Steven Sust

All Publications

• Intentional self-harm mortality among 15-24 year olds in Asian American subgroups, 2005-2022: a population-based incidence study. Lancet regional health. Americas Uy, L. A., Chang, E., Desai, S., Villarreal Rodriguez, M. E., Hung, G. A., Kikuta, N., Jamal, A., Bacong, A. M., Huang, R. J., Kim, G. S., Palaniappan, L. P., Srinivasan, M., Rajeshuni, N., Sust, S. 2026; 59: 101484

  Abstract

  Among U.S. youth aged 15-24 years, suicide is the leading cause of death for Asian American youth, yet surveillance data are rarely disaggregated by racial subgroup. We examined whether suicide mortality differs across six Asian American subgroups.We analyzed National Center for Health Statistics mortality data for 2005 through 2022, linked with American Community Survey population denominators. Deaths from intentional self-harm (ICD-10 codes X60-X84, Y87.0) were identified among Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese youth, with non-Hispanic White and Asian Youth as comparison groups. We calculated annualized mortality rates (AMR), rate ratios (RR), proportional mortality, proportional mortality ratios, crude mortality rate (CMR) trends, and annual percentage changes (APC) using Joinpoint regression with heteroscedastic error models.Between 2005 and 2022, 2519 Asian American youth died by intentional self-harm. The AMR for Asian Youth was 8.37 per 100,000 (95% CI, 8.04-8.69), compared with 14.34 (14.23-14.46) for non-Hispanic White youth. Korean youth had the highest AMR (9.92; 8.87-10.97) and mortality (33.8%; 30.9-36.7); Chinese youth had the lowest AMR (6.38; 5.87-6.90). Among Asian Youth, Korean (RR, 1.19; 1.06-1.33), Vietnamese (1.14; 1.03-1.27), and Filipino (1.13; 1.03-1.24) youth had significantly elevated mortality. Four subgroups showed sustained CMR increases (APC, 4.9-9.1%), while Asian Indian youth rose significantly before declining. These trends contrast with a post-2018 decline among non-Hispanic White youth. State-level analysis demonstrated substantial inter-subgroup heterogeneity.Disaggregation reveals clinically meaningful variation in mortality that aggregated surveillance conceals. Race-specific, culturally grounded prevention strategies are needed, particularly for Korean, Vietnamese, and Filipino youth who bear a disproportionate and growing burden.This study received no external funding. The Stanford Center for Asian Health Research and Education provided institutional support; the Chi-Li Pao Foundation USA supported conference dissemination.

  View details for DOI 10.1016/j.lana.2026.101484

  View details for PubMedID 42099552

  View details for PubMedCentralID PMC13146612

• Evaluating the impact of integrated care clinics on Asian American populations' mental health. Frontiers in medicine Wong, S., Wan, C., Sust, S. 2026; 13: 1686739

  Abstract

  There has been a persistent underutilization of mental health (MH) services among Asian Americans. Many researchers have attempted to explore possible etiologies and to find more effective solutions for the considerable ethnic disparities in MH. Several studies have found that integrated psychiatry and community health primary care increases treatment engagement and access to specialty MH services for low-income Asian Americans. As a result, integrated care models may serve as a crucial preventative model for proper MH care within this population. By evaluating the data from a primary care clinic, Northeast Medical Services (NEMS), which utilizes the integrated care model to serve a predominantly Asian American population, we hope to determine the impact interprofessional collaboration between primary care physicians and psychiatrists has on patients' MH outcomes. Consequently, this helps inform our understanding of help-seeking pathways that could serve Asian American immigrants in the United States.

  View details for DOI 10.3389/fmed.2026.1686739

  View details for PubMedID 42254392

  View details for PubMedCentralID PMC13233236

• ACCULTURATION AND MENTAL HEALTH CHALLENGES IN ASIAN AMERICAN YOUTH Ahn, S., Valencia, F. M., Wang, K., Gowrikanthan, T., Choi, J., Uy, L., Huang, R., Kim, G., Palaniappan, L., Rajeshuni, N., Srinivasan, M., Sust, S. ELSEVIER SCIENCE INC. 2025

  View details for DOI 10.1016/j.jaac.2025.08.034

  View details for Web of Science ID 001642068800141

• COMPETING WITH TIKTOK: CULTIVATING POSITIVE COMMUNITIES FOR YOUTH IN THIS INCREASINGLY DIGITAL WORLD Li, E. Y., Yuen, E. Y., Sust, S., Sharma, N. ELSEVIER SCIENCE INC. 2025

  View details for DOI 10.1016/j.jaac.2025.07.554

  View details for Web of Science ID 001603117800155

• Kotaro Lives Alone JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Li, E. Y., Xu, J. A., Ky, C., Ngo, M., Reyes, M. P., Sust, S. 2025; 64 (4): 521-522

  View details for DOI 10.1016/j.jaac.2025.01.013

  View details for Web of Science ID 001459921600001

• INTENTIONAL SELF-HARM MORTALITY AMONG 15-TO 24-YEAR-OLDS IN ASIAN AMERICAN SUBGROUPS, 2011-2020 Uy, L., Chang, E., Desai, S., Hung, G., Kikuta, N. T., Jamal, A., Bacong, A., Villarreal, M., Huang, R., Kim, G., Palaniappan, L., Srinivasan, M., Sust, S. ELSEVIER SCIENCE INC. 2024: S309-S310

  View details for DOI 10.1016/j.jaac.2024.08.497

  View details for Web of Science ID 001330511902343

• Asian American Adolescent Help-Seeking Pathways for Psychological Distress ASIAN AMERICAN JOURNAL OF PSYCHOLOGY Chiang, S., Chin, C. A., Meyer, E. W., Sust, S., Chu, J. 2021

  View details for DOI 10.1037/aap0000241

  View details for Web of Science ID 000733195900001

• The Farewell (Book Review) JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Book Review Authored by: Thai, J., Sust, S., Kwok, M. 2021; 60 (4): 524–27

  View details for DOI 10.1016/j.jaac.2021.02.010

  View details for Web of Science ID 000634629400018

• BEST PRACTICES OF POSTVENTION IN ACTION Sust, S. ELSEVIER SCIENCE INC. 2020: S52

  View details for DOI 10.1016/j.jaac.2020.07.221

  View details for Web of Science ID 000579844100168

• BEST PRACTICES OF POSTVENTION IN ACTION Sust, S. ELSEVIER SCIENCE INC. 2019: S46

  View details for DOI 10.1016/j.jaac.2019.07.343

  View details for Web of Science ID 000518857300159

• PARENT TRAINING: THEATRICAL VIGNETTES AS AN EDUCATIONAL TOOL TO IMPROVE COMMUNICATION IN IMMIGRANT FAMILIES Sust, S., Hu, R., Lee, J. ELSEVIER SCIENCE INC. 2019: S374

  View details for DOI 10.1016/j.jaac.2019.07.298

  View details for Web of Science ID 000518857303165

• Integrated Care Assessing and Treating Youth Exposed to Traumatic Stress Grunwald, D., Sust, S. 2019: 429–442
• Integrated Models ASSESSING AND TREATING YOUTH EXPOSED TO TRAUMATIC STRESS Grunwald, D. S., Sust, S. edited by Carrion, V. G. 2019: 429–42

  View details for Web of Science ID 000549804100022

• Suicide Among East Asian Youth Suicide Among Diverse Youth Sust, S., Hecht, L., Yu, Z. Springer, Cham. 2017

  View details for DOI 10.1007/978-3-319-66203-9_8

• Multiple Drug Treatments That Increase cAMP Signaling Restore Long-Term Memory and Aberrant Signaling in Fragile X Syndrome Models FRONTIERS IN BEHAVIORAL NEUROSCIENCE Choi, C. H., Schoenfeld, B. P., Bell, A. J., Hinchey, J., Rosenfelt, C., Gertner, M. J., Campbell, S. R., Emerson, D., Hinchey, P., Kollaros, M., Ferrick, N. J., Chambers, D. B., Langer, S., Sust, S., Malik, A., Terlizzi, A. M., Liebelt, D. A., Ferreiro, D., Sharma, A., Koenigsberg, E., Choi, R. J., Louneva, N., Arnold, S. E., Featherstone, R. E., Siegel, S. J., Zukin, R., McDonald, T. V., Bolduc, F. V., Jongens, T. A., McBride, S. M. J. 2016; 10: 136

  Abstract

  Fragile X is the most common monogenic disorder associated with intellectual disability (ID) and autism spectrum disorders (ASD). Additionally, many patients are afflicted with executive dysfunction, ADHD, seizure disorder and sleep disturbances. Fragile X is caused by loss of FMRP expression, which is encoded by the FMR1 gene. Both the fly and mouse models of fragile X are also based on having no functional protein expression of their respective FMR1 homologs. The fly model displays well defined cognitive impairments and structural brain defects and the mouse model, although having subtle behavioral defects, has robust electrophysiological phenotypes and provides a tool to do extensive biochemical analysis of select brain regions. Decreased cAMP signaling has been observed in samples from the fly and mouse models of fragile X as well as in samples derived from human patients. Indeed, we have previously demonstrated that strategies that increase cAMP signaling can rescue short term memory in the fly model and restore DHPG induced mGluR mediated long term depression (LTD) in the hippocampus to proper levels in the mouse model (McBride et al., 2005; Choi et al., 2011, 2015). Here, we demonstrate that the same three strategies used previously with the potential to be used clinically, lithium treatment, PDE-4 inhibitor treatment or mGluR antagonist treatment can rescue long term memory in the fly model and alter the cAMP signaling pathway in the hippocampus of the mouse model.

  View details for DOI 10.3389/fnbeh.2016.00136

  View details for Web of Science ID 000378896600001

  View details for PubMedID 27445731

  View details for PubMedCentralID PMC4928101

• FMRI evidence for functional epistasis between COMT and RGS4 MOLECULAR PSYCHIATRY Buckholtz, J. W., Sust, S., Tan, H. Y., Mattay, V. S., Straub, R. E., Meyer-Lindenberg, A., Weinberger, D. R., Callicott, J. H. 2007; 12 (10): 893-895

  View details for DOI 10.1038/sj.mp.4002008

  View details for Web of Science ID 000249920500003

  View details for PubMedID 17895922

• Epistasis between catechol-O-methyltransferase and type II metabotropic glutamate receptor 3 genes on working memory brain function. Proceedings of the National Academy of Sciences of the United States of America Tan, H. Y., Chen, Q., Sust, S., Buckholtz, J. W., Meyers, J. D., Egan, M. F., Mattay, V. S., Meyer-Lindenberg, A., Weinberger, D. R., Callicott, J. H. 2007; 104 (30): 12536-41

  Abstract

  Dopaminergic and glutamatergic systems are critical components responsible for prefrontal signal-to-noise tuning in working memory. Recent functional MRI (fMRI) studies of genetic variation in these systems in catechol-O-methyltransferase (COMT) and in metabotropic glutamate receptor mgluR3 (GRM3), respectively, suggest that these genes influence prefrontal physiological signal-to-noise in humans. Here, using fMRI, we extend these individual gene findings to examine the combined effects of COMT and GRM3 on dissociable components of the frontoparietal working memory network. We observed an apparent epistatic interaction of these two genes on the engagement of prefrontal cortex during working memory. Specifically, the GRM3 genotype putatively associated with suboptimal glutamatergic signaling was significantly associated with inefficient prefrontal engagement and altered prefrontal-parietal coupling on the background of COMT Val-homozygous genotype. Conversely, COMT Met-homozygous background mediated against the effect of GRM3 genotype. These findings extend putative brain dopaminergic and glutamatergic relationships indexed by COMT and GRM3 to a systems-level interaction in human cortical circuits implicated in working memory dysfunction such as in schizophrenia.

  View details for DOI 10.1073/pnas.0610125104

  View details for PubMedID 17636131

  View details for PubMedCentralID PMC1920538

• Allelic variation in RGS4 impacts functional and structural connectivity in the human brain. The Journal of neuroscience : the official journal of the Society for Neuroscience Buckholtz, J. W., Meyer-Lindenberg, A., Honea, R. A., Straub, R. E., Pezawas, L., Egan, M. F., Vakkalanka, R., Kolachana, B., Verchinski, B. A., Sust, S., Mattay, V. S., Weinberger, D. R., Callicott, J. H. 2007; 27 (7): 1584-93

  Abstract

  Regulator of G-protein signaling 4 (RGS4) modulates postsynaptic signal transduction by affecting the kinetics of G alpha-GTP binding. Linkage, association, and postmortem studies have implicated the gene encoding RGS4 (RGS4) as a schizophrenia susceptibility factor. Using a multimodal neuroimaging approach, we demonstrate that genetic variation in RGS4 is associated with functional activation and connectivity during working memory in the absence of overt behavioral differences, with regional gray and white matter volume and with gray matter structural connectivity in healthy human subjects. Specifically, variation at one RGS4 single nucleotide polymorphism that has been associated previously with psychosis (rs951436) impacts frontoparietal and frontotemporal blood oxygenation level-dependent response and network coupling during working memory and results in regionally specific reductions in gray and white matter structural volume in individuals carrying the A allele. These findings suggest mechanisms in brain for the association of RGS4 with risk for psychiatric illness.

  View details for DOI 10.1523/JNEUROSCI.5112-06.2007

  View details for PubMedID 17301167

  View details for PubMedCentralID PMC6673752

• Dysfunctional prefrontal regional specialization and compensation in schizophrenia. The American journal of psychiatry Tan, H. Y., Sust, S., Buckholtz, J. W., Mattay, V. S., Meyer-Lindenberg, A., Egan, M. F., Weinberger, D. R., Callicott, J. H. 2006; 163 (11): 1969-77

  Abstract

  It has been suggested that in healthy persons higher-order cognitive processing engaged by incremental working memory load hierarchically employs more dorsal than ventral prefrontal resources in healthy individuals. Given that working memory performance is impaired in schizophrenia, especially at higher executive loads, the authors investigated how this prefrontal functional organization might be altered in disease, independent of performance deficits.Using N-back working memory functional magnetic resonance imaging (fMRI) data, the authors studied 15 patients with schizophrenia and 26 healthy comparison subjects. Subgroups based on median performance accuracy at 2-back were analyzed; high performers included eight schizophrenia patients and 14 comparison subjects, and low performers included seven patients and 12 comparison subjects.High-performing but not low-performing comparison subjects responded to incremental working memory executive load with disproportionately greater dorsal but not ventral prefrontal cortex activation, which also predicted performance accuracy. In the high- and low-performing patient groups, incremental working memory load caused a disproportionate increase in ventral but not dorsal prefrontal cortex activation relative to the respective comparison group, which also correlated with accuracy. Functional connectivity between the ventral prefrontal cortex and posterior parietal cortex was relatively greater in patients, whereas comparison subjects had greater functional connectivity between the dorsal prefrontal cortex and posterior parietal cortex.The hierarchical organization of the prefrontal cortex may be compromised in schizophrenia, resulting in loss of functional specialization and integration at the dorsal prefrontal cortex and in compensatory activation from the ventral prefrontal cortex, which may ultimately affect working memory and executive cognition.

  View details for DOI 10.1176/ajp.2006.163.11.1969

  View details for PubMedID 17074949