Predicting and Preventing Suicidal Ideation among High-Risk Sexual and Gender Minority Adolescents

预测和预防高危性和性别少数青少年的自杀意念

• 批准号: 10301276
• 负责人: Kirsty A Clark
• 金额: $ 17.34万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10301276
• 关键词: Acute; Address; Adolescence; Adolescent; Assertiveness; Attitude; Behavioral; Cause of Death; Cellular Phone; Clinical; Cognitive; Cognitive Therapy; Complex; Data; Data Collection; Development; Ecological momentary assessment; Educational workshop; Environment; Exposure to; Feeling hopeless; Feeling suicidal; Focus Groups; Global Positioning System; Goals; Hospitalization; Individual; Inpatients; Interdisciplinary Study; Intervention; Interview; Link; Measures; Mediation; Mentors; Mentorship; Methods; Minority Groups; Monitor; National Institute of Mental Health; Nature; Observational Study; Ownership; Participant; Patient Self-Report; Population; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Research Project Grants; Research Scientist Award; Research Training; Resources; Risk; Safety; Scientific Inquiry; Scientist; Self-control as a personality trait; Sexual and Gender Minorities; Stress; Suicide; Suicide attempt; Suicide prevention; Surveys; Taxes; Technology; Testing; Thinking; Time; Training; United States; Universities; adaptive intervention; adolescent health; adolescent suicide; base; bullying; career; design; experience; high risk; high risk population; innovation; meetings; minority disparity; novel; prevent; preventable death; programs; prospective; psychological stressor; real time monitoring; reducing suicide; responsible research conduct; self esteem; skills; skills training; social stigma; stressor; substance use; suicidal behavior; suicidal risk; symposium; therapy development; transgender

PROJECT SUMMARY Sexual and gender minority (SGM) adolescents are at increased risk for suicide. Approximately 1 in 3 SGM adolescents report having attempted suicide compared to 1 in 10 non-SGM adolescents. SGM adolescents are thought to be vulnerable to suicide because they must negotiate typical stressors of adolescence alongside coming to terms with an SGM identity, which can involve managing exposure to stigma-related stressors including external stressors (e.g., bullying) and navigating taxing internal psychological stressors (e.g., identity concealment). The overarching goal of this proposed K01, entitled Project SPIRiT (Suicide Prediction In Real- Time), is to examine the influence of stigma-related stressors (e.g., bullying, identity concealment) and universal suicide precursors (e.g., hopelessness) on suicidal ideation among SGM adolescents recently hospitalized for acute suicidality. I will utilize state-of-the-art real-time mobile monitoring methods incorporating both ecological momentary assessment (EMA) and global positioning system (GPS) data to pursue the project’s three aims: (Aim 1) develop an EMA+GPS assessment approach capable of capturing both self- reported and place-based exposure to stigma through focus groups with SGM adolescent recent inpatients; (Aim 2) examine precursors to suicidal ideation among SGM adolescent recent inpatients through a 28-day EMA+GPS study; and (Aim 3) develop and refine components of a just-in-time adaptive intervention (JITAI) targeting SGM adolescent suicide risk, informed by qualitative data from focus groups with Aim 2 participants and in-depth interviews with clinicians and JITAI experts. Evidence from Project SPIRiT will lay the groundwork for an NIMH R01 to further test an empirically informed suicide prevention JITAI for high-risk SGM adolescents. To successfully conduct the proposed research project, I will: (1) obtain training in innovative approaches to micro-longitudinal research methodology, including EMA+GPS technology; (2) develop expertise in conducting responsible research with clinical populations and addressing safety concerns; and (3) acquire skills in developing an empirically informed JITAI to reduce suicide risk. By engaging in mentored research with Dr. John Pachankis (primary mentor) and an expert team of co-mentors and collaborators at Yale University and beyond, and participating in coursework, seminars, workshops, scientific conferences, and regular mentorship meetings, I will develop the skills necessary to successfully carry out the proposed research activities and meet my long-term career goal of becoming an independent scientist. Yale University offers rich intellectual and practical resources, an interdisciplinary research and training environment, and professional development and collaborative opportunities to support early-career investigators in launching their independent research careers. The proposed K01 will provide me with the training, mentorship, and protected time necessary to establish an independent program of research focused on SGM disparities and suicide prevention through rigorous scientific inquiry and intervention development.

项目概要 性少数和性别少数 (SGM) 青少年的自杀风险增加，大约三分之一的 SGM 青少年。 青少年报告曾尝试自杀，而非 SGM 青少年中就有 1 人有自杀倾向。 人们认为他们很容易自杀，因为他们必须同时应对青春期的典型压力源 接受 SGM 身份，这可能涉及管理与耻辱相关的压力源 包括外部压力源（例如欺凌）和应对内部心理压力源（例如身份认同） 拟议的 K01 的总体目标名为 Project SPIRiT（真实的自杀预测）。 时间），是为了检查与耻辱相关的压力源（例如欺凌、身份隐瞒）的影响，以及 最近SGM青少年自杀意念中普遍存在的自杀前兆（例如绝望） 我将利用最先进的实时移动监测方法，将其纳入急性自杀倾向住院治疗。 生态瞬时评估（EMA）和全球定位系统（GPS）数据，以追求 项目的三个目标：（目标 1）开发一种 EMA+GPS 评估方法，能够捕获自我 通过 SGM 青少年最近住院患者的焦点小组报告和基于地点的耻辱暴露； （目标 2）通过 28 天的研究，检查近期住院的 SGM 青少年自杀意念的前兆 EMA+GPS 研究；以及（目标 3）开发和完善及时适应性干预 (JITAI) 的组成部分 针对 SGM 青少年自杀风险，根据 Aim 2 参与者焦点小组的定性数据提供信息 以及对新人和 JITAI 专家的深入采访 SPIRiT 项目的证据将为我们奠定基础。 NIMH R01 进一步测试高风险 SGM 的基于经验的自杀预防 JITAI 为了成功开展拟议的研究项目，我将：（1）获得创新培训。 微观纵向研究方法，包括EMA+GPS技术；（2）开发 负责对临床人群进行研究和解决安全问题的专业知识；以及 (3) 通过参加指导，获得在经验丰富的 JITAI 中发展的技能，以降低自杀风险。 与 John Pachankis 博士（主要导师）以及共同导师和合作者组成的专家团队一起进行研究 耶鲁大学及其他大学，并参加课程、研讨会、讲习班、科学会议和 定期导师会议上，我将培养成功执行拟议计划所需的技能 研究活动并实现我成为一名独立科学家的长期职业目标。 提供丰富的智力和实践资源、跨学科的研究和培训环境， 专业发展和合作机会，以支持早期职业研究人员启动 他们的独立研究生涯将为我提供培训、指导和帮助。 建立一个专注于 SGM 差异的独立研究计划所需的受保护时间 通过严格的科学探究和干预措施的发展来预防自杀。