PROJECT SUMMARY/ABSTRACT
Suicide is the second leading cause of death for adolescents and young adults, with rates of suicide deaths
rising in the past two decades. Research examining risk for suicide has focused largely on long-term risk
factors, with limited empirical investigations of short-term predictors of suicide in adolescents during periods of
highest risk. To develop effective interventions to prevent suicidal behaviors during these elevated risk periods,
it is crucial to understand the regulatory mechanisms that may intensify risk or enhance resilience. Risk for
suicide is a dynamic, state-sensitive process, often characterized as a relatively brief period of dysregulation.
Thus, the ability to flexibly regulate emotional and biological responses to stressors is a critical process to
examine in adolescents vulnerable to suicide. The proposed study seeks to address an important gap in
current research by examining stress responses and emotion regulation flexibility at multiple levels of analysis
to determine whether these processes are predictive of short-term suicide risk during the transition out of
intensive hospital services. The study will include a sample of adolescents (N=90) with a past 30-day history of
suicidal ideation and/or events that are currently receiving treatment in the Bradley Hospital adolescent partial
hospital program. Participants will complete an initial assessment followed by a 2-week EMA protocol and a 3-
month follow up assessment. The goals for the proposed project include: (1) characterizing emotion regulation
flexibility in the context of interpersonal stress utilizing self-report, laboratory, and ecologically valid
assessments; (2) examine associated physiological responses to affective cues and stressors; and (3)
prospectively examine the relationship between regulatory responses and suicidal thoughts and
behaviors. The proposed training plan closely aligns with the research goals of this project, and includes: (1)
cultivating expertise in translational clinical research in adolescents at high-risk for suicidality; (2) immersive
training in EMA data acquisition and intensive longitudinal data analysis; (3) gaining skills in utilizing
psychophysiological methodology; and (4) professional development, including dissemination of research,
fostering research collaborations, and further training in grant writing. The mentorship team has expertise in
translational research in adolescent suicidality (Drs. Richard Liu and Brandon Gaudiano), EMA data collection
during transition periods (Dr. Brandon Gaudiano), multi-level modeling for intensive longitudinal data (Drs.
Leslie Brick and Richard Jones), and psychophysiological methods (Dr. Stephen Sheinkopf). This application
has important clinical implications, as findings from this study may identify critical variables to monitor and
target during high-risk periods. Thus, the proposed study has the potential to inform future research studies
testing regulatory flexibility as a target mechanism for interventions for adolescents vulnerable to suicide.