Neurocognitive characteristics of short-term risk for suicidal behavior in adolescents

青少年自杀行为短期风险的神经认知特征

• 批准号: 10228105
• 负责人: Richard T Liu
• 金额: $ 67.13万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-07 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10228105
• 关键词: Acute; Address; Adolescent; Adult; Assessment tool; Behavior; Biological Markers; Cause of Death; Characteristics; Child; Clinical; Cognition; Cognitive; Complement; Complex; Data; Detection; Development; Diffusion; Event; Executive Dysfunction; Future; Goals; Hospitalization; Hospitals; Impaired cognition; Impulsivity; Individual; Inpatients; Intervention; Knowledge; Length; Link; Longitudinal Studies; Measures; Modeling; National Institute of Mental Health; Neurocognitive; Patient Self-Report; Patients; Population; Positioning Attribute; Process; Prospective Studies; Psychiatry; Public Health; Research; Research Priority; Risk; Risk Assessment; Risk Behaviors; Risk Factors; Risk Marker; Sampling; Self-Injurious Behavior; Short-Term Memory; Statistical Methods; Suicide; Suicide attempt; Suicide prevention; Time; Visit; Work; adolescent suicide; base; candidate marker; clinical application; clinically significant; cognitive process; executive function; flexibility; follow-up; high risk; high-risk adolescents; improved; indexing; information processing; innovation; neural circuit; neuropsychiatry; novel; predictive modeling; prospective; recruit; response; suicidal; suicidal adolescent; suicidal behavior; suicidal risk; suicide rate; trait

Abstract Suicide is the second leading cause of death among adolescents. In fact, the national suicide rate has increased 24% over the last 15 years, and hospital visits for child and adolescent suicidality have doubled in the last 10 years. Although considerable research has been devoted to identifying risk factors for suicidal behavior, the research to date has focused on long-term risk, with average follow-up intervals of 10 years. Indeed, there are currently no studies of short-term risk for this behavior in adolescents. Addressing this gap in suicide research is important because long-term risk factors are poor predictors of short-term risk. Therefore, clarifying processes relevant to short-term risk for suicidal behavior is important for advancing our knowledge from who is at risk to when they are most at risk. Neurocognitive function has been identified as having particular potential as indicators of short-term risk. Although core components of neurocognitive function have been associated with suicidality, short-term longitudinal studies of adolescent suicide attempts, are notably lacking. Additionally, although traditional statistical methods have been used to model these neurocognitive processes, recent developments in computational psychiatry involving cognitive process models may more realistically reflect these processes. Furthermore, computational psychiatry allows for simultaneous consideration of multiple variables in a manner that produces a complex prediction model that is often substantially superior to those derived from traditional statistical approaches. Our long-term goal is to improve detection of short-term risk and to identify potential modifiable targets for clinical intervention. Toward this end, the objective of the current application is to evaluate candidate neurocognitive markers of short-term risk for suicide attempts and suicidal events (i.e., over one-month follow-up) in a sample of adolescent psychiatric inpatients, supplementing traditional statistical methods with novel advances in computational psychiatry. Importantly, the primary reason for the absence of studies investigating short-term risk for suicidal behavior in adolescents is that the low base rate for this behavior poses a significant challenge for feasibility. Large samples drawn from high-risk or clinically severe populations are required to overcome this obstacle. We are uniquely positioned to address this challenge by leveraging existing data from our current studies. We will pool our current data with data collected on 200 new patients for a final sample of 414. This application is innovative by: (i) being the first statistically powered study of risk factors for suicide attempts over one month; (ii) featuring a comprehensive neurocognitive battery that includes general and self-harm-specific neurocognitive processes; and (iii) applying novel computational psychiatry approaches to modelling neurocognitive indices of short-term risk. This application addresses the research objectives of Aspirational Goal 1 in the NIMH/National Action Alliance for Suicide Prevention's Prioritized Research Agenda for Suicide Prevention: identifying neuropsychiatric profiles and cognitive dysfunction associated with suicide risk.

抽象的 自杀是青少年死亡的第二大原因。实际上，国家自杀率有 在过去的15年中，增长了24％，儿童和青少年自杀的医院就诊增加了一倍 过去十年。尽管大量研究致力于确定自杀的风险因素 行为，迄今为止的研究集中在长期风险上，平均随访时间为10年。 实际上，目前尚无对青少年行为的短期风险的研究。解决这个差距 自杀研究很重要，因为长期风险因素是短期风险的预测因素不佳。所以， 澄清与自杀行为的短期风险相关的过程对于促进我们的知识很重要 从谁处于危险中到最大的危险。神经认知功能已确定为 作为短期风险指标的特别潜力。尽管神经认知功能的核心成分具有 与自杀性相关，青少年自杀尝试的短期纵向研究是显着的 缺乏。此外，尽管传统的统计方法已被用于对这些神经认知进行建模 过程，涉及认知过程模型的计算精神病学的最新发展可能会更多 现实地反映了这些过程。此外，计算精神病学允许同时进行 以产生通常是复杂预测模型的方式来考虑多个变量 基本上优于传统统计方法。我们的长期目标是改善 检测短期风险并确定潜在的可修改靶标的临床干预措施。朝着这一目标， 当前应用的目的是评估短期风险的候选神经认知标记 在青少年精神科样本中，自杀未遂和自杀事件（即超过一个月的随访） 住院患者，补充传统的统计方法，以计算精神病学的新进展。 重要的是，缺乏研究研究短期风险自杀行为的主要原因 青少年是，这种行为的基本率低对可行性构成了重大挑战。大的 需要从高危或临床上严重的人群中抽取的样本来克服这一障碍。我们是 通过利用我们当前研究的现有数据来解决这一挑战，以应对这一挑战。我们将游泳 我们当前的数据，收集了200名新患者的数据，最终样本为414。此应用是创新的 作者：（i）是一个月以来自杀企图的统计学统计学研究； （ii）特色 一个全面的神经认知电池，包括一般和自我伤害特异性的神经认知 过程； （iii）应用新颖的计算精神病学方法来建模神经认知指数 短期风险。该申请旨在解决NIMH/NANTARD中有抱负目标1的研究目标 预防自杀的行动联盟的预防自杀的优先研究议程：确定 与自杀风险相关的神经精神特征和认知功能障碍。