# A Novel Cognitive Reappraisal Intervention for Suicide Prevention

> **NIH NIH R33** · WEILL MEDICAL COLL OF CORNELL UNIV · 2020 · $551,272

## Abstract

ABSTRACT
The goal of this project is to refine and test a novel emotion-regulation based psychosocial intervention
designed to reduce suicide risk in middle-aged and older adults (50-90 years old) who have been discharged
after a suicide-related hospitalization (i.e. for suicidal ideation or suicide attempt). Suicide rates in this group
are alarmingly high, and reducing suicide rates in at-risk populations is a major NIMH priority.
 We developed a novel psychosocial intervention called “Cognitive Reappraisal Intervention for Suicide
Prevention (CRISP),” which aims to improve cognitive reappraisal (i.e. modifying the appraisal of a situation to
alter its emotional significance) (target), and reduce suicide risk (outcome). Our conceptual framework views
suicidal ideation and behavior as failed attempts to regulate negative emotions and by improving cognitive
reappraisal, an effective emotion regulation strategy, we expect to reduce suicide risk. Our theory is supported
by studies showing that unsuccessful attempts to regulate negative emotions and decreased cognitive
reappraisal are associated with increased suicidal ideation and behavior.
 The R61 phase is a proof-of-principle phase and its goals are to optimize CRISP and test its engagement
with cognitive reappraisal. Certified social workers will administer 6 or 12 weekly sessions of CRISP to 30
middle-aged and older adults (50-90 years old) after a suicide-related hospitalization. Research assistants,
unaware of the study aims, will conduct assessments at study entry (hospital admission), discharge, 6 and 12
weeks post-discharge. Target engagement will be assessed with electrocortical measures (i.e. late positive
potential, LPP) and self-reported affect during a novel cognitive reappraisal paradigm.
 The R33 phase aims to provide further evidence of target engagement of the optimized CRISP in a larger
sample, evaluate the relationship of cognitive reappraisal with suicide risk as measured with Columbia Suicide
Severity Rating Scale-C-SSRS and estimate implementation parameters for a large-scale clinical trial. A
different sample of 75 middle-aged and older adults (using the same inclusion/exclusion criteria as for the R61
phase) will be randomized (4 to 1) to CRISP (N=60) or to Supportive Therapy (ST, a control treatment not
designed to improve emotion regulation) (N=15). Assessments will be conducted on admission, at discharge,
and at 6, 12 and 24 weeks post-discharge. Primary aims are: 1) CRISP participants will show improvement in
cognitive reappraisal from discharge to end of treatment; and 2) improvement in cognitive reappraisal will be
associated with suicide risk over 24 weeks.

## Key facts

- **NIH application ID:** 10005464
- **Project number:** 5R33MH110542-05
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** DIMITRIS N KIOSSES
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $551,272
- **Award type:** 5
- **Project period:** 2016-09-23 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005464

## Citation

> US National Institutes of Health, RePORTER application 10005464, A Novel Cognitive Reappraisal Intervention for Suicide Prevention (5R33MH110542-05). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10005464. Licensed CC0.

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