Social-Affective Vulnerability to Suicidality among LGBTQ Young Adults: Proximal and Distal Factors

LGBTQ 年轻人自杀的社会情感脆弱性：近端和远端因素

• 批准号: 10376274
• 负责人: Erika E Forbes
• 金额: $ 72.37万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10376274
• 关键词: Address; Adult; Affect; Affective; Age; Artificial Intelligence; Base of the Brain; Behavior; Brain imaging; Cellular Phone; Characteristics; Clinical; Communities; Computational Technique; Data; Data Analytics; Demographic Factors; Development; Distal; Distress; Ecological momentary assessment; Emergency Situation; Equilibrium; Event; Exclusion; Face; Feeling suicidal; Frequencies; Functional Magnetic Resonance Imaging; Goals; Hospitalization; Hotlines; Hour; Impulsive Behavior; Impulsivity; Individual Differences; Intervention; Interview; Lesbian Gay Bisexual; Lesbian Gay Bisexual Transgender Queer; Machine Learning; Measures; Mediator of activation protein; Mental Health; Modeling; Moods; Neurosciences; Pain; Participant; Population; Predictive Value; Prevention; Protocols documentation; Psychiatry; Recording of previous events; Recurrence; Regulation; Reporting; Risk Factors; Role; Safety; Same-sex; Self-Injurious Behavior; Shame; Sleep; Sleep disturbances; Social Environment; Source; Standardization; Suicide; Suicide prevention; Techniques; Technology; Testing; Text; Text Messaging; Thinking; Time; Victimization; Visit; actigraphy; affective neuroscience; base; behavior change; brain circuitry; emerging adult; experience; family support; follow-up; functional MRI scan; health disparity; longitudinal design; minority stress; modifiable risk; negative affect; neuromechanism; queer; recruit; relating to nervous system; response; sensor; sleep quality; smartphone based assessment; social; social media; social model; social stigma; suicidal behavior; theories; trait; transgender; young adult

Project Summary/Abstract Rates of suicidal thoughts and behaviors (STB) among young adults have reached a crisis level, especially for those in the LGBTQ (i.e., lesbian, gay, bisexual, queer, questioning and/or transgender) population, who face social stigma in addition to the typical developmental challenges. Although we know the general risk factors for suicide, those have limited utility in predicting how, when, and in whom suicide occurs. It is critically important to consider the role of social context because STB often occurs in response to a recent social threat event such as rejection and could be more likely in those who have altered sensitivity of neural social circuitry. The proposed R01 study in response to RFA MH-20-327 builds on social models such as Minority Stress Theory and the Interpersonal Theory of Suicide and examines social risk factors of STB from distal to proximal levels. The overarching goal is to predict change in STB, including cumulative intensity of STB and transition from suicidal thoughts to behaviors, on a time scale from hours to days to months. We propose that in LGBTQ young adults, STB occurs through social processing and regulation of socially generated negative affect (e.g., shame). Specifically, we examine the distal vulnerability factors of sensitivity in social brain circuitry and negative urgency, or the tendency toward impulsive behavior in the face of painful negative affect, and the proximal, time-varying factors of sleep dysregulation and social experiences (e.g., rejection). The study will test the association of these distal and proximal factors with STB; differences in these factors between LGBTQ young adults with vs. without STB; the interplay of distal and proximal factors; and the role of LGBTQ-related characteristics (e.g., victimization, outness) in STB. The study will include 130 participants age 18-30, all of whom identify as LGBTQ and 2/3 of whom have recurrent suicidal ideation and lifetime history of suicidal behavior. Participants will complete a detailed interview of STB, an fMRI scan using social threat paradigms, a 3-month protocol of actigraphy and smartphone-based assessment, and a follow-up interview at 6 months. Smartphone data will include ecological momentary assessment of social threat experiences and STB, as well as passively collected sensor data (e.g., social media app use, texting activity). Traditional and machine learning quantitative techniques will be applied to determine contributions of distal and proximal factors to STB (e.g., occurrence of suicidal behavior), individual differences in risk factors, and contributions of neural, sleep, social, clinical, and demographic factors to STB. The study will elucidate the role of modifiable risk factors in STB and have relevance to clinical neuroscience, suicidology, and prevention efforts.

项目摘要/摘要 年轻人的自杀思想和行为率（STB）达到了危机水平，特别是对于 面对LGBTQ（即女同性恋，同性恋，双性恋，酷儿，质疑和/或变性者）中的人 除了典型的发展挑战之外，社会污名。尽管我们知道一般的风险因素 自杀，那些在预测如何，何时和在谁发生自杀方面的实用性有限。这是批判性的 重要的是要考虑社会环境的作用，因为STB通常是针对最近的社会威胁而发生的 拒绝之类的事件，并且在改变神经社会循环敏感性的人中可能更有可能。 拟议的R01对RFA MH-20-327的研究基于少数群体压力等社会模型的建立 理论和自杀的人际理论，并研究了从远端到近端的STB的社会风险因素 水平。总体目标是预测STB的变化，包括STB和过渡的累积强度 从自杀的思想到行为，在数小时到几天到几个月的时间范围。我们建议在LGBTQ中 年轻人，STB是通过社会处理和对社会产生的负面影响的调节而发生的（例如， 耻辱）。具体而言，我们研究了社交大脑回路中灵敏度的远端脆弱性因素和 负面紧迫感，或面对痛苦的负面影响，朝着冲动行为的趋势， 睡眠失调和社会经历的近端，时变因素（例如，拒绝）。该研究将测试 这些远端和近端因子与STB的关联； LGBTQ之间这些因素的差异 有没有STB的年轻人；远端和近端因子的相互作用；以及与LGBTQ相关的作用 STB中的特征（例如，受害，外向）。 该研究将包括130名18-30岁的参与者，所有人都将其识别为LGBTQ，其中2/3 自杀行为的复发性自杀念头和终生历史。参与者将完成详细的 使用社会威胁范式的fMRI扫描STB的访谈，三个月的Actraphy和 基于智能手机的评估以及6个月的后续访谈。智能手机数据将包括生态 对社会威胁经历和STB的暂时评估以及被动收集的传感器数据（例如， 社交媒体应用程序使用，发短信活动）。传统和机器学习定量技术将是 应用于确定远端和近端因子对STB的贡献（例如，自杀行为的发生）， 危险因素的个体差异以及神经，睡眠，社会，临床和人口的贡献 STB的因素。该研究将阐明可修改风险因素在STB中的作用，并与临床相关 神经科学，自杀学和预防工作。