Behavioral Mechanisms, Prediction, and Treatment of Short-Term Suicide Risk

2 research findings from this AFSP-funded study.

Research finding · June 2026

Lithium changed brain activity patterns in survivors of suicide attempts

Lithium has long been studied for its association with lower suicide risk, particularly among people with mood disorders such as bipolar disorder and major depression. Researchers are still working to understand why lithium may have this protective effect and what changes in the brain may accompany treatment. One area of interest is brain regulation: the balance of activity that helps the brain process emotion, respond to stress, control impulses, and support decision-making. Gamma-band activity, a fast pattern of brain signaling involved in attention, information processing, and coordination across brain networks, may offer one window into these regulatory processes. Understanding these mechanisms could help the field move beyond knowing that lithium may reduce suicide risk and toward understanding how that protection may occur biologically.

With his AFSP-funded grant, Dr. Alan Swann examined how short-term lithium treatment affected brain activity in survivors of medically severe suicide attempts using resting-state electroencephalography (EEG), a noninvasive method that measures electrical activity in the brain. Participants completed EEG recordings before treatment, after four weeks of lithium, and after four weeks of placebo treatment. Dr. Swann found that lithium produced measurable changes in brain signaling patterns linked to excitation and inhibition balance, which reflects how the brain regulates and stabilizes neural activity. Specifically, lithium increased gamma-band activity, while also altering broader background activity patterns associated with cortical regulation. These findings suggest that lithium may help improve the coordination and stability of brain networks involved in impulse control and emotional regulation, processes closely tied to suicidal behavior and suicide attempt recurrence.

Citation: Murphy, N., Thomas, Y. T., Murgulet, I., Shah, K., Engelhardt, J., Moukaddam, N. J., Kosten, T. R., Mathew, S. J., & Swann, A. C. (2026). Short-term lithium treatment modulates excitation/inhibition balance in resting-state electroencephalography (EEG) among survivors of medically severe suicide attempts. Experimental and Clinical Psychopharmacology. Advance online publication. https://doi.org/10.1037/pha0000857

This finding comes from an AFSP-funded study — see the grant below ↓

Research finding · January 2026

Suicide risk may be shaped by long-term stress and differences in impulse regulation

Suicidal behavior is complex and does not always follow a predictable path. Many people who experience suicidal crises do not have a prior suicide attempt or a specific psychiatric diagnosis, which makes it difficult to rely on traditional warning signs alone. Researchers are increasingly interested in how suicide risk may reflect an interaction between longer-term vulnerabilities, such as past stress or trauma, and short-term changes in how people regulate emotions and actions under pressure. Rather than assuming a simple progression from suicidal thoughts to attempts, this perspective focuses on how difficulties with impulse control, stress tolerance, and self-awareness might shape risk, sometimes in ways that are not obvious through self-reported distress alone. Clarifying these patterns could help improve how suicide risk is recognized and addressed before a crisis escalates.

Dr. Alan Swann compared 28 individuals who had survived a medically severe suicide attempt with 23 individuals who had experienced suicidal thoughts but had never attempted suicide. All participants were evaluated several months after the acute crisis, allowing the researchers to examine more stable characteristics rather than short-term distress. Dr. Swann found that some factors associated with severe attempts were closely tied to the intensity of suicidal thoughts, including current depression and alcohol use. Other factors, however, appeared to distinguish people with medically severe attempts even when levels of suicidal ideation were taken into account. These included greater lifetime exposure to stress and adversity, more impulsive responding on a behavioral task, higher physiological activation, and a tendency to minimize or deny childhood trauma. Notably, minimizing trauma was linked with reporting less suicidal ideation while still being associated with higher risk of a severe attempt. Together, the findings suggest that suicide risk may sometimes be shaped by underlying patterns of stress exposure and action regulation that are not fully captured by self-reported suicidal thoughts, pointing to the value of broader, behavior- and history-informed approaches to prevention.

Citation: Murphy, N., Kypriotakis, G., Lijffijt, M., Iqbal, S., Iqbal, T., Amarneh, D., O'Brien, B., Tamman, A., Thomas, Y., Moukaddam, N., Kosten, T. R., Averill, L. A., Mathew, S., & Swann, A. C. (2025). Interacting immediate and long-term action regulation in suicidal behavior. Journal of mood and anxiety disorders, 10, 100118. https://doi.org/10.1016/j.xjmad.2025.100118

This finding comes from an AFSP-funded study — see the grant below ↓

The grant behind this work · 2017 Focus Grant