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

基本信息

批准号：
10557843
负责人：
Erika E Forbes
金额：
$ 68.69万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
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/10557843
关键词：
Address Adult Affect Affective Age Artificial Intelligence 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 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 behavior change brain based brain circuitry emerging adult experience family support follow-up functional MRI scan health disparity longitudinal design minority stress modifiable risk negative affect neural neuromechanism queer recruit response sensor sleep quality smartphone based assessment social social media social model social stigma suicidal suicidal behavior suicide model suicide rate theories trait transgender young adult

项目摘要

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.

项目概要/摘要年轻人的自杀念头和行为 (STB) 率已达到危机水平，尤其是对于 LGBTQ（即女同性恋、男同性恋、双性恋、酷儿、质疑和/或跨性别者）人群中，除了典型的发展挑战之外，社会耻辱。尽管我们知道一般风险因素自杀，这些在预测自杀如何、何时以及谁发生方面作用有限。这是批判性的考虑社会环境的作用很重要，因为 STB 通常是为了应对最近的社会威胁而发生的诸如拒绝之类的事件更有可能发生在那些神经社交回路敏感性发生改变的人身上。针对 RFA MH-20-327 提议的 R01 研究建立在少数族裔压力等社会模型的基础上自杀理论和人际理论，并从远端到近端审视 STB 的社会危险因素水平。总体目标是预测 STB 的变化，包括 STB 的累积强度和转变从自杀想法到行为，时间范围从几小时到几天到几个月。我们建议在 LGBTQ 对于年轻人来说，STB 是通过社会处理和调节社会产生的负面情绪（例如，耻辱）。具体来说，我们检查了社会大脑回路敏感性的远端脆弱因素，以及消极的紧迫感，或者面对痛苦的负面情绪时倾向于冲动行为，以及睡眠失调和社交经历（例如拒绝）的近端、随时间变化的因素。该研究将测试这些远端和近端因素与 STB 的关联； LGBTQ 之间这些因素的差异有 STB 的年轻人与没有 STB 的年轻人；远端因素和近端因素的相互作用；以及 LGBTQ 相关角色 STB 中的特征（例如受害、出局）。该研究将包括 130 名年龄在 18-30 岁之间的参与者，他们都被认定为 LGBTQ，其中 2/3 反复出现的自杀意念和自杀行为的终生史。参与者将完成详细的 STB 访谈、使用社会威胁范式的功能磁共振成像扫描、为期 3 个月的体动记录仪协议基于智能手机的评估，以及 6 个月后的后续访谈。智能手机数据将包括生态对社会威胁经历和 STB 以及被动收集的传感器数据（例如，社交媒体应用程序的使用、短信活动）。传统和机器学习定量技术将用于确定远端和近端因素对 STB 的影响（例如自杀行为的发生），危险因素的个体差异以及神经、睡眠、社交、临床和人口统计学的影响 STB 的因素。该研究将阐明可改变的危险因素在 STB 中的作用，并与临床相关神经科学、自杀学和预防工作。