# Neural Mechanisms and Predictors of an Ultra-Brief Suicide Prevention Strategy

> **NIH NIH R01** · OHIO STATE UNIVERSITY · 2021 · $648,388

## Abstract

Close to 45,000 Americans die from suicide each year and rates have been steadily rising for the last two
decades. There is an urgent need for better access to effective suicide prevention strategies that are highly
transportable across medical settings. Data from the current team indicates that a single session of crisis
response planning (CRP) reduces suicide behavior by 76%; however, it is unknown how CRP works, and for
whom, curtailing strategy optimization and widespread implementation. Clinicians speculate that CRP works by
strengthening emotion regulation capabilities and reducing stress reactivity; however, this hypothesis has never
been tested and no prior study has identified neural mechanisms and predictors of changes in suicide risk
following intervention. Related, there are no objective brain-based markers of ‘reduced’ suicide risk to inform
clinical decision making and guide high-risk patients to needed services. To address these gaps and ultimately
improve suicide prevention efforts we seek to identify brain-based mechanisms and predictors of changes in
suicidality following a single session of CRP in a cohort of adults with active suicidal intent. We will take an
innovative and comprehensive approach by probing stress reactivity and emotion regulation neural circuits in
the context of a clinical trials design. Specifically, we will combine sources of information and simultaneously
collect assessments of neural function, psychophysiology (i.e., startle eyeblink potentiation), behavior
and self-report during functional magnetic resonance imaging (fMRI) before (Time 1) and after (Time 2)
randomization to a single, one-hour session of CRP or standard suicide risk management (control). A small
group of volunteers with no history of suicide ideation or intent will be included for comparison. Using ecological
momentary assessment (EMA) technology, acute changes in suicidality following intervention will be assessed
twice daily for the first week. Monthly online clinical surveys will also be administered, and at 6-months post-
intervention, the entire multimodal assessment battery will be re-administered (Time 3). This innovative,
multilayered, longitudinal design will allow for a well-controlled test of how a single session of CRP acutely
changes suicide risk (Aim 1). The study will also address whether the acute effects of CRP are sustained over
time and how neural function influences long-term changes in suicidality (Aim 2). Lastly, we will conduct
sophisticated analyses to integrate data across ‘units of analysis’ and functional domains to test whether there
are reliable prognostic indicators of CRP intervention success (Aim 3). Findings from this study will provide
critical new knowledge regarding how an ultra-brief session of CRP works and for whom, while uncovering a
mechanistic signal of reduced suicide risk. In addition, consistent with the mission of the NIMH BRAINS program,
the award will facilitate the launch of the PI’s innov...

## Key facts

- **NIH application ID:** 10198354
- **Project number:** 1R01MH126116-01
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Stephanie Gorka
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $648,388
- **Award type:** 1
- **Project period:** 2021-05-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10198354

## Citation

> US National Institutes of Health, RePORTER application 10198354, Neural Mechanisms and Predictors of an Ultra-Brief Suicide Prevention Strategy (1R01MH126116-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10198354. Licensed CC0.

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