Research Roundup July 2025: 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…

• A range of variables impacted nurses’ experience of burnout and suicidal ideation
• Perinatal factors may influence vulnerability to suicidal behavior later in life
• A new intervention may help youth experiencing early psychosis symptoms, and
• The immune system may play a role in suicidal thoughts and behavior

Researcher: Bernadette Mazurek Melnyk, PhD
Institution: The Ohio State University
Grant Type: 2022 Focus Grant — $1,498,914
Grant Title: HEAR Plus MINDBODYSTRONG: A Mental Health Resiliency Intervention for Nurses

Nurses in the United States face alarmingly high rates of burnout, depression, and suicidal ideation, outpacing many other occupational groups. Despite increasing awareness, many nurses struggling with mental health concerns do not receive support or treatment, often due to negative attitudes (stigma), workplace culture, or fear of professional consequences. Suicide prevention in the nursing workforce requires more than individual coping strategies. It demands a systemic understanding of which work-related and personal factors contribute to risk, and which can offer protection. As health systems confront ongoing staffing shortages and workforce distress, identifying modifiable contributors to suicidal ideation is critical for both employee well-being and patient safety.

Dr. Bernadette Mazurek Melnyk examined data from 499 U.S. nurses identified as moderate-to-high-risk for mental health concerns, including suicidal ideation. Dr. Melnyk analyzed associations between suicidal ideation and a range of variables: burnout, depression, anxiety, PTSD, shift length, job satisfaction, workplace mattering, and more. She found that suicidal ideation was significantly associated with burnout, depression, anxiety, PTSD, working 12-hour shifts, and intent to leave the job. Protective factors included resilience, healthy lifestyle beliefs and behaviors, job satisfaction, and especially a sense of mattering in the workplace. Nurses who felt they mattered to their organization had 40% lower odds of suicidal ideation. This study highlights the urgent need for health care systems to address structural causes of burnout, invest in evidence-based mental health supports, and create cultures where nurses are valued –– not only to reduce distress, but potentially to save lives.

Citation: Melnyk, B. M., Davidson, J. E., Tucker, S., Tan, A., Hsieh, A. P., Cooper, A., Mayfield, C., & Hoying, J. (2025). Burnout, Mental Health, and Workplace Characteristics: Contributors and Protective Factors Associated With Suicidal Ideation in High-Risk Nurses. Worldviews on evidence-based nursing, 22(3), e70042. https://doi.org/10.1111/wvn.70042

Researcher: Ian Colman, PhD
Institution: University of Ottawa (Canada)
Grant Type: 2021 Standard Research Grant — $98,862
Grant Title: Real Time Assessment of Emotion Regulation and Suicidal Ideation among Individuals with First-Episode Psychosis

While many known risk factors for suicidal behavior emerge in adolescence or adulthood, there is growing interest in how conditions around the time of birth may shape later vulnerability. The perinatal period (which encompasses pregnancy, birth, and early infancy) can influence physical and mental health outcomes through mechanisms like maternal stress and early-life adversity. However, most research linking perinatal factors to suicide risk has been conducted in high-income countries, leaving a critical gap in our understanding of how these early-life factors operate in low-resource settings where such risks may be more prevalent.

With his AFSP-funded grant, Dr. Ian Colman used data from the 1993 Pelotas Birth Cohort in Brazil, which followed 3,493 individuals from birth into early adulthood, and examined the relationship between various perinatal exposures and suicidal outcomes. Dr. Colman found that female sex, low maternal education, and maternal smoking during pregnancy were associated with higher odds of both lifetime suicide attempts and recent suicidal ideation at ages 18 and 22. In contrast, mothers receiving social support from friends or neighbors around the time of birth significantly reduced these risks in their children. The findings align with patterns observed in high-income countries but highlight the added importance of modifiable, early-life interventions in lower-resource settings. This research underscores the need to consider perinatal environments in suicide prevention strategies, especially in global contexts where social supports and maternal education remain inequitable.

Citation: Eccles, H., Kingsbury, M., Murray, J., Geoffroy, M. C., Menezes, A. M. B., Blair, D. L., Calegaro, G., Wehrmeister, F. C., Gonçalves, H., & Colman, I. (2024). Perinatal Factors and Their Association with Early-Adulthood Suicidal Behavior in a Brazilian Birth Cohort. Archives of suicide research : official journal of the International Academy for Suicide Research, 1–16. Advance online publication. https://doi.org/10.1080/13811118.2024.2405737       

Researcher: Shirley Yen, PhD
Institution: Brown University
Grant Type: 2015 Standard Research Grant — $90,000
Grant Title: Adolescents Coping with Co-occurring Early Psychosis and Suicidality: A Parent Training Intervention (ACCEPT)

Young people with psychotic symptoms are at significantly elevated risk for suicidal behavior, particularly in the early years of onset. Yet, they are frequently excluded from suicide prevention trials, leaving a critical gap in available treatment options. Family involvement is a cornerstone of early psychosis care and suicide prevention, but few interventions address the parent-child dynamic in this high-risk group. Acceptance-based therapies, like Acceptance and Commitment Therapy (ACT), offer promising strategies to manage distress by fostering psychological flexibility and values-driven action. These interventions are also ripe for modifying to reduce distress in young people experiencing early psychotic symptoms, supporting their safety, and engaging their families as allies in recovery.

Dr. Shirley Yen used her AFSP grant funds to test the feasibility and acceptability of ACCEPT (Adolescents Coping with Co-occurring Early Psychosis Treatment), a novel, family-focused, acceptance-based intervention for youth ages 12–25 with both psychotic symptoms and suicidal ideation or behavior. Nine families were recruited from inpatient, outpatient, and partial hospital settings. The intervention included individual, family, and joint sessions, and focused on psychoeducation, emotion coaching, safety planning, and ACT-based skill-building. Results from five completers and three detailed case studies showed reductions in psychiatric symptoms and functional impairment, increased psychological flexibility, and no suicide attempts or hospitalizations during the study or follow-up period. Both youth and parents reported high satisfaction, and all case study participants achieved progress toward their valued goals. Though preliminary, these findings suggest ACCEPT may serve as a valuable adjunct or bridge for suicidal youth with psychosis, particularly in settings with limited access to full coordinated specialty care.

Citation: Foo, C.Y.S., Gaudiano, B.A., Friedman-Yakoobian, M. et al. Acceptance-Based Parent Training Intervention for Youths with Co-occurring Psychotic Symptoms and Suicidal Behaviors: a Case Series from an Open Trial. J Cogn Ther 17, 31–52 (2024). https://doi.org/10.1007/s41811-023-00181-1  

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

After a suicide attempt, individuals hospitalized for depression face a heightened risk of attempting again, especially in the first few months after discharge. While stress, trauma, and psychiatric history are all well-known risk factors, these alone don’t explain who is most at risk. Research increasingly suggests that the immune system (the system that protects us from infection) may also play a role. Immune-related health conditions like asthma have been linked to suicidal behavior, and signs of immune system activation have been observed in people with mood disorders, but few studies have followed high-risk individuals over time to investigate this connection.

With her AFSP pilot study, Dr. Faith Dickerson conducted follow-ups with 69 adults with major depressive disorder (MDD) who were recently hospitalized after a suicide attempt. Blood samples were collected to measure immune system activity, and participants were tracked for six months after discharge. Among the 62 with follow-up data, 15 (24%) made another suicide attempt. Those with elevated levels of certain inflammatory markers (that have been associated with suicide behavior in prior research) and lower antibodies to Epstein-Barr virus were significantly associated with attempting suicide after discharge. While most people with Asthma are not at risk for suicide, in the context of these contributors to suicide, Asthma diagnosis was also associated with a repeated suicide attempt in this study. Notably, individuals with both asthma and high immune marker levels had more than a 25-fold increased risk of repeat attempts. These findings suggest that immune markers, combined with clinical information, may help identify individuals at heightened risk for repeated suicide attempt after hospitalization.

Citation: Dickerson, F., Katsafanas, E., Khan, S., Origoni, A., Rowe, K., Ziemann, R. S., Bhatia, K., Yang, S., & Yolken, R. (2024). A pilot study of repeated suicide attempts in persons hospitalized for depression: The role of immune factors. Journal of affective disorders reports, 17, 100823. https://doi.org/10.1016/j.jadr.2024.100823 

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