(PS9-33) Smiling: Exploring a Behavioral Marker of Positive Affect while Suicidal Individuals Imagine their Future

Abstract Text: Typically, people tend to feel optimistic about the future. Studies with nonpsychiatric samples show that people smile more when discussing their future than their past. However, it is less understood how individuals who have a weaker desire to live feel about their future. Prior research shows that future thinking abilities differ in suicidal and non-suicidal youth, yet non-verbal behaviors related to future thinking in suicidal individuals remain underexplored. Facial affect (i.e., micro-expressions of facial muscles) can provide insight into emotional reactions, and prior research shows that suicidal individuals tend to exhibit a decrease in facial expressivity and fewer genuine smiles. This study tested two hypotheses: 1) suicidal young adults will show fewer genuine smiles while thinking about their future, and 2) the frequency of genuine smiles while thinking about the future will predict subsequent suicidal behavior over the next three months. This secondary analysis involved 67 participants ages 18 to 24 years (M=21.32, SD=2.09) who predominantly identified as female (59.7%) and white (49.3%). Participants were divided into two groups based on the presence of suicidal behavior in the past year (n=33) or no lifetime history of suicidal thoughts or behaviors (n=34), as assessed with the Columbia-Suicide Severity Rating Scale (C-SSRS). Participants were recorded during an interview answering the future thinking prompt: “Describe a realistic event that could happen in the next 5 years.” Videos were analyzed using the machine learning based tool PyAFAR, which uses the Facial Action Coding System (FACS) to obtain the occurrence percentage of ‘Duchenne’ smiles (i.e., genuine smiles, expressed by facial action units 6+12) shown by each participant. Individuals with past suicidal behaviors also completed a 3-month follow-up survey using C-SSRS to assess future suicidal behavior (n=8). A Mann-Whitney U test was performed to address each aim. Suicidal individuals (M=29.26) showed significant blunted positive emotional expression while imagining their future compared to non-suicidal individuals (M=38.88), U=400.00, z=-2.019, p=.043. However, there was no significant difference in smile occurrence among the suicidal individuals who reported subsequent suicidal behavior (M=14.00) versus those who did not (M=16.05), U=76.00 z=-.563, p=.574. While reduced positive facial expressions may correspond with concurrent suicidality, they did not predict future suicidal behaviors within this timeframe. These findings introduce the facial affect as a potential behavioral indicator of emotional experience in suicidal individuals to be further explored via future multimodal research.