David Pagliaccio

@columbiapsych.bsky.social thanks to @almabitran.bsky.social @prof-nick-allen.bsky.social and others!!

critically, most teens reported ⬇️ stress with peers; teens with a suicide risk history showed smaller social buffering of stress vs. when alone
Though suicide attempts and hospitalizations were thankfully rare, they were more common for teens reporting ⬆️ stress in the 1st ESM week

We had a large group of teens complete ESM for 4x week periods (4-7x/day). Focusing on stress based on recent social context, teens with a history of suicide ideation and/or attempts, reported:
-Spending more time alone
-Worse/more stress

New work from @paulbloom.bsky.social and our team
@auerbachlab.bsky.social
Momentary stress and social context among adolescents at risk for #suicide: An experience sampling study 📳
doi.org/10.1016/j.ja...

@auerbachlab.bsky.social @columbiapsych.bsky.social @columbiauniversity.bsky.social #MedSky
#PsychSky

Suicide risk is worrying common among young kids ending up in the psych ED. Some critical risk factors are logged routinely in EHR but we identify other factors that could be more regularly tracked/assessed with checkboxes or flowsheets to enhance use as data and flag risk in EHR

Some may not expect in young kids, but we often see ⬆️ risk for STB among girls. LGBTQ+ disparities in risk also start this young. Increasingly, we see mention of social media or tech; parent revoking access to📱💻🎮 was a notable source of conflict precipitating attempts

1/5 of kids returned to our ED for STB, typically w/i 90 days. Despite the young age of this sample, this was similar to rates for teens. Girls were more likely to return as were kids on antidep. meds, with family stress, sleep concerns, and esp. with hx of prior hospitalization

We coded multiple domains of risk factors in EHR notes from treating & psych providers. Nearly all were more frequent in STB cases-including abuse, irritability, impulsivity, bullying, etc. Concerningly, 93% of cases that mentioned LGBTQ+ identity reported STB.

32 kids were brought to the ED following an attempt, mainly girls, mainly ingestion/overdose. Most had a prior history of suicide behavior before this event. 56% reported an interpersonal stress trigger, i.e. family conflict or bullying.

We identified 920 8-12yo children in our ED over a 3 year period presenting with behavioral health and/or suicide concerns. Suicide thoughts and behaviors (STB) were common in this population (65%) though thankfully acute suicide attempts were rare.

Our 2nd electronic health record (EHR) review on pre-teen suicide risk is out @JAACAPOpen. This is a deep dive into 920 cases from our emergency department (ED) at @nyphospital including extensive provider notes to understand risk in this population.
doi.org/10.1016/j.ja...

Thank to @auerbachlab.bsky.social, Jackie Kirshenbaum, & @epikerrykeyes.bsky.social

Unfortunately, many kids will end up back in the ER w/i a few months for additional care (similar to older teens). Early suicide thoughts or behaviors are the biggest risk factor in these data. More nuanced data can help us better understand risk and ways to help these families.

Overall, we see that many children seek mental health care in the ER and suicide risk is commonly observed even in young children. These rates are increasing over time. EHR are powerful but do likely underestimate the issue with potential undercoding in ICD diagnoses.

18% of kids had multiple mental health ER visits. 10% had multiple suicide-related visits. Mostly often returns were w/i 3 months of discharge. ER return w/i 1 year was most common for kids with suicide risk, more mental health diagnoses, without private insurance, and for girls.

Injury due to suicide behavior was present but not highly common–this was almost exclusively ingestion (overdose) or object (e.g., cutting) injuries. Suicide risk in the ER shows temporal patterns, most common during the day (vs. night) and school days (vs. weekends and summers).

Mental health and suicide risk are on the rise in the ER, accounting for 5% of all ER visits in 2010 to 10% in 2020. This also comes with an increase in patient related costs year over year $$.
Increasing % of suicide risk / all mental health visits by year x state.

Childhood Suicide Risk in the Emergency Department This cohort study examines electronic health records from children presenting to the emergency department (ED) for suicide thoughts and behaviors to identify risks of return ED visits.

Our new paper is out in ‪@jamanetworkopen.com‬now
jamanetwork.com/journals/jam...
We used the amazing HCUP dataset to analyze >600K electronic health records from 8-12-year-olds in the emergency room for mental health or suicide risk. This covered a decade of data from 12 states in the US.

Come work with us!

library(tidyverse)
library(tidytext)
library(readtext)
library(openxlsx)

nsf <- str_replace_all(readtext('NSF_keywords.docx')$text,"\n","|")
doc <- as_tibble(readtext("Grant.docx")$text)
df <- unnest_tokens(doc,"sentences",out,value)
df <- df %>% filter(str_detect(df$out,nsf))
df$replace <- str_match(df$out,nsf)
write.xlsx(df,"check.xlsx")

NSF keywords activism activists advocacy advocate advocates barrier barriers biased Biased toward biases Biases towards bipoc black and latinx community diversity community equity cultural differences cultural her...

If you are working on grants and want to identify any of the flagged NSF keywords without a ton of cntl+F, I wrote a very short R script here
docs.google.com/document/d/1...

Trump hits NIH with ‘devastating’ freezes on meetings, travel, communications, and hiring Researchers facing

What happened at NIH today www.science.org/content/arti...

All NIH study sections canceled indefinitely. This will halt science and devastate research budgets in universities.

"A study of federally funded research projects in the United States estimated that principal investigators spend on average about 45% of their time on administrative activities related to applying for and managing projects rather than conducting active research"

www.pnas.org/doi/10.1073/...

Who is going to be at @acnporg.bsky.social this year! #neuroskyence #psychology 🌈

Climate Survey - LGBTQIA+ in Neuroscience | Climate Survey - LGBTQIA+ in Neuroscience Climate Survey - LGBTQIA+ in Neuroscience

Reminder! We have a new Climate Survey for #LGBTQIA+ Academics in #Psychology and #Neuroskyence! This is a quick survey from @network_alba and will really help us out :)
tinyurl.com/LGBTNeuro #queerinstem

I created a feed for people who are interested in suicidology, or research on suicide, self harm, and related topics. It also tends to pick up other public reports, like newspaper articles, and job postings, which feels like more of a feature than a bug.

bsky.app/profile/did:...
#suicideresearch

After a couple weeks, I've added a few hundred of you to Brain and Mind by request. The list is really an awesome source of posts in neuroscience, cognitive neuroscience, and compneuro. Has basically replaced my home feed! bsky.app/profile/did:...