# Targeting Emotion Dysregulation to Reduce Suicide in People with Psychosis

> **NIH NIH K23** · UNIVERSITY OF MARYLAND BALTIMORE · 2024 · $174,622

## Abstract

Project Summary
Suicide is an alarmingly common cause of death for people living with psychosis. Conservative estimates suggest that
at least 5% of people with psychotic spectrum disorders complete suicide, accounting for approximately 11% of suicides
worldwide or nearly 100,000 suicides each year. The absolute risk of suicide remains high even for people who are
engaged in specialty psychosis treatment, and interventions that have been designed specifically to prevent suicide in
people with psychosis have shown limited impact.
One important suicidogenic factor for people with psychosis is emotion dysregulation, which is the failure to regulate
emotion resulting in problematic emotional states. Emotion dysregulation is a core feature of psychotic disorders and
yet this factor is commonly neglected in treatments provided to this population. Research has shown that emotion
dysregulation is closely linked to suicide in people with psychosis and emotion regulation is a primary target of some of
the best-established and most effective psychosocial interventions for suicidality in other populations, most notably
Dialectical Behavior Therapy (DBT), but relevant clinical trials routinely exclude people with psychosis. The goal of this
K23 is to conduct a prepilot and pilot randomized controlled trial of group DBT skills training (DBT-ST), an intervention
that targets emotion regulation, in a sample of people with psychosis and heightened suicidality. This pilot study would
allow us to determine feasibility, acceptability, and obtain preliminary estimates of the impact of DBT-ST on key
outcomes.
A critical component of this work is the use of a rigorous methodology for measuring emotion dysregulation. Such
measurement has seen advances in recent years in the form of ecological momentary assessment (EMA) which
enables the direct statistical modeling of emotion dysregulation without reliance on retrospective self-report. To further
increase rigor and reproducibility, we propose to pair such ecological measurements with qualitative assessments of
participant experiences of EMA data collection to aid in the construction and interpretation of sophisticated statistical
models of emotion dysregulation in psychosis that account for non-random missingness as well as exogenous variables
that may confound measurement of the impact of DBT on emotion dysregulation. This mixed methods approach will
allow us to better assess how DBT-ST might improve emotion regulation in people with psychosis. The proposed study
will pave the way for a larger trial evaluating whether treatment of emotion dysregulation can decrease suicide risk in
psychosis.
The above research proposal will be carried out within the University of Maryland Division of Psychiatric Services
Research—an institution with a strong track record of successful clinical trials research with people with serious mental
illness—and will be paired with mentorship and training in the areas of (1) the conduct of experim...

## Key facts

- **NIH application ID:** 10915471
- **Project number:** 5K23MH125024-03
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** Peter Lee Phalen
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $174,622
- **Award type:** 5
- **Project period:** 2022-09-01 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10915471

## Citation

> US National Institutes of Health, RePORTER application 10915471, Targeting Emotion Dysregulation to Reduce Suicide in People with Psychosis (5K23MH125024-03). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10915471. Licensed CC0.

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