# Suicide risk interventions: A comparison of treatment dose and neural markers of treatment outcome > **NIH VA I01** · VA BOSTON HEALTH CARE SYSTEM · 2024 · — ## Abstract The suicide rate among active duty service members and veterans increased substantially following the onset of post-9/11 conflicts in Iraq and Afghanistan1. Accordingly, veteran suicide prevention has been identified as a national healthcare and research priority2. Psychosocial interventions for suicide risk vary substantially in dose and resource allocation. A single therapy session designed to evaluate risk factors and provide support resources (e.g., Enhanced Crisis Response Plans [ECRP]3) has been shown to reduce risk for future suicide attempts. Other interventions consisting of 10-12 outpatient sessions following inpatient discharge (e.g., Brief Cognitive Behavioral Therapy for suicide prevention [BCBT]4) have been shown to reduce suicide attempts by 50-60% relative to treatment as usual. Although both forms of intervention have been shown to reduce risk, interventions that vary in dose and resource allocation have yet to be directly compared, leaving two critical gaps in our ability to intervene most effectively. First, the assumption that more time- and resource-intensive 10-12 session interventions translate to greater suicide risk reduction has yet to be demonstrated. Second, it may be that less resource intensive interventions are adequate for some individuals whereas others require more intensive care. To date, there is no evidence to guide what interventions are indicated for specific clinical presentations. Pharmacological and brain stimulation interventions for suicide risk are extremely limited. This is due, in part, to an incomplete understanding of the neurobiological mechanisms of suicide risk. Although numerous studies have examined cross-sectional neuroimaging correlates of current suicide ideation or compared individuals with and without history of a suicide attempt, to date no studies have examined a) neurobiological predictors of future suicide attempts in high-risk samples, b) how changes in neurobiological markers over time relate to changes in suicide risk, or c) theoretically and mechanistically relevant neuroimaging procedures in a prospective design. Cross-sectional research examining neuroimaging markers of past or current self-injurious thoughts and behaviors (SITBs) has identified dysfunction in regions associated with emotion regulation, inhibitory control, and decision-making5,6, namely in cognitive control networks (CCN). On the other hand, dysfunction has also been observed in regions associated with negative affect and rumination such as limbic (LN) and default mode (DMN) networks. Despite these cross-sectional findings, identification of neuroimaging predictors of future suicide attempts, and neural markers of successful suicide risk intervention outcomes represents a completely novel, critical step to guiding optimal targeting of neurobiologically-informed interventions and translating neuroimaging of suicide into practice. Whether these potential neuroimaging predictors are identifiable during resting sta... ## Key facts - **NIH application ID:** 10695329 - **Project number:** 1I01CX002583-01A1 - **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM - **Principal Investigator:** Michael Esterman - **Activity code:** I01 (R01, R21, SBIR, etc.) - **Funding institute:** VA - **Fiscal year:** 2024 - **Award amount:** — - **Award type:** 1 - **Project period:** 2024-01-01 → 2027-12-31 ## Primary source NIH RePORTER: https://reporter.nih.gov/project-details/10695329 ## Citation > US National Institutes of Health, RePORTER application 10695329, Suicide risk interventions: A comparison of treatment dose and neural markers of treatment outcome (1I01CX002583-01A1). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10695329. Licensed CC0. --- *[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*