# Examining Mechanisms of Change in Adolescent Self-Inflicted Injury

> **NIH NIH K23** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2024 · $199,481

## Abstract

PROJECT SUMMARY/ABSTRACT
Suicide is a global public health concern that marks an extreme along a spectrum of self-inflicted injury (SII)
and is the leading cause of death among adolescents. Although we have evidence-based interventions for
youth SII, mechanisms of change are underexplored, and suicide rates have not appreciably declined.
Efficacious treatments like Dialectical Behavior Therapy (DBT) are intensive, expensive, and require extensive
therapist training, making it inaccessible for many adolescents in need. We also lack vital data on whether and
how adolescents apply and retain therapeutic skills in daily life. There are too few researchers interested in and
trained to develop mechanistic innovations in this area. The candidate will complete training in the neural
underpinnings of skill acquisition (fMRI, Training Aim 1), measurement in everyday life (Ecological momentary
assessment; EMA, Training Aim 2), and factors (life stress) that may impede skill acquisition (Training Aim 3).
This training is embedded within a research study that uses a rigorous multi-method approach to: compare
intra- vs. interpersonal skills targeting emotion dysregulation (Aim 1); assess the potency of intervention effects
in daily life (Aim 2); and examine persistence/decay effects of skill use in daily life following initial skill exposure
and a “booster” call (Aim 3). We will also examine bi-directional effects of life-stress and underlying
mechanisms of risk and change. Adolescents with a history of repeated SII (N = 100) will attend 4 study visits
with a parent. At Visit 1, participants will complete baseline assessments of psychiatric diagnoses, SII, and life
stress. Fifty-six of the 100 youth will be randomly assigned to complete fMRI paradigms to tap neural
processes underlying perspective taking and empathy, and approach/avoidance (Training Aim 1). Adolescents
will then complete a 2-week EMA (EMA1, Training Aim 2) to measure daily affect, perceived stressors, SII, and
suicidal thoughts. At Visit 2, dyads will be randomly assigned to learn and practice GIVE (interpersonal skills
training) or opposite-to-emotion action (OA; intrapersonal skill). We will assess behavioral, affective, and
physiological regulatory processes during two conflict discussions: (1) pre- skills training, and (2) post-training,
while dyads use their assigned skill. A second EMA period (EMA2) will assess skill use along with all variables
from EMA1. Dyads will return for Visit 3 to repeat fMRI assessment before crossing over to learn the alternate
skill ⎯ followed by another 2-week EMA (EMA3). Visit 4 is completed 6 months post-EMA3, where we will
reassess SII, symptom severity, and life stressors. The candidate has existing expertise in adolescent SII,
DBT, and cardiac psychophysiological measures of emotion regulation. The mentorship team will support her
in growing her skill set to include fMRI task design, data acquisition, and analysis, EMA methods and analysis,
and life stre...

## Key facts

- **NIH application ID:** 10782866
- **Project number:** 1K23MH135225-01
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Erin Anne Kaufman
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $199,481
- **Award type:** 1
- **Project period:** 2024-04-01 → 2029-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10782866

## Citation

> US National Institutes of Health, RePORTER application 10782866, Examining Mechanisms of Change in Adolescent Self-Inflicted Injury (1K23MH135225-01). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10782866. Licensed CC0.

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