Christianne Esposito-Smyther Adjunct Assistant Professor of Behavioral and Social Sciences

Recent Publications

Esposito, C. & Clum, G.A. (2002). Social support and problem-solving as moderators of the relationship between childhood abuse and suicidality: Applications to a delinquent population. Journal of Traumatic Stress, 15, 137-146.

Esposito, C. & Clum, G.A. (2002). Psychiatric symptoms and their relation to suicidal ideation in a high risk adolescent community sample. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 44-51.

Esposito, C. & Clum, G. (2003). The relative importance of diagnostic and psychosocial factors in the prediction of adolescent suicidal ideation. Journal of Clinical Child and Adolescent Psychology, 32, 386-395.

Penn, J., Esposito, C., Shaeffer, L., Fritz, G., & Spirito, A. (2003). Suicide attempts and self-mutilative behavior in a juvenile correctional facility. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 762-769.

Esposito, C., Spirito, A., Boergers, J., & Donaldson, D. (2003). Affective, cognitive, and behavioral functioning in adolescents with multiple suicide attempts. Suicide and Life Threatening Behavior, 33, 389-399.

Esposito, C. & Spirito, A. (2003). Behavioral factors: Impulsive and aggressive behavior. In A. Spirito & J. Overholser (Eds.), Evaluating and Treating Adolescent Suicide Attempters: From Research to Practice. San Diego, CA: Academic Press.

Esposito, C., Johnson, B., Spirito, A., & Overholser, J. (2003). Cognitive factors: Hopelessness, coping, problem-solving, self-esteem. In A. Spirito & J. Overholser (Eds.), Evaluating and Treating Adolescent Suicide Attempters: From Research to Practice. San Diego, CA: Academic Press.

DiFillippo, J., Esposito, C., & Overholser, J. (2003). High risk populations. In A. Spirito & J. Overholser (Eds.), Evaluating and Treating Adolescent Suicide Attempters: From Research to Practice. San Diego, CA: Academic Press.

Esposito-Smythers, C., Jobes, D.A., Lester, D., & Spirito, A. (2004). A case study on adolescent suicide: Tim. Archives of Suicide Research, 8, 187-197.

Esposito-Smythers, C. & Spirito, A. (2004). Adolescent Suicidal Behavior and Substance Use: A Review With Implications for Treatment Research. Alcoholism: Clinical and Experimental Research, 28 (supplement), 77S-88S.

Colby, S.M., Lee, C.S., Lewis-Esquerre, J., Esposito-Smythers, C., & Monti, P. (2004). Adolescent alcohol misuse: Methodological issues for enhancing treatment research. Addiction, 99 (suppl. 2), 47-62.

Donaldson, D., Spirito, A., & Esposito-Smythers, C. (2005). Treatment For Adolescents Following a Suicide Attempt: Results of a Pilot Trial. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 113-120.

Spirito, A. & Esposito-Smythers, C. (2005). Cognitive behavioral therapy for adolescent suicidal behavior. In Kendall (ed.), Child and Adolescent Therapy: Cognitive-Behavioral Procedures, 3rd Edition. New York: Guildford Press.

Spirito, A. & Esposito-Smythers, C. (in press). Attempted and completed suicide in adolescence. (in press). In Nolen-Hoeksema (ed.), Annual Review of Clinical Psychology, Vol 2. Palo Alto, CA: Annual Review.

Esposito-Smythers, C., McClung, T., & Fairlie, A. (in press). Adolescent perceptions of a suicide prevention group on an inpatient Unit. Archives of Suicide Research.

Honors

Student Loan Repayment Recipient, NIAAA, 7/03-6/05
Student Loan Repayment Renewal, NIAAA, 7/05-6/07
Sharon Chauncy Fellowship Award (humanitarian award), Center for Alcohol & Addiction Studies at Brown University, 6/04

Research Projects

Young Investigator Award: Treatment of Youth Alcohol Abuse and Suicidality. American Foundation for Suicide Prevention. Principal Investigator. 7/1/03 – 6/30/05. The purpose of this grant is to pilot an integrated cognitive behavioral intervention for adolescents with co-occurring suicidality and substance use disorders in an open trial.

Psychopathology, Cognition, and Suicide in Adolescents. NIMH. Principal Investigator (MH065885). 1/1/04-12/31/06. The purpose of this grant is to test a cognitive mediational model to explain the relation between psychopathology and suicidality among adolescents.

Treatment of Youth Alcohol Abuse and Suicidality. NIAAA. Principal Investigator (AA014191). 4/15/04-10/31/07. The purpose of this grant is to compare an integrated cognitive behavioral treatment to enhanced standard care for adolescents with co-occurring suicidality and substance use disorder in a randomized clinical trial.

Research Areas

research overview

Christianne Esposito-Smythers primary research interests focus on cognitive behavioral interventions for adolescents with co-occurring mental health and substance use disorders. She is the principal investigator (PI) on a National Institute on Alcohol Abuse and Alcoholism (NIAAA)-funded clinical trial testing an integrated cognitive behavioral treatment for depressed suicidal substance abusing adolescents. She is also interested in cognitive assessment research with suicidal youth. She is also the PI on a National Institute of Mental Health (NIMH)-funded research grant that examines the relation between adolescent psychopathology, cognitive processes, and suicidality.

research statement

Christianne Esposito-Smythers is most interested in the development of integrated cognitive behavioral treatments for adolescents with co-occurring mental health and substance use disorders. She is currently the principal investigator for a treatment study funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The primary purpose of this study is to conduct a randomized Stage I trial to evaluate a manualized cognitive behavioral treatment protocol for adolescents with a substance use disorder and co-occurring suicidality. The long-term objective is to yield a more effective and feasible outpatient treatment approach for adolescents with these co-occurring conditions. There are three primary aims in this project: 1) pilot and refine the manualized cognitive behavioral treatment protocol; 2) test this intervention in a small randomized Stage I clinical trial to calculate an effect size for a future Stage II trial; and 3) demonstrate feasibility and acceptability of this intervention relative to treatment-as-usual. Forty adolescents will be randomly assigned to the integrated cognitive behavioral treatment provided by project staff or treatment-as-usual delivered by therapists in the community. Outcome is assessed mid-treatment, end of treatment, and 6 months post-treatment. The proposed treatment is designed to address objectives18-10 and 18-2 of Healthy People 2010 to "increase the proportion of persons with co-occurring substance abuse and mental disorders who receive treatment of both disorders" and "reduce the rate of suicide attempts by adolescents."

Christianne Esposito-Smythers is also interested in examining clinical disorders and cognitive processes associated with the development of adolescent suicidal ideation and behavior. She is currently the principal investigator on a study funded by the National Institute of Mental Health (NIMH). The purpose of this three-year application is to test a cognitive mediational model to explain the relationship between clinical disorders (mood, anxiety, disruptive behavior disorders) and suicidality. Specifically, this study will examine whether psychopathology is related to suicidality through unique dysfunctional cognitive processes and products linked with various clinical disorders in adolescents. The proposed study will also explore the manner in which comorbid forms of psychopathology affect dysfunctional cognitive processes/products and suicidality in adolescents. The manner in which gender affects these relationships will also be examined. The proposed study will employ a cross-sectional design to test hypotheses. Two hundred psychiatrically hospitalized adolescents will complete a diagnostic interview and symptom inventories to assess psychopathology, as well as performance based measures and questionnaires to assess dysfunctional cognitive processes, cognitive products, and suicidality. Structural equation modeling (SEM) will be used to analyze the data. Information obtained from this study will help explicate cognitive patterns in suicidal adolescents with varying forms of psychopathology and could ultimately be used to tailor cognitive-behavioral and multimode interventions for these high-risk youth.

funded research

Linking Childhood Abuse to Suicidal Behavior: An Examination of the Mediating Variables
Graduate Student Association, Virginia Tech
Total Costs: $300
Date of grant: completed 10/97
Role: Principal Investigator

An Examination of the Relative Contribution of Diagnostic and Psychosocial Factors in the Prediction of Adolescent Suicidal Ideation
Graduate Student Association, Virginia Tech
Total Costs: $500
Date of grant: completed 4/00
Role: Principal Investigator

Young Investigator Award: Treatment of Youth Alcohol Abuse and Suicidality
American Foundation for Suicide Prevention
Total Costs: $69,693
Dates of grant: 7/03 – 6/05
Role: Principal Investigator

Psychopathology, Cognition, and Suicide in Adolescents
R01 MH065885-01
National Institute on Mental Health (NIMH)
Total Costs: $538,598
Dates of grant: 1/1/04-12/31/06
Role: Principal Investigator

Treatment of Youth Alcohol Abuse and Suicidality
R01 AA014191-01
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Total Costs: $1,179,494
Dates of grant: 4/15/04-10/31/07
Role: Principal Investigator

An Affect-Management Intervention for Juvenile Offenders
R21 DA019245 (Brown PI)
National Institute on Drug Abuse (NIDA)
Dates of grant: 10/1/04-8/31/06
Total Costs: $410,575
Role: Consultant

Relapse Prevention for Suicidal Dually Diagnosed Youths
R34MH067904 (Goldston PI)
NIMH
Dates of grant: 7/19/05-5/31/08
Role: Consultant