A new study has revealed that individuals with depression who attempt to suppress their emotional reactions to negative memories may have a higher risk of developing suicidal thoughts in response to daily stress. The research, published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, sheds light on how emotional regulation interacts with real-world stressors to affect suicide risk in depressed individuals.
The study aimed to understand how the ability to regulate emotions in response to negative memories could influence reactions to everyday stress, which is a known trigger for suicidal behavior. While previous research has shown that stressful life events often precede suicidal acts, it is challenging to study how stress contributes to acute suicidality in real-time.
Dr. Sarah Herzog, co-first author of the study and a researcher at the New York State Psychiatric Institute, explained, “Ecological momentary assessment allows us to observe how individuals with depression react to stress in their daily lives, including with increased suicidal thoughts and worsened mood. Our study took this a step further by linking a lab-based biological marker of risk to real-world responses, providing a more accurate way to predict suicide risk.”
Methodology: fMRI and Ecological Momentary Assessment
The study involved 82 participants with major depressive disorder. Two innovative methods were used to assess their emotional responses:
Functional MRI (fMRI)-based neural signature: This approach measured the participants’ engagement in emotion regulation while recalling personal negative memories. The goal was to see how individuals processed these memories and whether they actively tried to suppress their emotional reactions.
Ecological momentary assessment (EMA): EMA involves repeatedly measuring participants’ thoughts and emotions in real-time during daily life. This method provided insights into how participants responded to stressors over the course of a week, focusing on changes in mood and suicidal thoughts.
Key Findings
The results showed that individuals who reflexively engaged emotion regulation while recalling negative memories were more likely to experience an increase in suicidal thoughts when faced with daily stress. This suggests that while emotion regulation might be a helpful coping strategy in some contexts, it can backfire when applied automatically to stressors.
In contrast, when participants were instructed to use reappraisal—an adaptive emotion regulation strategy—they showed more positive responses to stress, with less emotional distress and fewer suicidal thoughts.
Dr. Cameron S. Carter, editor-in-chief of the journal, commented, “Flexibility in emotion regulation is typically a sign of psychological health. However, this study reveals that automatic engagement in emotion regulation during unexpected stressors may not always be beneficial. These findings, which combine functional imaging with real-world assessments, offer important insights into how to handle stress effectively.”
Future Implications
Dr. Noam Schneck, co-first author, emphasized the potential of neural decoding to identify mental processes, such as spontaneous emotion regulation, that were previously difficult to study. He added, “In future research, we can use this approach to better understand how spontaneous emotion regulation impacts mood and suicidal thoughts on a daily basis, helping to refine suicide risk assessments.”
The study was led by Dr. Barbara H. Stanley, a senior author who passed away in 2023. Dr. Stanley was instrumental in designing the study, and her contributions were crucial to its success. Her colleague, Dr. John Mann, reflected on her legacy, stating, “It was Dr. Stanley’s insight to combine ecological momentary assessment with the fMRI task. This unique combination of research methods led to these groundbreaking findings.”
Conclusion
This study offers important new insights into how emotion regulation strategies, particularly automatic responses to stress, can influence the risk of suicidality in depression. The use of both neuroimaging and real-world assessment techniques could help improve predictions of suicide risk and open the door to more effective interventions for those at risk.
Related topics:
- French Researchers Develop MassiveFold: A Faster, More Efficient Protein Structure Prediction Tool
- Study Investigates Genetic Factors Linked to Alzheimer’s Disease Using Cerebrospinal Fluid Proteins
- Researchers Aim To Create Noninvasive Tests For Chronic Fatigue Syndrome
