Duke Center for the Study of Suicide Prevention and Intervention (CSSPI)


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About the Duke Center for the Study of Suicide Prevention and Intervention (CSSPI)

The Duke Center for the Study of Suicide Prevention and Intervention (CSSPI) represents a collaborative effort among several research scientists at the Duke Child and Family Study Center to advance the knowledge base on suicide risk and prevention using innovative, multidisciplinary, and scientifically-sound research studies. The CSSPI partners with local, state, and national community organizations and foundations, as well as academic institutions. Specifically, the CSSPI maintains active collaborations with several groups, including:

  • Southeastern Center for Study and Prevention of Suicidal Behaviors (SCSPS)
  • Family Diversity Research and Service Initiative (FDRSI)
  • Center for Diverse Family Studies (CDFS)

The CSSPI has three key missions related to (1) research, (2) intervention, and (3) education.


The faculty members of the CSSPI have conducted research focused on understanding the emergence and maintenance of adolescent suicidal and self-harming behaviors, and on the prevention and treatment of suicidal behaviors. Studies have examined the course and risk for suicidal behavior from adolescence through young adulthood, the emotional and behavioral outcomes of high-risk youths, and the impact of adolescent suicidal behavior on parents’ well-being and involvement in youths’ treatment. Studies also have focused on the development and evaluation of a new intervention (Cognitive Behavioral Therapy – Relapse Prevention or CBT-RP) for suicidal young people with depression and alcohol-/substance abuse disorders, the evaluation of national suicide prevention efforts funded through the Garrett Lee Smith Memorial Suicide Prevention Act, and the evaluation of a new intensive cognitive behavioral intervention (Post Admission Cognitive Therapy or PACT) aimed at preventing the recurrence of suicidal behaviors among individuals in the military.

Ongoing Studies and Collaborative Research and Evaluation Efforts

  • Impact of Adolescent Suicide Attempts on Parents (NIMH R01-MH081947) - The study is designed to help us learn more about the impact of adolescent suicidal behavior and psychiatric hospitalization on families, and the needs of families working with suicidal youths. In this study, mothers of 144 teenagers who have hospitalized for suicide attempts and mothers of 144 teenagers who have been hospitalized for other reasons are participating in assessments at 1, 3, 6, and 12 months after hospital discharge. We specifically are interested in the treatment and support needs for mothers, the differences among mothers in their reactions to suicidal behavior, factors related to differences among families in how they cope with adolescent difficulties, and how differences among families are related to treatment participation and parenting after hospitalization. In two supplements to this study from NIMH, we are examining racial and ethnic differences among mothers in the impact of suicidal behavior, and we are examining impact of suicidal behavior on fathers.
  • Post Admission Cognitive Therapy (PACT) for Treatment of Military Personnel with Suicidal Behaviors: A Multi-Site Randomized Trial. (DOD Contract W81XWH-11-2-0106) - This study is a randomized controlled trial of an augmenting intensive cognitive behavioral intervention and follow-up care for military personnel who have been hospitalized following suicide attempts. Via subcontract from the Henry Jackson Foundation, Duke University is collaborating in the development of this study and will provide follow-up assessments for military personnel participating in this study
  • The Garrett Lee Smith Memorial Suicide Prevention Cross-Site Evaluation (SAMHSA/CMHS Contract 280-03-1606) - Via a contract from SAMHSA to Macro International, a cross-site evaluation is being conducted of the state, tribal, and campus suicide prevention programs funded via the Garrett Lee Smith Memorial Act. Duke University is participating in this project via subcontract from Macro International as part of the cross-site evaluation team. A recent contribution by Duke University is preparation of a white paper regarding policies and protocols for youths at risk for suicide, and youths who have attempted suicide that are identified through suicide prevention programs or present in emergency settings.

Past Studies

  • A Longitudinal Study of Suicide Attempts in Adolescents (NIMH R01-MH48762) - This is a prospective (20 year), naturalistic, repeated assessment study of risk for suicidal thoughts and behavior, and psychological adjustment over time among adolescents who have been psychiatrically hospitalized followed through young adulthood.
  • Relapse Prevention for Suicidal Dually Diagnosed Youths (NIMH R34-MH67904) - An augmenting motivational interviewing and cognitive behavioral relapse prevention intervention (CBT-RP) for suicidal, depressed, and alcohol or substance abusing/dependent adolescents was developed, refined, and compared to treatment as usual in a pilot randomized controlled trial. There was preliminary evidence that youths receiving CBT-RP as an augmenting intervention had larger improvements in depressive symptoms and suicide ideation, and were less likely to need intensive intervention (e.g., hospitalization, day treatment, intensive outpatient care, residential treatment) relative to youths without the intervention.


The CSSPI faculty members provide clinical services through the Duke Child and Family Study Center. Services are available for children, adolescents, adults, and families seeking evidence-based assessment, diagnosis, and treatment services for a range of psychological or adjustment difficulties, including suicide-related thoughts and behaviors and self-harm. Treatment is provided in individual therapy and group therapy formats. For more information, please contact the Referral Coordinator at 919-668-0397.


The CSSPI is involved in the provision of training opportunities for individuals interested in suicide- or self-harm-related research. Mentored research experiences are available for graduate students, postdoctoral fellows, and junior faculty. Opportunities also are available for clinical training in the assessment and treatment of suicide-related thoughts and behaviors. In terms of community-based education, the CSSPI maintains an active collaboration with a North Carolina-based group interested in suicide prevention (the Triangle Consortium for Suicide Prevention), as well as the American Foundation for Suicide Prevention.


American Foundation for Suicide Prevention
American Association of Suicidology
Depression and Bipolar Support Alliance
National Action Alliance for Suicide Prevention
National Institute of Mental Health
Substance Abuse and Mental Health Services Administration (SAMHSA)
Suicide Prevention Resource Center

The Jed Foundation
The Trevor Project
Triangle Consortium for Suicide Prevention
The National Suicide Prevention Lifeline - 1-800-273-TALK (8255) is a free, 24-hour hotline available to anyone in suicidal crisis or emotional distress.

Selected Recent Publications

Esposito-Smythers, C., Miller, A., Weismoore, J., Doyle, O., & Goldston, D. B. (in press). Suicide. In R. Brown & M. Prinstein (eds.), Encyclopedia of Adolescence, New York: Elsevier.

Goldston, D. B., Weller, B, & Doyle, O. (in press). Suicide. In G. Nagayama-Hall, L. Comas-Diaz, V. McLloyd & J. Trimble. APA Handbook of Multicultural Psychology. Washington, DC: American Psychological Association Press.
Daniel, S. S., & Goldston, D. B. (2012). Hopelessness and lack of connectedness to others as risk factors for suicidal behavior across the lifespan: Implications for cognitive-behavioral treatment. Cognitive and Behavioral Practice, 19(2), 288-300.

Esposito-Smythers, C., Walsh, A., Spirito, A., Rizzo, Christie; Goldston, David, B., & Kaminer, Y. (2012). Working with the suicidal client who also abuses substances. Cognitive and Behavioral Practice, 19(2), 245-255.

Wells, K. C., & Heilbron, N. (2012). Family-based cognitive-behavioral treatments for suicidal adolescents and their integration with individual treatment. Cognitive and Behavioral Practice, 19(2), 301-314.

Pisani, A., Schmeelk-Cone, K., Gunzler, D., Petrova, M., Goldston, D. B., Tu, X., & Wyman, P. A. (2012). Associations between suicidal high school students’ help-seeking and their attitudes and perceptions of social environment. Journal of Youth and Adolescence.

Sapyta, J., Goldston, D. B., Erkanli, A., Daniel, S. S., Heilbron, N., Mayfield, A., & Treadway, S. L. (2012). Evaluating the predictive validity of suicidal intent and medical lethality in youth. Journal of Consulting and Clinical Psychology, 80(2), 222-231.

Goldston, D. B., Curry, J. F., Wells, K. C., & Roley, M. (2011). Assessment and treatment of suicidal behavior. In Y. Kaminer and C. Winters (Eds.), Clinical manual of adolescent substance abuse treatment. Arlington, VA: American Psychiatric Publishing, Inc., 349-377.

van Tilburg, M.A.,Spence, L., Naomi J., Whitehead, W.E., Bangdiwala, S., & Goldston, D. B. (2011). Chronic pain in adolescents is associated with suicidal thoughts and behaviors. The Journal of Pain, 12(10), 1032-1039.

Weller, B., & Goldston, D. B. (2011). Suicidal thoughts and behavior and non-adherence to medical regimen.. In A. Berman and M. Pompili (Eds.), Medical condition and suicide risk. Washington, DC: American Association of Suicidology.

Dew, R., Daniel, S. S., Goldston, D. B., McCall, W. V., Kuchibhatia, M., Schieffer, C., Triplett, M., & Koenig, H. (2010). A prospective study of religion/spirituality and depressive symptoms among adolescent psychiatric patients. Journal of Affective Disorders, 120,149-157.

Franklin, J. C., Hessel, E. T., Aaron, R. V., Arthur, M. S., Heilbron, N., & Prinstein, M. J. (2010). The functions of nonsuicidal self-injury: Support for cognitive–affective regulation and opponent processes from a novel psychophysiological paradigm. Journal of Abnormal Psychology, 119(4), 850-862.

Goldston, D. B., Walrath, C. M., McKeon, R., Puddy, R. W., Lubell, K. M., Potter, L. B., & Rodi, M. S. (2010). The Garrett Lee Smith memorial suicide prevention programs. Suicide and Life-Threatening Behavior, 40(3), 245-256.

Heilbron, N., Compton, J. S., Daniel, S. S., & Goldston, D. B. (2010). The problematic label of suicide gesture: Alternatives for clinical research and practice. Professional Psychology: Research and Practice, 41(3), 221-227.

Heilbron, N., & Prinstein, M. J. (2010). Adolescent peer victimization, peer status, suicidal ideation, and nonsuicidal self-injury. Merrill-Palmer Quarterly: Journal of Developmental Psychology, 56(3), 388-419.

Prinstein, M. J., Heilbron, N., Guerry, J. D., Franklin, J. C., Rancourt, D., Simon, V., & Spirito, A. (2010). Peer influence and nonsuicidal self injury: Longitudinal results in community and clinically-referred adolescent samples. Journal of Abnormal Child Psychology, 38(5), 669-682.

Wilson, M. P., Castillo, E. M., Batey, A. M., Sapyta, J., & Aronson, S. (2010). Hepatitis C and depressive symptoms: Psychological and social factors matter more than liver injury. International Journal of Psychiatry in Medicine, 40(2), 199-215.

Barksdale, C., Walrath, C., Compton, J. S., & Goldston, D. B. (2009). Caregiver burden and suicide attempts: Are they related? Suicide and Life Threatening Behavior, 39,152-160.

Daniel, S., & Goldston, D. (2009). Interventions for suicidal youths: A review of the literature and developmental considerations. Suicide and Life Threatening Behavior, 39, 252-268.

Daniel, S., Goldston, D., Erkanli, A., Franklin, J., & Mayfield, A. (2009). Trait anger, anger expression, and suicide attempts among adolescents and young adults: A prospective study. Journal of Clinical Child and Adolescent Psychology, 38, 661-671.

Goldston, D. B., Daniel, S. S., Erkanli, A., Reboussin, B. A., Mayfield, A., Frazier, P., & Treadway, S. L. (2009). Psychiatric disorders as contemporaneous risk factors for suicide attempts among adolescents and young adults: Developmental changes. Journal of Consulting and Clinical Psychology, 77, 281-290.