ABSTRACT
The goal of this project is to evaluate the temporal and
predictive association
of emotion
reactivity (ER) and cognitive reappraisal (CR) (a well-studied emotion regulation strategy) with
intensity and duration of suicidal ideation (SI) in middle-aged and older adults following their
discharge from a suicide-related hospitalization, a period of high suicide risk.
Our preliminary Event Related Potential (ERP) and self-reported affect data on middle-aged
: a) increased
ER and reduced CR at Discharge were independently associated with increased intensity and
longer duration of suicidal ideation at Week 6; and b) patients with combined high ER and low
CR at Discharge had higher intensity and longer duration of suicidal ideation at Week 6 than the
rest of the patients.
and older adults (N=36) who were hospitalized for suicidality demonstrated that
We will recruit 162 middle-aged and older adults (40-90 years old) who have been
hospitalized for suicidal ideation or suicidal behavior [Columbia Suicide Severity Rating Scale
(C-SSRS) at Admission > 1, i.e., 1=Wishes to be Dead]. We will follow the participants for 6
months after discharge. Suicidal ideation and behavior will be measured weekly through an
interviewer-administered instrument (C-SSRS). ER and CR will be assessed with: 1)
electrocortical measures (Late Positive Potential) and self-reported affect during an emotion
reactivity and regulation EEG task (primary measures), and 2) the Emotion Regulation
Questionnaire and the Perth Emotional Reactivity Scale (secondary measures). Assessments
will be conducted at Admission (without EEG), Discharge, and at Weeks 6, 12, 18, and 24.
1. Examine the Independent Effects of ER and CR on Intensity and Duration of
SI. 2. Examine the Combined Effects of ER and CR on Intensity and Duration of SI.
Exploratory Analyses: 1. Examine whether demographic variables, discharge clinical
characteristics, rehospitalization, medical comorbidities, and other suicide risk factors moderate
the relationship of ER and CR with suicidal ideation. 2. Examine association of the longitudinal
profile of ER and CR with the longitudinal profile of intensity and duration of suicidal ideation.
Primary Aims:
This is the first study to examine the predictive relationship of ER and CR with suicidal
ideation in middle-aged and older adults at high suicide risk. Understanding this relationship will
help identify: a) mechanisms which increase suicidal ideation, and b) subgroups of patients at
increased suicide risk. Consistent with the concept of “Precision Medicine”, the findings may
contribute to the development of personalized psychosocial interventions for this population.
