine if these abnormalities also exist in patients with histories of suicidal behavior. Since patients with BPD have a very high rate of suicidal behavior, 20 BPD patients with suicidal behavior, 20 BPD patients without histories of suicidal behavior and 20 healthy controls will be studied. The key aim of this study is to examine the structural integrity of white matter tracts in the brains of individuals with BPD who have a history of attempting suicide. Demonstration of abnormalities in white matter tracts in individuals with histories of suicide attempts will highlight the role played by white matter integrity, as well as the nature of the neuronal circuits, that may be involved in suicide risk. Such work will enhance our understanding of neuronal pathways in individuals with histories of suicidal behavior.
William Coryell, M.D.
University of Iowa
A Prospective Study of Completed Suicide in a Large Bipolar I Disorder Sample. $89,783
This research program will identify clinically important risk factors for suicide in bipolar I disorder and collect data necessary for genetic association studies of completed suicide. This study will collect the names and birthdates of individuals with bipolar I disorder identified in five successive waves conducted by the NIMH Genetics Initiative Bipolar Group. These will be submitted to a National Death Index search to identify those who have died and their causes of death. This outcome information will be added to the central data file and used to test hypothesis concerning relative risk factors for suicide in bipolar I disorder. The advantage of this study is that it will clearly identify risk factors in pure bipolar I disorder, uncontaminated by risk factors from other mood disorder patients.
Guy Diamond, Ph.D.
Children’s Hospital of Philadelphia
Family Therapy for Hospital Care. $85,000
Despite the fact that managed care has limited inpatient treatment of seriously suicidal adolescents, there are few empirically-supported clinical services programs available for post-hospitalization care of this population. In this study, the investigators will collaborate with the adolescent inpatient unit of a psychiatric hospital in Philadelphia to test the efficacy, acceptability and feasibility of Attachment Based Family Therapy (ABFT) as an aftercare treatment for youth who have been hospitalized following a suicide attempt. Ten such adolescents will be randomly assigned to 12 weeks of treatment with ABFT, which centers on strengthening family relationships, while 10 others will receive a comparable period of treatment as usual. Subsequently, all youth will be assessed to determine reductions in suicidal ideation, behavior problems and family conflict, and improvements in adaptive functioning. It is hoped that promising results obtained in this small study will lead to NIMH funding to support a larger, randomized clinical trial of ABFT.
Mark Kaplan, M.P.H., Dr.P.H.
Portland State University
Suicide among Military Veterans: Analysis of the National Violent Death Reporting System. $85,000
The goal of this research is to help explain why veterans in the general population have elevated rates of suicide, using data available through the National Violent Death Reporting System (NVDRS). The NVDRS is a surveillance system now operating in 17 states that was established by the Centers for Disease Control in 2002 to gather information on deaths by suicide and other violent means. In this study, the investigators will compare 4,231 veterans and 13,748 non-veterans who died by suicide between 2003-2005. These groups will be stratified by age, gender and race/ethnicity, and then compared on such variables as socioeconomic characteristics, substance use, mental health factors and life events to identify key differences that could account for differences in suicide rates. A unique aspect of the research will involve determining a “suicide score” for each individual, which represents a weighted average of suicide risk factors including past suicide attempts, history of mental disorder and history of misuse of alcohol and other drugs. By helping to illuminate the particular vulnerabilities of veterans and the circumstances surrounding their suicide deaths, the investigators hope to inform the design and implementation of suicide prevention programs for military veterans.
Gregory Luke Larkin, M.D., M.S., M.S.P.H.
Yale University School of Medicine
Suicide Clusters Across the Globe: Geospatial Trends from America, Ireland and New Zealand. $99,998
Suicides which occur close together in time and/or space, beyond the rate which would be normally be expected in a community, tend to be regarded as forming a suicide “cluster.” This study plans to gather data about suicide clusters at multiple sites in three countries: America, Ireland and New Zealand. Using a mixture of statistical techniques including descriptive statistics and geospatial mapping, the study will explore the extent to which the scientific scrutiny of suicide clusters using modern statistical techniques can add to current understanding about the frequency with which clusters occur, their characteristics, mechanisms and trends. There is increasing concern about allegedly rising numbers of suicide clusters, particularly in rural areas and in youth; however, there has been remarkably little study of this phenomenon to inform community and professional responses to emerging or suspected clusters. Initially, spatial scan and time series statistics will be used to analyze geospatially-linked mortality data in order to examine the incidence of suicide clusters in the five-year period 2001/2-2005/6 and time trends in selected geographic areas from 1984-2006. This study will provide an evidence base for developing cluster prevention and interruption strategies.
Mark Olfson, M.D., M.P.H.
Columbia University
Emergency Mental Health Management Following Deliberate Self-Harm. $99,996
The primary goal of this study is to identify modifiable factors that promote emergency mental health services and follow-up outpatient mental health treatment for youth and adults who present to emergency departments with deliberate self-harm.Epidemiological analyses will be used to characterize naturally occurring variation in mental health assessments and follow-up mental health treatment of a national cohort of over 60,000 youth and adults treated in emergency departments for deliberate self-harm. This study will identify and characterize systems of care that promote timely mental health treatment of individuals who deliberately harm themselves focusing specifically on potentially lethal events. This knowledge will inform and enhance treatment interventions and policy reform aimed at improving mental health care for the large number of these high risk individuals who do not currently receive mental health services.
Gregory Ordway, Ph.D.
East Tennessee State University
Glutamatergic Signaling in the Locus Coeruleus in Depression and Suicide. $85,000
This study aims to better understand the biological basis of depression and suicide by examining disruptions in glutamate and norepinephrine transmission. The neurotransmitter glutamate regulates brain noradrenergic activity by providing a major, stress-activated input to the noradrenergic locus coeruleus (LC), the group of brainstem neurons that are the principal source of norepinephrine in the brain. The investigator hypothesizes that glutamatergic transmission in the noradrenergic LC is abnormal in depressed suicide victims, compared to normal control subjects. The study will use laser capture microdissection to selectively collect noradrenergic neurons from the LC of 15 pairs of subjects (suicide victims and matched controls). From these cells, the researchers will examine glutamate receptor gene expression. It is anticipated that findings from the research will point the way to new therapies for depression that will aid in preventing suicide.
Stephen Russell, Ph.D.
University of Arizona
Explaining the Sexual Orientation Disparity in Adolescent Suicide Risk. $85,000
Studies over the last several decades have pointed to significantly higher rates of self-reported suicidal ideation and suicide attempts among gay, lesbian and bisexual youth. In this research, the investigator will seek to explain this disparity by examining data from the National Longitudinal Study of Adolescent Health (Add Health). The Add Health survey data were obtained from a nationally-representative sample of over 13,000 U.S. adolescents, and are unique in including information about sexual orientation, suicidality and many different contexts that shape adolescent development (e.g., family, peers, school). The key goal of the study is to identify factors within each context that are related to suicidal ideation and attempts among adolescents reporting same-sex orientation. It is hoped that the results will guide the development of suicide prevention and intervention programs for sexual minority youth.
Barbara Stanley, Ph.D.
Columbia University
Safety Planning Intervention for Suicidal Individuals who Contact Crisis Centers. $99,928
This project will develop and test a safety planning manual for use in crisis centers with calls from suicidal individuals, in collaboration with the National Suicide Prevention Lifeline Crisis Center. Hotlines receive a significant portion of their calls from suicidal individuals and, in fact, for many of these callers, this is the only intervention they receive either due to their unwillingness to seek treatment or the unavailability of treatment. Therefore, maximizing the clinical utility of the hotline calls is of utmost importance. The principal investigator along with the National Suicide Prevention Lifeline director will select two matched crisis centers to be included. One center will implement the safety planning intervention and the other will not, serving as the control. Outcome study measures will be obtained at both sites. Efficacy will be evaluated in several ways: perceived utility of the safety planning mechanism by crisis workers and callers; whether or not the plan was used in times of distress; and reduction in suicidal behavior. This intervention has great potential for immediate impact in the reduction of suicidality in a population that generally receives minimal treatment but is at high risk for suicide.
Gustavo Turecki, M.D., Ph.D.
Douglas Hospital Research Institute, McGill University
Differential microRNA (µRNA) Expression in the Prefrontal Cortex of Suicides. $99,500
This state-of-the-art genomic study will identify µRNA differences in prefrontal brain cortex of depressed suicides as compared to appropriate controls. µRNAs are non-coding, small, single stranded, 21-base RNA transcripts that play an important role in the posttranscriptional regulation messengerRNA (mRNA) thus playing a major role in the regulation of a large number of genes, including those expressed in the brain. A global profiling of expression patterns of µRNA levels in the orbital prefrontal cortex in 40 depressed suicide subjects and 40 psychiatrically normal controls will be done. The results of the global profiling analysis will be used for bioinformatics analysis to determine specific µRNA targets for validation, subsequent investigation and functional characterization. This study will facilitate our understanding of molecular mechanisms associated with the regulation of brain gene activity and how these mechanisms could be related to major depression and suicide. µRNA may, in fact, be an important regulating mechanism in the biological processes associated with suicide, and could lead to new biological markers, therapeutic targets and ultimately prevention.
Danuta Wasserman, M.D., Ph.D.
Karolinska Institute, Stockholm, Sweden
Investigation of Inheritance Patterns of Polymorphisms in Genes Regulating the Hypothalamic-Pituitary-Adrenal (HPA Axis), in Relation To Suicidal Behavior and its Endophenotypes. $100,000
This is an excellent proposal from a very productive investigator with an outstanding research career in suicide and suicidal behaviors. This study will use 700 well-characterized family trios to study the genetics of suicidality. The proposal is strongly focused on HPA-axis genes. DNA has been collected from 672 family trios consisting of one suicide attempter offspring and both parents and from 520 healthy volunteers. Clinical data consists of interview and self-report data regarding demography, data on the attempt(s), personality, psychiatric diagnosis, suicide family history, medical damage rating, life events, perceived stress and objective measures of life stress. Many of the trios are derived from families that show an enrichment of suicidality not only in the offspring, but in the parents and siblings. The applicant plans to genotype 384 SNPs among 18 genes relevant to the HPA axis and three other genes based on previous studies including the 5HT1A, 5HT2A and GABAA1 receptor genes. The genetic variation in 21 genes related to HPA function, serotonin and GABA will be linked and associated with suicide attempt primarily, but also to psychiatric disorders, personality traits and exposure to life-time stress.
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