Uncovering the Risk Architecture of Suicidal Behaviors: a Representative Sample at High Risk: Diversity Supplement

揭示自杀行为的风险架构：高风险的代表性样本：多样性补充

• 批准号: 10469863
• 负责人: Christina W. Hoven
• 金额: $ 5.49万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-02 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10469863
• 关键词: Age; Age-Years; Architecture; Autopsy; Barbados; Cause of Death; Characteristics; Clinical; Cohort Studies; Collaborations; Communities; Complex; Country; DNA analysis; Data; Development; Ethnic Origin; Ethnic group; Event; France; Future; Gender; Geographic Locations; Guyana; Hindu; Individual; Infrastructure; International; Intervention; Location; Muslim population group; Pan American Health Organization; Persons; Population; Poverty; Prevention program; Psychopathology; Public Health; Race; Religion; Religion and Spirituality; Reporting; Research; Risk; Risk Factors; Saliva; Sample Size; Sampling; Social Environment; Sri Lanka; Stress; Suicide; Suicide prevention; Time; Training; United States; World Health Organization; biobank; case control; cohort; completed suicide; cost; design; high risk; longitudinal design; multi-racial; prospective; psychologic; racial and ethnic; religious group; socioeconomics; statistics; suicidal; suicidal behavior; suicidal risk; suicide attempter; suicide rate

The World Health Organization (WHO) reports that approximately 800,000 people die by suicide every year, with rates per 100,000 varying from 0.3 (Barbados) to 34.6 (Sri Lanka), with Guyana at 30.6, the second highest suicide rate of any country; about three times the global average. Worldwide, suicide is the second leading cause of death among those 15 - 29 years of age. The United States rate (13.4) has been rising significantly, in spite of great effort, and remains slightly worse than France (12.3). Psychopathology, poverty, stress, age and gender are among the most often cited risk factors associated with suicide. However, because it is a rare event, suicide research often lacks adequate statistical power to effectively examine the associations and interactions of even the most common risk factors. On the other hand, most countries that have very high suicide rates also lack adequate infrastructure to support good research and/or have homogenous populations, thus limiting analysis of risk factor associations and interactions. Furthermore, because of its rarity, the cost of obtaining an adequate sample size to effectively investigate suicide is generally prohibitive. To overcome these limitations and to move suicide risk research forward, we have developed a partnership with the Guyanese Ministry of Public Health, the Guyanese National Bureau of Statistics, the Pan American Health Organization (PAHO-WHO) and the collaboration of an internationally recognized group of suicidologists. With this team, we propose, to study suicide risk factors in a unique, multipronged approach. First, we will thoroughly assess a nationally representative community cohort for recent and lifetime suicidal behviors, as well as characterize their individual and community level risk factors. We will then follow this cohort in a longitudinal design over two additional waves of assessment, allowing for prospective analyses of suicidal behviors. Second, we will ascertain and assess all suicide attempters who present clinically, and, third, we will conduct psychological autopsies on a subset of suicide completers. We will also collect and biobank saliva for future DNA analysis. Together these samples will allow for case-control analyses, differentiating risk factors specific to attempts and completions across major racial/ethnic and religious groups. Finally, suicide rates in Guyana vary across the 10 geographic regions, among the three major religious groups (Hindu, Christian and Muslim) and among the four major races/ethnicities, in ways that have yet to be explained. This study is designed to help understand how the relationships of key characteristics, interact with individual risk factors to influence suicidal behaviors. Through a collaborative design that utilizes training and data-driven input throughout, this study has the potential to make critically important contributions to the development of more targeted suicide prevention programs in any setting, particularly in multi-racial/ethnic and multi-religious settings, such as Guyana and the United States.

世界卫生组织 (WHO) 报告称，大约 80 万人死于自杀 每年，每 10 万人的比率从 0.3（巴巴多斯）到 34.6（斯里兰卡）不等，其中圭亚那为 30.6， 自杀率在所有国家中位居第二；约为全球平均水平的三倍。在世界范围内，自杀是 15 - 29 岁人群的第二大死因。美国利率（13.4） 尽管付出了巨大努力，但仍显着上升，但仍略低于法国（12.3）。精神病理学， 贫困、压力、年龄和性别是最常被提及的与自杀相关的风险因素。然而， 由于这是一种罕见事件，自杀研究往往缺乏足够的统计能力来有效检验 即使是最常见的风险因素之间的关联和相互作用。另一方面，大多数国家 自杀率非常高 也缺乏足够的基础设施来支持良好的研究和/或 同质人群，从而限制了对危险因素关联和相互作用的分析。此外， 由于其稀有性，获得足够的样本量以有效调查自杀的成本为 一般是令人望而却步的。为了克服这些限制并推动自杀风险研究的发展，我们 与圭亚那公共卫生部、圭亚那国家局建立了合作伙伴关系 统计数据、泛美卫生组织 (PAHO-WHO) 以及国际组织的合作 公认的自杀学家团体。我们建议通过这个团队，以独特的方式研究自杀风险因素， 多管齐下。首先，我们将彻底评估具有全国代表性的社区群体 最近和一生的自杀行为，以及描述他们个人和社区层面的风险因素。 然后，我们将在纵向设计中跟踪该队列，进行另外两波评估，以便 自杀行为的前瞻性分析。其次，我们将查明并评估所有自杀未遂者 临床上存在，第三，我们将对一部分自杀完成者进行心理尸检。我们 还将收集唾液并建立生物银行用于未来的 DNA 分析。这些样本一起将有助于病例控制 分析，区分主要种族/族裔的尝试和完成特定的风险因素 宗教团体。最后，圭亚那的自杀率在 10 个地理区域（其中三个地区）之间存在差异。 主要宗教团体（印度教、基督教和穆斯林）以及四大种族/族裔之间，在某种程度上 这还有待解释。本研究旨在帮助了解关键因素之间的关系 特征，与个体危险因素相互作用，影响自杀行为。通过协作 整个设计都利用培训和数据驱动的输入，这项研究有潜力做出批判性的 对在任何情况下制定更有针对性的自杀预防计划做出重要贡献， 特别是在多种族/族裔和多宗教环境中，例如圭亚那和美国。