Project 5

Stress, Inflammation, Aggression and Emotion Regulation in Suicidal Behavior

Aggression, childhood adversity, and behavioral and physiological responses to stress are all critical factors that may contribute to risk for suicidal behavior. We have studied the role of childhood adversity childhood adversity and impulsive aggression in depressed suicide attempters, depressed nonattempters and healthy volunteers. We found that while aggression was higher in attempters, stress responsivity was heightened only in attempters with high reactive/impulsive aggression. We also observed that this highly stress responsive, impulsive group displayed a cluster of characteristics: a pattern of frequent brief, highly variable suicidal ideation that correlated to a history of childhood adversity and increased in response to daily stressors, together with poorer emotion regulation. In contrast, we found that high planning of suicide attempts was related to family history of suicide and persistent suicidal thinking. Thus, we observe different sets of characteristics associated with suicidal outcomes at opposite ends of a continuum from very impulsive to highly planned and deliberate suicidal behaviors. In this project, we expand our work by further exploring the neurobiological and cognitive underpinnings of impulsivity/planning of suicide attempts. A second promising extension of our work is to study related stress response mechanisms, particularly inflammation, which is associated with suicide risk factors of childhood adversity and aggression.

Understanding How Stress Responses and Emotion Dysregulation Relate to Suicidal Behavior

Project 5 examines the role of emotional and physiological responses to social stress and day-to-day stress, comparing depressed patients with and without a history of suicidal behavior and healthy volunteers. Using the Trier Social Stress Test and Ecological Momentary Assessment tools, and blood sampling for cytokines, polyunsaturated fatty acids and kynurenine, we will

• investigate relationships between stress biomarkers, emotion regulation, and neurocognition; and
• examine the role of inflammation and stress response. 

Exploring the Use of Real-Time Monitoring to Help Predict Suicide Risk

(Project 5 Supplement)

Using state-of-the-art smartphone technology, we will also study the value of passive real-time monitoring of emotional distress, social functioning, and sleep disturbance to parse out how well these characteristics relate to suicidal behavior. We will test how effective this type of passively obtained information is compared with other types of information we are obtaining (including stress response, mood regulation and cognitive data) in terms of suicide risk prediction. Finally, we will use powerful computational machine learning methods to combine the full range of data we gather from active and passive monitoring to develop predictive models.

How To Participate In This Study

Please click here for information on how to participate in this study as a patient or a healthy volunteer.