January Research Roundup 2026: Recently Published Findings From AFSP-Funded Studies

The Research Roundup is a regular update of recently published findings in suicide prevention research. AFSP-funded studies included in this roundup examined how…

• Day to day relationship stress may play a role in suicidal ideation for young adults
• Commonly reported suicide risk and warning signs differ by sex and age
• Suicide risk may be shaped by long-term stress and differences in impulse regulation, and
• Immune-related biological markers may help identify periods of heightened suicide risk

Researcher: Ewa Czyz, PhD
Institution: University of Michigan
Grant Type: 2020 Standard Research Grant — $99,808
Grant Title: Advancing short-term prediction of suicidal behavior among high-risk youth: Real-time monitoring of suicide risk after psychiatric emergency department visits

Suicide risk does not come from a single cause. Instead, it tends to emerge from a shifting mix of risk factors that can change from day to day. For young adults, relationships often play a central role in daily life, and ongoing stress with friends, family, or romantic partners may contribute to periods of heightened vulnerability. While past research has consistently linked interpersonal difficulties with suicidal thoughts, much of that work has focused on broader time frames, such as weeks or months. Less is known about how relationship stress and suicidal ideation interact in everyday life, particularly in the period following a suicidal crisis. Studying these short-term dynamics can help clarify whether moment-to-moment changes in relationships meaningfully influence risk, or whether longer-standing patterns of stress and self-perception are more important for understanding recovery and prevention.

Using her AFSP-funded grant, Dr. Ewa Czyz and colleagues followed 102 young adults (ages 18–25) for two months after an emergency department visit for suicide-related concerns, using smartphone-based surveys to capture daily experiences in real time. Participants reported on suicidal ideation, feelings of perceived burdensomeness and belonging, and whether they experienced a significant negative relationship event each day. When the researchers examined whether changes in one area predicted changes the following day, they found little evidence that day-to-day spikes in suicidal ideation led to next-day relationship conflict, or that daily conflicts reliably led to next-day increases in suicidal thoughts. Instead, clearer patterns emerged across individuals rather than days: participants who generally felt more like a burden to others tended to experience more frequent relationship conflicts over the study period, and those with more ongoing conflict also reported higher average feelings of burdensomeness. These findings suggest that, in this high-risk group, suicide-related distress may be shaped more by chronic interpersonal stress and enduring self-perceptions than by single-day fluctuations in relationship conflict. Clinically, this points to the value of addressing longer-term relationship strain and persistent feelings of burdensomeness alongside strategies for coping with acute stress during recovery from a suicidal crisis.

Citation: Horwitz, A. G., Al-Dajani, N., McCarthy, K., Hong, V., King, C. A., & Czyz, E. K. (2025). Bidirectional associations between negative relationship events and suicidal ideation: an EMA study of stress exposure and generation. Anxiety, stress, and coping, 1–11. Advance online publication. https://doi.org/10.1080/10615806.2025.2584314

Researcher: Christian Rück, MD, PhD
Institution: Karolinska Institutet (Sweden)
Grant Type: 2022 Focus Grant — $1,494, 898
Grant Title: Saving Lives: Constructing a Nationwide Cohort With Multi-modal Data to Improve Precision in Prediction and Prevention of Suicide

Suicide does not look the same across the lifespan, nor does it present in the same way for women and men. While suicide rates are higher among men and increase with age, some of the warning signs clinicians and researchers rely on (e.g., mental health diagnoses or recent contact with psychiatric services) are actually more common in women and younger people. This mismatch creates a challenge for prevention: the very indicators we tend to watch for may be less visible in groups at the highest risk for suicide. Understanding how patterns of distress differ by sex and age, especially in the period leading up to suicide, can help refine how we identify risk and support people more effectively.

Dr. Christian Rück used nationwide health and social registry data from Sweden to study nearly 20,000 people who died by suicide and compare them with more than 190,000 similar living individuals who matched on age and sex. They examined whether people had any of 25 commonly cited risk indicators in the year before death, including mental health diagnoses, self-harm, psychiatric care, medication use, serious physical illness, bereavement, unemployment, or financial stress. What Dr. Rück found was not that these indicators were unimportant, but that they appeared unevenly across groups. Women and younger people who died by suicide were more likely to have had these warning signs documented beforehand. In contrast, men and older adults who died by suicide were less likely to have had these indicators recorded at all. This means that many men and older adults may be at risk without ever appearing on clinicians’ or systems’ “radar.” At the same time, because men have higher overall suicide rates, men who did show these indicators were often at particularly high risk, though this may reflect a potential bias of not asking or recording risk factors for men. Overall, the findings suggest that suicide prevention efforts relying mainly on documented mental health or social warning signs may miss many at-risk men and older adults, pointing to the need for broader, more tailored approaches to identifying and supporting people in distress.

Citation: Johansson, F., Gunnarsson, L., Grossmann, L., Mataix-Cols, D., Fernández de la Cruz, L., Fazel, S., Gardner, R. M., Dalman, C., Wallert, J., & Rück, C. (2025). Patterns of sex-specific and age-specific risk indicators of suicide: a population-nested case-control study. BMJ mental health, 28(1), e301959. https://doi.org/10.1136/bmjment-2025-301959

Researchers: Dr. Alan Swann, MD
Institution: Baylor College of Medicine
Grant Type: 2017 Focus Grant — $975,000
Grant Title: Behavioral Mechanisms, Prediction, and Treatment of Short-Term Suicide Risk

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

Researcher: Faith Dickerson, PhD, MPH
Institution: Sheppard Pratt Health System
Grant Type: 2019 Standard Research Grant — $100,000
Grant Title: The Gut-Brain Axis and Suicide Attempts: New Markers for Assessment and Prevention

Predicting suicide risk based on clinical symptoms alone remains a challenge, particularly among people living with major depressive disorder (MDD). While depression is strongly associated with suicide attempts, not everyone with severe symptoms goes on to attempt suicide, and warning signs can vary widely from person to person. For this reason, researchers have been exploring whether biological markers (i.e., measurable signals in the body) might help clarify periods of heightened vulnerability. One area of growing interest is the immune system. Increasing evidence suggests that inflammation and immune-related processes may be linked to mood disorders and suicidal behavior, though these relationships are complex and not yet fully understood. Studying how specific immune markers differ across clinical groups may help researchers better understand when suicide risk is elevated and guide future prevention strategies, without assuming any single marker tells the whole story.

With support from her AFSP-funded grant, Dr. Faith Dickerson examined blood levels of matrix metalloproteinase-9 (MMP-9), an enzyme involved in inflammation and brain-related processes, in 186 adults hospitalized with major depressive disorder and 79 adults without a psychiatric diagnosis. Among those with MDD, the researchers compared individuals who had made a suicide attempt within the past month, those with no recent attempt (including people with and without a past attempt), and a non-psychiatric comparison group. Dr. Dickerson found that elevated MMP-9 levels were most strongly associated with a recent suicide attempt, rather than with depression alone or with a distant history of attempts. Individuals with MDD who had not attempted suicide recently showed MMP-9 levels similar to those without a psychiatric disorder. This pattern remained even after accounting for depression severity, medication use, substance use history, body mass index, and other clinical factors. While the study does not show that MMP-9 causes suicide attempts, it suggests that immune-related changes may be particularly relevant during periods of acute risk. The findings point toward the potential value of biological markers like MMP-9 in future research aimed at identifying high-risk windows and developing more targeted, timely suicide prevention approaches.

Citation: Dickerson, F., Katsafanas, E., Origoni, A., Rowe, K., Khan, S., Mukhtar, F., Yang, S., Splan, V.W., Yolken, R., Levels of Matrix Metalloproteinase 9 (MMP-9) are Elevated in Persons with Major Depressive Disorder Who Have Had a Recent Suicide Attempt, Brain, Behavior, & Immunity - Health, https://doi.org/10.1016/j.bbih.2025.101163 

Learn more about the AFSP research grants featured in this monthly roundup, as well as others, here.