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Research / Funded grants

2014 Linked Standard Research Grant

Neurocognitive Markers of Vulnerability to Suicidal Behavior Across the Life-Cycle

2 research findings from this AFSP-funded study.

Research finding · October 2024

A suicide assessment fared in identifying individuals with suicidal behavior

Developing tools that can effectively assess suicide risk is a major goal in the suicide prevention field. One test that was developed to differentiate individuals with prior or prospective suicide attempts is the Death/Suicide Implicit Association Test (d/s-IAT). This test is based on prior research showing that individuals at risk for suicide tend to respond more quickly to stimuli associating death or suicide with themselves when compared to stimuli associating life with themselves, with faster response times leading to higher scores, indicating an individual is at higher risk. While the d/s-IAT has been mostly studied in younger populations, little is known about its effectiveness in older adults.

As part of the AFSP Lifespan Study, Drs. Jeffrey Bridge, John Keilp, and Katalin Szanto examined the d/s-IAT in 248 individuals aged 16-80. The sample was divided into three groups – depressed patients who have attempted suicide, depressed patients with no history of suicide attempt, and non-psychiatric participants. The team found that individuals with depression had higher scores than non-psychiatric participants, but there was no difference between those with and without prior suicide attempts. Age affected the test results, with older participants showing slower response times.

Citation: Ruch, D. A., Bridge, J. A., Tissue, J., Madden, S. P., Galfavy, H., Gorlyn, M., Sheftall, A. H., Szanto, K., & Keilp, J. G. (2024). Alterations in performance and discriminating power of the death/suicide implicit association test across the lifespan. Psychiatry Research, 335, 115840. https://doi.org/10.1016/j.psychres.2024.115840

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

Research finding · September 2023

Problem-solving skills can play a part in suicidal behaviors across the lifespan

Feelings of entrapment – the sense of being trapped by internal and external factors with no end in sight – and deficits in social problem-solving skills, are two risk factors that have been linked with suicidal behavior. It is not clear if this association is seen across the lifespan since contributors to suicide risk tend to change with age. For example, difficulty solving problems can contribute to suicide risk at any age, whereas feeling like you are trapped or stuck may not occur until adulthood.

To examine the association between entrapment and social problem-solving deficits with suicidal behavior over the lifespan, from adolescence through adulthood, Drs. Katalin Szanto, Jeffrey Bridge, and John Keilp assessed for these factors in 297 participants aged 16-80. The sample was divided into three groups – depressed patients who have attempted suicide, depressed patients with no history of suicide attempt, and non-psychiatric participants.

The research team found that higher scores on scales for impulsive problem-solving styles were consistently associated with suicide attempts across the lifespan. In contrast, feelings of entrapment significantly distinguished suicide attempters from non-suicide attempters from middle to older ages but not youth. These findings indicate that problem solving difficulties can be addressed at any age, while feelings of entrapment identified at older ages may signal suicide risk and must be considered when treating this population.

Citation: Wang, C., J.G. Keilp, H. Galfalvy, Bridge, J. A., Sheftall, A. H., & Szanto, K. (2023). Entrapment and social problem-solving in suicidal behavior across the adult lifespan. 329, 176–183, https://doi.org/10.1016/j.jad.2023.02.099

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

The grant behind this work · 2014 Linked Standard Research Grant

Neurocognitive Markers of Vulnerability to Suicidal Behavior Across the Life-Cycle

Katalin Szanto, M.D.

Katalin Szanto, M.D.

Western Psychiatric Institute and Clinic of the University of Pittsburgh School of Medicine

Jeffrey Bridge, Ph.D.

Jeffrey Bridge, Ph.D.

The Research Institute at Nationwide Children's Hospital and Ohio State University

John Keilp, Ph.D.

John Keilp, Ph.D.

Columbia University College of Physicians & Surgeons

Amount awarded
$187,168 Focus area
Neurobiological

Inside the Research

Bios: Dr. Keilp received his Ph.D. in clinical psychology from Fordham University in 1990. He is currently Assistant Professor of Clinical Psychology in the Department of Psychiatry at Columbia University College of Physicians & Surgeons.

Dr. Bridge received his Ph.D. in psychiatric epidemiology in 2001 from the University of Pittsburgh Graduate School Of Public Health. He is currently Associate Professor of Pediatrics at The Ohio State University College of Medicine.

Dr. Szanto received her medical degree from Semmelweis Medical University (Budapest) in 1980. She is currently Associate Professor of Psychiatry at the Western Psychiatric Institute and Clinic of the University of Pittsburgh School of Medicine.

Grant Categories: Neurobiological studies, brain functioning studies

Abstract: While there are many contributors to suicide, neurocognitive processes and the way people think and make decisions play a central role by distorting the manner in which information is processed, blocking access to adaptive behavior and undermining the individual’s capacity to deal with stressful life events.  This study will attempt to identify those neurocognitive deficits that are affected by developmental changes over time and those that are constant across the life span.  The investigators also evaluate the unique contribution of neurocognitive deficits over and above other clinical risk factors in people who have made suicide attempts.  Past research indicates that vulnerability to suicidal behavior is influenced by multiple, possibly overlapping, levels of neurocognitive dysfunction.  Deficits in basic information processing and higher order executive processes that affect behavioral control, as well as psychological content are suggested to contribute to suicidal behavior. To examine individuals across the age spectrum and control for possible confounders, the researchers will comprehensively assess neurocognitive function, suicidal behavior, psychopathology, personality traits, potential factors that can affect decision-making, physical status, and medication exposure. Participants will be 120 individuals with depression and a suicide attempt in the past year, 120 individuals depression and without a suicide attempt, and 96 non-psychiatric individuals. The study will operate at three sites, with ages ranging from 16-80. This is the first study to utilize multiple empirically-validated measures of neurocognitive functioning in a single assessment battery for the purpose of finding the most efficient set of classifiers of past suicide attempt status, and also incorporates a developmental focus to investigate the possibility that different neurocognitive deficits may play a different role at different points in the life span.

Impact: In addition to informing the development of brief screening measures of risk for suicidal behavior that are developmentally sensitive, if that proves to be needed,  markers for genetic and neurobiological studies, as well as targets for therapeutic interventions based on these neurocognitive deficits may be identified.

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