Project Summary/Abstract
This National Research Service Award will provide essential training and resources for the PI to facilitate her
goal of becoming an independent investigator, focused on the prediction, prevention, and treatment of suicidal
thoughts and behaviors (STB). Suicide is a major public health concern, with rates steadily rising; despite
decades of research focused on prediction, our ability to predict when individuals are at high-risk of engaging
in STB remains poor. Identifying periods of acute risk is critical in informing suicide prevention and intervention
efforts. Research suggests that negative interpersonal experiences (e.g., childhood trauma, rejection) are
associated with STB. However, these experiences are often uncontrollable, and tend to be measured
retrospectively via self-report; identifying potential modifiable mechanisms that explain how such negative
interpersonal experiences may lead to acute STB risk is vital. Increases in self-criticism is one candidate
mechanism (e.g., parental rejection leads to STB via elevated self-criticism). However, self-criticism is often
measured at the broad trait level; it is possible that undergoing an acute negative interpersonal experience
may prompt immediate increases in state self-criticism and associated self-conscious emotions, and that this
then places an individual at imminent risk for STB. The present study will address these gaps in the literature
by exploring whether acute increases in self-criticism and self-conscious emotional reactions to (1) a lab-based
interpersonal stressor, and (2) interpersonal stressors in daily life predict imminent risk for STB (measured both
in the lab and on a momentary basis). Data collection for this innovative project will build upon an ongoing
study (R01MH124832); we aim to recruit 85 participants from an inpatient hospital at high risk for suicide. In
the lab, we will manipulate social exclusion with a well-tested paradigm (i.e., Cyberball), and measure
participants’ state self-criticism and self-conscious affect (shame, guilt), as well as lifetime STB. Participants
will also complete 4 weeks of ecological momentary assessment (EMA). This project will be conducted with an
individualized training program to facilitate the acquisition of key skills and knowledge to move the applicant
towards her career goals. This includes advanced didactic and experiential training in (1) EMA methodology,
(2) acute suicide risk prediction models, (3) risk assessment and management in a high-risk clinical sample, (4)
advanced statistical tools for analyzing intensive longitudinal data, and (5) grantsmanship and manuscript
preparation. The applicant will work closely with her Sponsor, Dr. Armey (expert in EMA and suicide), and her
Co-Sponsors Dr. Schatten (expert in EMA and risk management), Dr. Nugent (expert in social contexts of risk
and childhood trauma), and Dr. Brick (expert in statistical tools for intensive longitudinal data). This outstanding
mentorship team, in combination with the infrastructure and resources available through Butler Hospital and
Alpert Medical School of Brown University, represents the ideal environment to accomplish the applicant’s
training goals, foster her professional development, and increase her autonomy as a suicide researcher.