Passive Assessment of Behavioral Warning Signs for Suicide Risk in Adolescents: An Idiographic Approach

青少年自杀风险行为警告信号的被动评估：一种具体方法

• 批准号: 10433042
• 负责人: Taylor A Burke
• 金额: $ 11.42万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 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 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10433042
• 关键词: Acute; Adolescent; American; Behavior assessment; Behavioral; Cause of Death; Cellular Phone; Complement; Data Sources; Detection; Distal; Environment; Event; Failure; Feeling suicidal; Foundations; Future; Goals; Hospitalization; Hospitals; Individual; Influentials; Inpatients; Intervention; Interview; Knowledge; Measurement; Measures; Mentorship; Methodology; Methods; Modeling; Movement; National Institute of Mental Health; Participant; Pathway Analysis; Patient Self-Report; Pattern; Persons; Physical activity; Positioning Attribute; Process; Reinforcing Factor; Research; Research Design; Research Training; Resources; Rhode Island; Risk; Risk Assessment; Risk Behaviors; Risk Factors; Science; Sleep; Structure; Suicide; Suicide attempt; Suicide prevention; Surveys; Symptoms; System; Technology; Teenagers; Text; Time; Training; Universities; Youth; actigraphy; adolescent suicide; base; career; data modeling; density; digital; digital health; follow-up; high-risk adolescents; improved; indexing; innovation; insight; medical schools; neglect; network models; personalized intervention; programs; psychologic; recruit; reducing suicide; sensor; social engagement; social media; suicidal adolescent; suicidal behavior; suicidal risk; suicide rate; theories; therapy development; unsupervised learning

PROJECT SUMMARY/ABSTRACT Suicide is the second leading cause of death among adolescents and the rates have doubled since 2000. The rise in suicide rates is due in part to a failure to identify short-term risk factors for suicidal thoughts and behaviors. Additionally, most existing research relies primarily on group-level methodological approaches to suicide risk assessment; intraindividual suicide risk processes are largely neglected. Because of the lack of knowledge on short-term and individual-level suicide risk, it remains unclear when and how to intervene with the individual adolescents who need it most. Three particularly promising observable, state-sensitive, temporally delimited, and modifiable proximal indicators of suicide risk among adolescents are social engagement, sleep, and physical activity. Although acute changes in these behavioral processes are often denoted as imminent “behavioral warning signs” of suicide, most existing research has examined these behavioral factors only as distal predictors and correlates of suicide risk. Importantly, their contribution to short- term risk using individual-level approaches (i.e., fully idiographic, “n-of-1” methods) remains unknown. The Candidate’s proposed K23’s overarching goal is to employ mobile sensing and actigraphy to assess whether objectively and passively measured acute behavioral changes from typical patterns of social engagement, sleep, and physical activity indicate proximal risk for increases in suicidal ideation using idiographic n-of-1 models in high-risk adolescents. It further aims to characterize the intraindividual network structure of these behavioral factors and suicidal ideation to enhance suicide risk assessment and guide intervention. Adolescents (N=100) admitted to an inpatient or partial hospital program due to acute suicide risk will be recruited. For a period of 3 months, wearable actigraphs will be used to assess adolescents’ sleep and physical activity and mobile sensing will be used to assess adolescents’ digital social engagement and patterns of movement to approximate additional indices of physical activity. Once-daily mobile surveys will be used to assess suicidal ideation. The proposed training plan complements the Candidate’s research plan and will facilitate training in: conducting translational digital health research in high-risk adolescents, passive mobile sensing, passive adolescent sleep and physical activity assessment via actigraphy, and advanced computational approaches to person-specific intensive data modeling. A team of leading scholars will provide expert mentorship to facilitate the Candidate’s training goals within the highly resourced environment of the Alpert Medical School of Brown University and Rhode Island Hospital. The proposed study will promote the Candidate’s long-term career goal to employ low-burden and scalable methods of assessment to develop personalized risk models that will improve the proximal prediction of suicide risk and inform intervention for youth. Through the execution of this research and training plan, the Candidate will be positioned to become a leader in the field of adolescent suicide.

项目摘要/摘要 自杀是青少年死亡的第二大原因，自2000年以来，率已经翻了一番。 自杀率上升的部分原因是未能确定自杀思想的短期风险因素和 行为。此外，大多数现有研究主要依赖于小组级方法论方法 自杀风险评估；内部自杀的风险过程在很大程度上被忽略了。因为缺乏 关于短期和个人自杀风险的知识，尚不清楚何时以及如何干预 最需要它的个人青少年。三个特别有前途的可观察，对国家敏感， 青少年中自杀风险的暂时界定和可修改的近端指标是社会 参与，睡眠和体育锻炼。尽管这些行为过程中的急性变化通常是 大多数现有研究都被称为自杀的迫在眉睫的“行为警告信号” 行为因素仅是自杀风险的不同预测因素和相关性。重要的是，它们对短暂的贡献 使用单个级别方法（即完全独立的“ N-1-1”方法）的术语风险仍然未知。这 候选人提议的K23的总体目标是采用移动感官和行动学来评估是否是否 客观和被动地衡量的急性行为从典型的社会参与模式变化， 睡眠和体育活动指示使用IDI摄影n-1的自杀念头增加的近端风险 高危青少年的模型。它进一步旨在表征这些的个体内网络结构 行为因素和自杀思想，以增强自杀风险评估和指导干预。 由于急性自杀风险而接受住院或部分医院计划的青少年（n = 100）将是 招募。在3个月的时间内，可穿戴的动作绘画将用于评估青少年的睡眠和 体育活动和移动敏感性将用于评估青少年的数字社会参与和模式 运动以近似其他体育锻炼指数。每天一次的移动调查将用于 评估自杀想法。拟议的培训计划完成了候选人的研究计划，并将 促进培训：在高风险青少年，被动移动中进行翻译数字健康研究 传感，被动的青少年睡眠和通过行为摄影评估以及先进的体育锻炼评估 针对人特定密集的数据建模的计算方法。一支领先的学者团队将提供 在资源丰富的环境中促进候选人的培训目标的实验精神训练 布朗大学和罗德岛医院的Alpert医学院。拟议的研究将促进 候选人的长期职业目标是采用低负担和可扩展的评估方法来发展 个性化风险模型，将改善自杀风险的近端预测并为干预提供干预 青年。通过执行本研究和培训计划，候选人将被定位为 青少年自杀领域的领导者。