A Multi-modal Integration of Neurobiological and Ecological Measures of Emotion Regulation in Suicidal Individuals

Aims: Difficulty regulating negative emotion contributes vulnerability toward suicidal ideation and behavior; however, there is a dearth of data on how suicidal individuals regulate negative affect in response to stressors. The goal of this proposal is to provide a multidimensional assessment of emotion regulation (ER) in suicidal individuals by bridging lab-based and real-world measures of emotion regulation. We will do this by measuring spontaneous emotion regulation in an fMRI context, and relate it to real-world, time-varying coping with stressors over a seven-day ecological momentary assessment (EMA) period, as well as physiological reactivity (i.e., heart rate variability; HRV) to an induced stressor. Sample: The sample will consist of 90 MDDs ages 18-65, half with a history of suicide attempts (matched on sex and age). Data for 65 participants have already been collected, and an additional 25 participants will be recruited before Oct. 2022. The data will available to the applicant to process, aggregate, and analyze under expert mentorship. Measures/Procedure: We will use a neural signature for emotion regulation' derived using machine learning-based analysis of functional neuroimaging (fMRI) data 'to track neural activity differentially associated with prompts to distance or immerse during an aversive image task. The signature will then be used to identify spontaneous expression of these strategies during a negative autobiographical memories task. Additionally, we will validate the neural signature by analyzing its relation to HRV, a non-invasive physiological indicator of emotion regulation, measured during the course of a lab-induced social stressor task. The emotion regulation neural signature will also be analyzed in relation to real-world coping with daily upsets, using EMA-derived measures of negative affect and suicidal ideation following stressors. We will examine group differences in these measures between suicidal individuals with and without a history of suicide attempt. As an exploratory analysis, the neural signature of ER will be used to predict SB over a 3-month follow-up. Hypotheses: Our central hypothesis is that greater spontaneous use of emotion regulation using a distancing strategy will be related to greater HRV reactivity to a lab-based stressor, more effective real-world coping with SI over the 7-day EMA period, and lower risk of SI and suicidal behavior (SB) at 3-month's follow-up. Potential impact: Our long-term goal is to identify effective short-term regulation strategies for regulation of negative affect and assess their utility as intervention targets in reducing SI/SB. Next Steps: This study will serve as a preliminary step and training opportunity in service of the applicant's goal of conducting independent research that considers both neural and physiological contributions to emotion dysregulation in suicidal individuals; and relates these measures to their real-world experiences of emotion, coping, and suicidal ideation and behavior.