Leslie Ann Brick

Substance use (SU) is often characterized as an affect regulation strategy. Yet, evidence is mixed for SU's acute affect regulation function, particularly in clinical populations and substances beyond cannabis and alcohol. We examined the affective antecedents and consequences surrounding use of alcohol, cannabis, and other substances among a high-risk clinical population. Recently suicidal adults receiving psychiatric inpatient care (N = 95) completed baseline measures followed by 28 days of ecological momentary assessment after discharge. Seven daily surveys assessed current negative affect (NA) and positive affect and SU. Within-person increases in affective intensity predicted any SU; any SU then predicted decreased affective intensity. When alcohol, cannabis, and other SU were analyzed separately, elevated NA predicted cannabis and other SU, while decreased NA predicted alcohol use. Further, alcohol use predicted subsequent increased NA, while cannabis use predicted decreased NA, and other SU predicted decreased positive affect. Sensitivity analyses were mixed, wherein the relationship between any SU and affect became somewhat more robust, while results considering each substance separately became nonsignificant. Although affective antecedents are consistent with SU as an attempt at affect regulation, use itself did not reliably improve affect in this high-risk clinical sample, highlighting the value of other affect regulation strategies as intervention targets given the risks of SU. Future research should examine real-time changes in affect to understand the reinforcement properties of various substances and to explore the drivers and outcomes of the potential affect regulatory function of cannabis use in high-risk adults. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Attentional biases toward depression-relevant stimuli (e.g., sad faces) are thought to contribute to the development and maintenance of depression, but research in youth is limited and primarily cross-sectional. Therefore, it remains unclear whether such biases are risk factors for, versus consequences of, depression (or both), and whether these links may be stronger among youth already at risk for depression due to a family history of the disorder. To address these questions, the present multiwave longitudinal study followed 242 mothers and their offspring (ages 8-14; 51.65% girls, 81.40% non-Hispanic White) over 2 years with assessments every 6 months (five assessments total) to examine prospective relations between attentional biases (measured via a dot-probe eye-tracking task) and depressive symptoms in youth. Of the mothers, 123 had a history of major depressive disorder (MDD) during their child's life and the rest had no lifetime history of MDD. Using random intercepts cross-lagged panel models, we found that depressive symptoms predicted prospective changes in attentional biases, but not the reverse, and the pattern of attentional bias change differed based on maternal history of MDD. Specifically, among offspring of mothers with MDD, higher depressive symptoms at a given assessment predicted future increases in attentional bias to sad faces, whereas among offspring of never depressed mothers, higher depressive symptoms predicted subsequent decreases in attentional bias to happy faces. These findings suggest that experiences of depression may contribute to different patterns of attention to emotional cues based on maternal history of MDD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Suicide is the second leading cause of death among adolescents and young adults, with rates of suicide in the United States increasing by 37% between 2000 and 2022 (Centers for Disease Control and ...

Objectives: Negative emotions have been well studied in relation to suicidal thoughts and behaviors (STBs); however, little research in these areas have been informed by affective science frameworks that consider the complex and time varying nature of STBs. Emotion differentiation is well‐validated as one such core construct in affective science. The present study is the first to examine negative emotion differentiation in relation to STBs and in a sample at heightened risk for suicide. In addition, to investigate how emotion differentiation relates to real time measures of emotion regulation, we examined the relationship between negative emotion differentiation and facets of affective dynamics (i.e., affective inertia, intensity, and variability). Methods: Adults leaving psychiatric inpatient care ( n = 68) with recent STBs completed semi‐structured interviews, self‐report measures, and a 4‐week ecological momentary assessment (EMA) protocol in the period from 2021 to 2023. Results: Results indicated no significant relationship between negative emotion differentiation and STBs (suicidal ideation duration, frequency, controllability, severity, nor suicide attempt history) when measured retrospectively or concurrently. However, negative emotion differentiation was significantly related to only some negative affective dynamics (i.e., inertia and variability). Conclusions: These findings have important clinical implications regarding type and timing of treatment for STBs.

Adolescent hospitalization for suicide-related thoughts and behaviors has increased over the past decade, with few interventions shown to improve outcomes post-discharge. Given the majority of adolescents return to school following a suicide-related crisis, we developed and pilot-tested Practice Experiences for School Reintegration (PrESR)^™, a virtual reality (VR) intervention designed to teach therapeutic skills to hospitalized adolescents and allowing them to practice using these skills in stressful situations set in school settings that they would be expected to experience following discharge. This pilot optimization trial examined the feasibility, acceptability, and safety of PrESR for augmenting standard inpatient care with adolescents hospitalized for suicide-related crises. Using a Multiphase Optimization Strategy (MOST) framework, we recruited adolescents hospitalized for suicide-related thoughts and behaviors (n=42) to be randomized into one of eight conditions testing three different VR-enhanced skill lessons and practice sessions: affect regulation, cognitive restructuring, and problem-solving. Research clinicians delivered individual sessions of PrESR with a high degree of fidelity (93-100%), but patients were often discharged before completing more than one skill. Of the participants who participated in the intervention, the majority agreed or strongly agreed with statements endorsing PrESR and its components as important, appropriate, and easy to use, largely supporting acceptability. Participants also provided feedback for improvement, informing slight changes to the next version of the intervention. More generally, PrESR did not appear to result in significant safety concerns based self-reported ratings of subjective distress and pre/post measures of physical symptoms related to cybersickness. Findings support the feasibility of delivering a brief version of PrESR and preliminary acceptability for the intervention. VR technology and content show promising potential for adolescent suicide prevention and mental health support. Future research should examine PrESR for improving patient outcomes and preventing suicide.

Nearly half of women in the United States experience intimate partner violence (IPV) in their lifetime, which is linked to deleterious sequelae related to health outcomes. To better understand these dynamic processes, the current study used secondary data from a 30‐day experience sampling methods (ESM) study to examine associations among IPV experiences, posttraumatic stress symptoms (PTSS), alcohol use, and emotion dysregulation. Participants were women over 18 years of age who experienced physical or sexual victimization in the past 6 months. Group iterative multiple model estimation (GIMME) was used to generate idiographic networks for each individual, followed by unsupervised subgroup classification to examine patterns of results across people. The results indicated great heterogeneity among networks. No overall group‐level paths emerged, but seven small subgroups emerged, and 30.6% of the sample did not fit into any subgroup. All networks had significant autoregressions, suggesting that associations between IPV, PTSS, emotion dysregulation, and alcohol use are variable and highly specific to the individual. Notably, across findings, most associations emerged at the contemporaneous level, with few lagged effects. The complexity of the findings suggests that substantial heterogeneity exists in the dynamic associations among these processes. Personally tailored approaches may be more effective than one‐size‐fits‐all approaches for assessing and intervening on IPV and related mental health concerns.

Diminished sleep health is a known warning sign for suicide. However, the contexts and time periods within which diminished sleep elevates suicide risk are unknown. Modeling the complex process by which diminished sleep health impacts daily functioning and establishing proximal suicide risk factors can aid in addressing these important knowledge gaps. This paper describes the methods and research protocol for a study that aims to elucidate the nature of the sleep–suicide relationship and develop an integrated model of proximal suicide risk. Participants will be 200 adults at high risk for suicide recruited from a psychiatric inpatient unit. They will complete a baseline assessment including clinical interviews and self-reports, and laboratory tasks with concurrent electroencephalography to phenotype-relevant risk processes. This baseline assessment will be followed by 4 weeks of ecological momentary assessment and digital phenotyping, coupled with assessments of sleep via a wearable used to generate a minute-by-minute metric of cognitive effectiveness using the Sleep Activity, Fatigue, and Task Effectiveness algorithm index. Follow-up assessments will be conducted 1-, 3-, and 6-months post-hospital discharge to determine how the developed proximal model of risk prospectively predicts suicidal ideation and behavior. The results of this study have the potential to greatly enhance understanding of how and why diminished sleep health is related to real-world fluctuations in suicide risk, knowledge that can inform efforts to better prevent, and intervene to reduce suicides.

Childhood adversity is linked to psychological, behavioral, and physical health problems, including obesity and cardiometabolic disease. Epigenetic alterations are one pathway through which the effects of early life stress and adversity might persist into adulthood. Epigenetic mechanisms have also been proposed to explain why cardiometabolic health can vary greatly between individuals with similar Body Mass Index (BMIs). We evaluated two independent cross-sectional cohorts of adults without known medical illness, one of which explicitly recruited individuals with early life stress (ELS) and control participants (n = 195), and the other a general community sample (n = 477). In these cohorts, we examine associations between childhood adversity, epigenetic aging, and metabolic health. Childhood adversity was associated with increased GrimAge Acceleration (GAA) in both cohorts, both utilizing a dichotomous yes/no classification (both p < 0.01) as well as a continuous measure using the Childhood Trauma Questionnaire (CTQ) (both p < 0.05). Further investigation demonstrated that CTQ subscales for physical and sexual abuse (both p < 0.05) were associated with increased GAA in both cohorts, whereas physical and emotional neglect were not. In both cohorts, higher CTQ was also associated with higher BMI and increased insulin resistance (both p < 0.05). Finally, we demonstrate a moderating effect of BMI on the relationship between GAA and insulin resistance where GAA correlated with insulin resistance specifically at higher BMIs. These results, which were largely replicated between two independent cohorts, suggest that interactions between epigenetics, obesity, and metabolic health may be important mechanisms through which childhood adversity contributes to long-term physical and metabolic health effects.

The period after psychiatric hospitalization is an extraordinarily high‐risk period for suicidal thoughts and behaviours (STBs). Affective–cognitive constructs (ACCs) are salient risk factors for STBs, and intensive longitudinal metrics of these constructs may improve personalized risk detection and intervention. However, limited research has examined how within‐person daily levels and between‐person dynamic metrics of ACCs relate to STBs after hospital discharge. Adult psychiatric inpatients (N = 95) completed a 65‐day ecological momentary assessment protocol after discharge as part of a 6‐month follow‐up period. Using dynamic structural equation models, we examined both within‐person daily levels and between‐person dynamic metrics (intensity, variability and inertia) of positive and negative affect, rumination, distress intolerance and emotion dysregulation as risk factors for STBs. Within‐person lower daily levels of positive affect and higher daily levels of negative affect, rumination, distress intolerance and emotion dysregulation were risk factors for next‐day suicidal ideation (SI). Same‐day within‐person higher rumination and negative affect were also risk factors for same‐day SI. At the between‐person level, higher overall positive affect was protective against active SI and suicidal behaviour over the 6‐month follow‐up, while greater variability of rumination and distress intolerance increased risk for active SI, suicidal behaviour and suicide attempt. The present study provides the most comprehensive examination to date of intensive longitudinal metrics of ACCs as risk factors for STBs. Results support the continued use of intensive longitudinal methods to improve STB risk detection. Interventions focusing on rumination and distress intolerance may specifically help to prevent suicidal crises during critical transitions in care.