Current Research Initiatives

Low-burden Adaptive Mobile Interventions for Mood and Suicide Risk (K23 MH131761)

Led by Dr. Adam Horowitz. Depression and suicidal ideation have been increasing among college students, and college mental health counseling centers have struggled to keep up with demand. Furthermore, students often struggle to identify their symptoms as problematic until they experience significant negative consequences. This project seeks to develop an adaptive personalized feedback intervention using digital tools to help college students better recognize downward trends in their stress and mental health, and provide recommendations/resources to help prevent the negative progression of depressive symptoms into more severe consequences.

WeCARE: A System of Care for Black Youth at Risk for Suicide

A System of Care for Black Youth at Risk for Suicide.  Dr. Cheryl King, together with Dr. Michael Lindsey at the NYU McSilver Institute for Poverty Policy and Research and Dr. Pamela Morris-Perez of NYU Steinhardt’s ARCADIA for Suicide Prevention, have been awarded a NIMH-funded R01 research grant to study the effectiveness of a system of care for Black youth with suicide risk who present for emergency services.

Targeted Firearm Safety Education to Reduce Morbidity and Mortality in Rural Youth

Funded by the National Institute of Mental Health (R24HD087149)
Principal Investigators: Cheryl A. King, Ph.D. & Cynthia Ewell Foster, Ph.D.

Our long-term goal is to develop an effective, universal strategy to increase safe firearm storage in rural communities. In this two-phase pilot project, we will use a community-based participatory research (CBPR) model in Phase One to develop a culturally tailored firearm safety message and to identify the community-based messengers and messaging strategies that are most acceptable and perceived as having the greatest likelihood of being impactful with rural families. In Phase Two, we will pilot test the acceptability and feasibility of our new prevention strategy: a multicomponent online intervention that includes a culturally tailored website, video, infographic fact sheet, and parent-child firearm safety contract/home safety checklist. We will focus on families with children at two different developmental periods: 1) mobile infants and toddlers and 2) older children/teens (ages 8-18). This delivery strategy capitalizes on what are hypothesized to be “critical periods” of behavior change in families in the hopes of creating safe storage behaviors that could impact not only unintentional injuries among young children but also firearm-related deaths in teens that may be due to suicide or other intentional injuries.

24-Hour Warning Signs for Adolescent Suicide Attempts

Funded by the National Institute of Mental Health (R01MH113582)
Principal Investigator: Cheryl A. King, Ph.D.
Co-Investigators: Iqbal Ahamed, Ph.D., Courtney Bagge, Ph.D., David Brent, M.D., Charlie Casper, Ph.D., Polly Gipson, Ph.D., Jacqueline Grupp-Phelan, M.D, MPH

This large-scale NIMH project recruited 1097 youth at elevated risk for suicide from the ED-STARS study. The project is designed to identify the warning signs that are associated with near-term risk for suicide. We also hope to determine why a patient attempted suicide on a given day versus a day without a suicide attempt. Youth will complete biweekly text message surveys across an 18-month period, regarding their mental health status. The Warning Signs for Suicide Attempt Interview – Adolescent (WSSA-A), a computer-assisted telephone interview, will be conducted with adolescents who report a suicide attempt (and matched control adolescents). Using a case-crossover within-subject design, we will compare the events, behaviors, emotions and thoughts of these adolescents during the 24-hour case window (day of attempt) to those during a matched 24-hour control window. Using a case-control group comparison design, we also will identify differences between suicide attempters and non-attempters in events, behaviors, emotions and cognitions during the 24-hour case window.

Developing an Adaptive Intervention for Suicidal Adolescents Following Inpatient Hospitalization: A Pilot SMART

Funded by the National Institute of Mental Health (K23MH113776)

Principal Investigator: Ewa Czyz, Ph.D.

This NIMH K award will be used to conduct a Sequential, Multiple Assignment, Randomized Trial (SMART) pilot with teens at risk for suicide (ages 13-17). Given the heterogeneity of responses to intervention and post-discharge suicide risk among suicidal youth, this personalized approach represents a critical first step in developing an innovative, technology-augmented adaptive intervention for hospitalized adolescents aimed at reducing suicide-related outcomes following the transition from inpatient care. Findings from this study will provide the groundwork for the construction of a technology-augmented adaptive intervention that could lead to a reduction in suicidal behaviors and related events during the high-risk post-discharge period—an important suicide prevention target.
Electronic Bridge to Mental Health for College Students (eBRIDGE)
Funded by the National Institute of Mental Health (R01MH103244)
Principal Investigator: Cheryl A. King, Ph.D.
Co-Investigators: Daniel Eisenberg, Ph.D., Todd K. Favorite, Ph.D., Inbal Nahum-Shani, Ph.D., Kai Zheng, Ph.D.
Site Principal Investigators: Ronald Albucher, M.D., William Coryell, M.D., Jacqueline Pistorello, Ph.D.

This research initiative began with an intervention development grant funded by the National Institute of Mental Health (NIMH), which enabled us to develop, pilot-test and iteratively refine a theoretically-driven intervention, Students’ eBridge to Mental Health (eBridge). This online intervention screens students for mental health concerns that include elevated suicide risk and facilitates their linkage to mental health (MH) services. eBridge is designed to work on computers, tablets and smartphones (i0S, Android) and is easily adaptable to evolving technologies in the future. It incorporates motivational interviewing (MI) principles and draws from health behavior models that emphasize autonomy and self-determination. Following a web-based screen using standardized scales to identify students at elevated risk, eBridge offers students options for personalized feedback (provided online in a conversational MI-adherent format) and corresponding online with professionals trained in MI and knowledgeable about university and community resources. We are currently conducting a larger more definitive efficacy trial at four universities: the University of Michigan, the University of Nevada-Reno, the University of Iowa, and Stanford University.

Family Support and Follow-Up Program-Psychiatric Emergency Services

Funded by Substance Abuse and Mental Health Services Administration and Michigan Department of Health and Human Services
Principal Investigator: Cynthia Ewell Foster, Ph.D.

Based on work completed in Michigan’s cohort 5 GLS project and in partnership with the University of Michigan Health System’s Psychiatric Emergency Services (PES), the Family Support and ED Follow-up Program aims to inform enhancements to crisis and emergency care for youth and families. 250-500 families will be enrolled at PES. Youth ages 10-18 with any suicide-related risk factors are eligible. Youth and parents complete surveys in PES and participate in follow-up surveys online (parents at 3 days and 2 weeks after discharge; youth at 2 weeks after discharge). Surveys are designed to help improve our understanding of how to care for youth seeking emergency services for suicide risk. Eventually, some families will be asked to join a focus group to inform the development of a text-message-based follow-up intervention for parents/caregivers of high risk youth. Funded by the state-wide youth suicide prevention grant, we hope to disseminate best practices to other emergency departments across Michigan.

Promoting Resilience and Outreach through Multi-tiered Interventions and Supportive Environments (PROMISE)

Funded by the Robert Wood Johnson Foundation

Principal Investigator: Polly Gipson, PhD

The goal of PROMISE is to implement a multi-disciplinary, multi-pronged approach to identifying and addressing trauma in adolescents. Research informs us that the devastating impacts of traumatic exposure not only threaten the healthy physical and mental development of its victims, but also threaten their ability to perform adequately in school. Because youth spend the majority of their time within school and require optimal functioning to succeed academically, trauma informed schools are an important first step in providing opportunities for adolescent victims and witnesses of trauma to thrive. PROMISE will be implemented in an urban, Southeastern Michigan community, specifically a school with high adverse childhood experiences, poverty, and community violence. PROMISE consists of a multi-tiered approach: 1) create safe environments and promote health; 2) early intervention and identification of individuals at-risk for post/secondary traumatic stress; and 3) intensive support and services for those exhibiting clinically significant traumatic stress symptoms.

Transforming Youth Suicide Prevention in Michigan

Youth-Nominated Support Team Intervention YST

YST is a psychoeducational, social support program developed by Dr. Cheryl King and her team across multiple grant initiatives. It is a 3-month program that pairs adolescents, who are being discharged from a healthcare facility after a suicide attempt, with adults (known as support adults) whom the patient selects to become their support network. The YST intervenes with these adults, providing them with education, resources, and support to facilitate the youth’s positive behavioral choices, treatment adherence, and healthy outcomes. YST has been associated with improved treatment follow-through and reduced self-injury mortality. Multiple initiatives are underway to further develop YST and understand its potential benefits. Dr. Arango is currently leading implementation of an eYST pilot project, which has two primary aims: 1) develop eYST, a platform to support more efficient implementation of YST; and 2) test the feasibility and acceptability of eYST in a single-group, open-label trial. Dr. Ewell Foster recently received NIMH funded to adapt YST for integration with cognitive-behavioral therapy for adolescent suicide risk.

Recent Publications

2024

  • Seewald L, Bonar EE, Bohnert ASB, Carter P, King CA, Losman ED, Bacon L, Wheeler L, Walton MA. Lifetime non-fatal overdose experiences among at-risk adolescents and young adults in the emergency department with past-year opioid use in the U.S. Injury Prevention. 2024. In Press.
  • Grupp-Phelan J, Horwitz A, Brent D, Chernick L, Shenoi R, Casper C, Webb M, King CA.   Management of suicide risk in the emergency department: A clinical pathway using the computerized adaptive suicide screen for youth. Journal of the American College of Emergency Physicians Open, 2024. In Press.
  • King CA, Czyz E, Brent DA, Grupp-Phelan et al. Examining the Interpersonal Theory of Suicide in adolescents. Journal of Clinical Child and Adolescent Psychology, 2024, In Press.

2023

  • King, CA., Gipson Allen, PY., Ahamed, SI., Webb, M., Casper, TC., Brent, D., Grupp-Phelan, J., Rogers, TA., Arango, A. 24-Hour Warning Signs for Adolescent Suicide Attempts. Psychological Medicine, In Press.
  • Al-Dajani N, Czyz EK, Eisenberg D, Zheng K, King CA. A Latent Profile Analysis of At-Risk First-Year Undergraduate Students.” Journal of American College Health, 1-8.
  • Arango A, Gipson PY, King CA. The attenuating role of connectedness domains on the relation between severity of victimization and internalizing problems. Journal of Child Psychology and Psychiatry, In Press. 
  • Bornheimer LA, Li Verdugo J, Krasnick J, Jeffers N, Storey F, King CA, Taylor SF,Florence T, & Himle JA. A cognitive-behavioral suicide prevention treatment for adults with schizophrenia spectrum disorders in community mental health: Preliminary findings of an open pilot study. Social Work in Mental Health, 21(5), 538-560.
  • Czyz EK, King CA, Al-Dajani N, Zimmermann L, Hong V, & Nahum-Shani I. Evaluation of ecological momentary assessments and passive sensing to predict short-term suicidal ideation in young adults. JAMA Network Open, In Press. 
  • Pomerville A, Wilbur RE, Pham TV, King CA, Gone JP. Behavioral Health Services in Urban American Indian Health Programs: Results from Six Site Visits. Journal of Community Psychology, 51(7), 2618-2634.
  • Arango A, Czyz EK, Magness CS, Hong V, Smith T, Kettley J, Ewell Foster C: Predictors of suicide coping self-efficacy among youth presenting to a psychiatric emergency department. Suicide Life Threat Behav. 05/2023. PM37157179
  • Bornheimer, L. A., *Li Verdugo, J., *Krasnick, J., Jeffers, N, Storey, F., King, C. A., Taylor, S. F., Florence, T., & Himle, J. A. (2023). A cognitive-behavioral suicide prevention treatment for adults with schizophrenia spectrum disorders in community mental health: Preliminary findings of an open pilot study. Social Work in Mental Health. [Epub ahead of print]
  • Bornheimer, L. A., *Li Verdugo, J., Humm, L., Steacy, C., *Krasnick, J., Goldstein Grumet, J., Aikens, J. E., Gold, K., Hiltz, B., & Smith, M. J. 2023). Computerized Suicide Prevention Clinical Training Simulations: A pilot study. Research on Social Work Practice.
  • Bornheimer, L. A., Wastler, H., *Li Verdugo, J., *Im, V., *Burke, H., *Holzworth, J., *Velasquez, E., &  *Mahmood, M. (2023). Depression, suicide intent, and plan among adults presenting in an emergency department after making a suicide attempt: Exploratory differences by psychosis experience. Journal of Psychiatric Research,  157, 197-201.
  • Brent D, Horowitz L, Grupp-Phelan J.………… King CA. Prediction of Suicide Attempts and Suicide-Related Events Among Adolescents Seen in Emergency Departments. JAMA Network Open – Pediatrics. February 15, 2023. doi:10.1001/jamanetworkopen.2022.55986
  • Chen Z, Fedina L, DeVylder J, Lemieux C, King C, Abbott K. Pandemic financial hardships and suicide risk in a nationally representative sample of young adults. Social Work in Mental Health, In Press.
  • Czyz EK, King CA, Al-Dajani N, Zimmermann L, Hong V, & Nahum-Shani I. Evaluation of ecological momentary assessments and passive sensing to predict short-term suicidal ideation in young adults. JAMA Network Open, In Press.
  • Ewell Foster C, Derwin S, Bornheimer LA, Magness C, Kahsay E, Eis M, Verdugo JL, Smith T, Massey L, Rivara FP, King CA: Firearm Safe Storage in Rural Families: Community Perspectives About Ownership and Safety Messaging. Health Promot Pract.: 15248399231166418, 05/2023. PM37148185
  • Ewell Foster C: Worsening Symptoms of Anxiety, Depression, and Sleep Problems in Caregivers Following Youths Suicide-Related Emergency Department Visit. Arch Suicide Res.: 1-10, 01/2023. PM36691847
  • Fedina, L., *Moss, L.,*Rousson, A., Smith, M.E., Bright, C., Herrenkohl, T.I., & DeVylder, J. (2023). Effects of neighborhood disconnection on psychological distress and suicide risk associated with interpersonal violence within racial groups. Journal of Child & Adolescent Trauma.
  • Fedina, L., King, C., DeVylder, J., & Herrenkohl, T. I. (2023). Distinct profiles of violence victimization and suicide risk: Findings from a national survey of emerging adults. American Journal of Orthopsychiatry.
  • Magness CS, Stern K, Burnside A, Masterson D, Finkelstein S, Kramer A, Smith PK, Foster CJ E: Changes in Gatekeeper Beliefs Following ASIST and Relation to Subsequent Gatekeeper Suicide Prevention Behaviors. Community Mental Health Journal.01/2023. PM36607521
  • Narita, Z., DeVylder, J.E., Bessaha, M., & Fedina, L. (2023). Associations of self-isolation, social support, and coping strategies with depression and suicidal ideation in U.S. young adults during the COVID-19 pandemic. International Journal of Mental Health Nursing.
  • Pomerville A, Wilbur RE, Pham TV, King CA, Gone JP.  Behavioral Health Services in Urban American Indian Health Programs: Results from Six Site Visits. Journal of Community Psychology, In Press.
  • Smith, M. J., Burke-Miller, J. K., Bornheimer, L. A., Ross, B., Bell, M. D., McGurk, S. R., Mueser, K T.., Brown, A., Prestipino, J., Borghani, N., Nelson, K., & Razzano, L. A. (2023). Psychometric Properties of the Mock Interview Rating Scale for Schizophrenia and Other Serious Mental Illnesses. Frontiers in Psychiatry, 14, 1150307
  • Smith T, Magness C, Arango A, Finkelstein S, Kahsay E, Czyz E, Hong V, Kettley J, Smith PK, Ewell Foster C: Worsening symptoms of anxiety, depression, and sleep problems in caregivers following youth’s suicide-related emergency department visit. Arch Suicide Res.: 1-10, 01/2023. PM36691847
  • Smith, M. J., Van Ryzin, M., Jordan, N., Atkins, M., Bornheimer, L. A., Sherwood, K., & Smith, J. D. (2023). Virtual job interview training: A dose response to improve employment for transition-age youth with disabilities. Career Development and Transition for Exceptional Individuals. [Epub ahead of print]
  • Uliaszek, A. A., Amestoy, M. E., Fournier, M. A., Al-Dajani, N. (2023). Criterion A of the Alternative Model of Personality Disorders: Structure and Validity in a Community Sample. Psychological Assessment.
  • Wexler L, Apala Flaherty A, Begum F, White L, Kouassi L, Wisnieski D, Davis A, Ewell Foster C: Describing meanings and practices related to firearms, safety, and household storage in rural Alaska Native communities. Journal of Rural Mental Health, 47(1), 30–40. https://doi.org/10.1037/rmh000020. Journal of Rural Mental Health.47(1): 30-40, 01/2023
  • Wooten, N., Fedina, L., & Hudson, D. (2023). Introduction to the special section: Developing antiracist research from research questions to dissemination. Journal of the Society of Social Work and Research. https://doi.org/10.1086/724718.

2022

  • Al-Dajani, N., & Czyz, E. K. (2022). Suicidal desire in adolescents: An examination of the interpersonal psychological theory using daily diaries. Journal of Clinical Child and Adolescent Psychology, 1-15.
  • Al-Dajani, N., Horwitz, A. G., Czyz, E. K. (2022). Does coping reduce suicidal urges in everyday life? Evidence from a daily diary study of adolescent inpatients. Depression and Anxiety.
  • Arango, A., Clark, M., & King, C. A. Predicting the severity of peer victimization and bullying perpetration among youth with interpersonal problems: A 6-month prospective study. Journal of Adolescence. 2022.
  • Bornheimer, L. A., Cobia, D.,  Li Verdugo, J.,  Holzworth, J., & Smith, M.J. (2022). Clinical insight and cognitive  functioning as mediators in the relationships between symptoms of psychosis, depression, and suicide ideation in first episode psychosis. Journal of Psychiatric Research, 147, 85-93.  
  • Bornheimer, L. A., Czyz, E., Jung Koo, H., Li Verdugo, J., Eisenberg, D., Zheng, K., Pistorello, J., Albucher, R. C., Coryell, W., Favorite, T., & King, C. (2022). Suicide risk profiles and barriers to professional help-seeking among college students with elevated risk for suicide. Journal of Psychiatric Research, 152, 305-312.
  • Bornheimer, L. A., Hong, V.,  Li, J.,  Fernandez, L., & King, C. (2022). Relationships between hallucinations,  delusions, depression, suicide ideation and plan among adults presenting with psychosis in psychiatric emergency  care. Psychosis, 14(2), 109-119.  
  • Bornheimer, L. A.,  Li Verdugo, J.,  Holzworth,  Im, V., Smith, F.,  Sliwa, H., Taylor, S. F., King, C. A., Florence,  T., Tarrier, N., & Himle, J. A. (2022). Modifying a cognitive behavioral suicide prevention treatment for adults with  schizophrenia spectrum disorders in community mental health. Psychiatry Research, 311, 114505.
  • Bornheimer, L. A.,  Li Verdugo, J.,  Holzworth, J., Smith, F. N., & Himle, J. A. (2022). Mental health provider  perspectives of the COVID-19 pandemic impact on service delivery: A focus on challenges in remote engagement,  suicide risk assessment, and treatment of psychosis. BMC Health Services Research, 22, 718.
  • Bornheimer, L. A., Martz, M. E., Suzuki, T., Tso, I. F., Burton, C. Z.,  Li Verdugo, J., Grove, T., Heitzeg, M. M., &  Taylor, S. F. (2022). Affective dysregulation precedes emergence of psychosis-like experiences in a community  sample of young adults. Schizophrenia Bulletin. [Epub ahead of print].
  • Cenkner DP, Burgess HJ, Huizenga B, Duval ER, Kim HM, Phan KL, Liberzon I, Klumpp H, Abelson J,  Horwitz A, Mooney A, Raglan GB, Zalta AK: Morning light treatment for traumatic stress: The role of  amygdala reactivity study protocol. PLoS One 17(6): e0269502, 2022. PM35675275
  • Coryell W, Eisenberg D, Zheng K, Horwitz A, Albucher R, Pistorello J, Favorite T, King CA. Suicidality and alcohol use as predictors of future suicidal behavior in college students. Alcohol and Alcoholism. 2022; DOI: 10.1093/alcalc/agac037
  • Czyz, E. K., Koo, H. J., Al-Dajani, N., Kentopp, S. D., Jiang, A., & King, C. A. (2022). Temporal profiles of suicidal thoughts in daily life: Results from two mobile-based monitoring studies with high-risk adolescents. Journal of Psychiatric Research.
  • Czyz, E. K., Koo, H. J., Al-Dajani, N., King, C. A., & Nahum-Shani, I. (2022). Predicting short-term suicidal thoughts in adolescents using machine learning: Developing decision tools to identify daily-level risk after hospitalization. Psychological Medicine. In press.
  • Harness, Jane “What does "Stranger Things" have to do with mental health?” University of Michigan Health Blog, July 6, 2022
  • Harness, Jane “Why Caregivers Should Worry About Elon Musk Buying Twitter” AACAP News, July 2022
  • Harness J, Fitzgerald K, Sullivan H, Selkie E. Youth Insight About Social Media Effects on Well/Ill-Being and Self-Modulating Efforts. Journal of Adolescent Health. Published online June 2022:S1054139X22004190. doi:10.1016/j.jadohealth.2022.04.011
  • Harness, Jane “Papageno Effect in Media: Fails and Triumphs” JAACAP Connect 2022
  • Hill RM, Oosterhoff B, King CA, & Kaplow JB. Open trial of a brief, web-assisted behavior intervention to reduce thwarted belongingness and suicidal ideation among adolescents: The Supporting Grieving Teens intervention. Counseling and Psychotherapy Research. 2022; DOI: https://doi.org/10.1002/capr.12582
  • Horwitz, A. G., Czyz, E. K., Al-Dajani, N., Dempsey, W., Zhao, Z., Nahum-Shani, I., & Sen, S. (2022). Utilizing daily mood diaries and wearable sensor data to predict depression and suicidal ideation among medical interns. Journal of Affective Disorders.
  • Horwitz, A. G., Hong, V., Eisenberg, D., Zheng, K., Albucher, R., Coryell, W., Pistorello, J., Favorite, T., & King, C. A. (2022). Engagement With Personalized Feedback for Emotional Distress Among College Students at Elevated Suicide Risk. Behavior therapy, 53(2), 365–375.
  • King CA, Eisenberg D, Pistorello J, Coryell W, Albucher RC, Favorite T, Horwitz A, Bonar EE, Epstein  D, Zheng K: Electronic bridge to mental health for college students: A randomized controlled intervention  trial. J Consult Clin Psychol: 2022. PM35099205
  • Kuehn, K. S., Foster, K. T., Czyz, E., King, C. A. (2022) Identifying person-specific coping responses to suicidal urges: A case series analysis and illustration of the idiographic method. Suicide and Life-Threatening Behavior. In press.
  • Meeks LM, Cleary J, Horwitz A, Pereira-Lima K, Zhao Z, Fang Y, Sen S: Analysis of Depressive  Symptoms and Perceived Impairment Among Physicians Across Intern Year. JAMA Netw Open 5(1):  e2144919, 2022. PM35076705
  • Rana, G. S., Nordsletten, A., Sivananthan, M., & Hong, V. (2022). A 6-year retrospective review of psychiatric emergency service utilization by school-age children. Clinical Child Psychology and Psychiatry. https://doi.org/10.1177/13591045211070924
  • Shobassy, A., Nordsletten, A. E., Ali, A., Bozada, K. A., Malas, N. M., & Hong, V. (2022). Effects of the COVID-19 pandemic in a psychiatric emergency service: Utilization patterns and patient perceptions. The American journal of emergency medicine, 52, 241–243.
  • Wexler, L., Apala Flaherty, A., Begum, F., White, L., Kouassi, L., Wisnieski, D., Davis, A., & Ewell Foster, C. (2022). Describing meanings and practices related to firearms, safety, and household storage in rural Alaska Native communities. Journal of Rural Mental Health. Advance online publication. https://doi.org/10.1037/rmh0000207