Developmental Pathways to Suicide Attempt

自杀未遂的发展途径

• 批准号: 8048435
• 负责人: Holly C Wilcox
• 金额: $ 26.64万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-01 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8048435
• 关键词: Acute; Adolescence; Adolescent; Adolescent Development; Adult; African American; Aggressive behavior; Alcohol consumption; Anxiety; Baltimore; Behavior; Behavioral; Biological; Brain-Derived Neurotrophic Factor; Candidate Disease Gene; Child Development; Childhood; Cities; Clinical; Communities; DNA; DSM-IV; Data; Depressed mood; Development; Disease susceptibility; Drug usage; Environmental Exposure; Environmental Risk Factor; Event; Exposure to; Family; Family history of; Feeling hopeless; Future; Gender; Genes; Genetic; Genetic Markers; Genetic Risk; Genetic Variation; Goals; Impulsivity; Individual; Intervention; Learning; Life; Literature; Longevity; Major Depressive Disorder; Maryland; Mental Depression; Mental disorders; Methods; Modeling; National Institute of Mental Health; Parenting behavior; Parents; Participant; Pathway interactions; Patients; Pharmaceutical Preparations; Population; Population Heterogeneity; Post-Traumatic Stress Disorders; Process; Recording of previous events; Records; Recruitment Activity; Reporting; Research; Risk; Risk Factors; Sampling; Schools; Severities; Source; Strategic Planning; Stress; Subgroup; Suicide attempt; Suicide prevention; Testing; Theoretical model; Trauma; Violence; Work; alcohol misuse; alcohol use disorder; anti social; base; cohort; depressive symptoms; early onset; emerging adult; experience; first grade; high risk sexual behavior; inner city; meetings; patient population; pediatric trauma; peer; physical abuse; population based; predictive modeling; preempt; prospective; psychosocial; sexual violence; single episode major depressive disorder; social; stressor; suicidal behavior; suicidal morbidity; suicidal risk; suicide attempter; teacher; trait; young adult

DESCRIPTION (provided by applicant): This exploratory study will examine if there are unique pathways to suicide attempt using 13 waves of prospective longitudinal data on two ongoing epidemiologically sampled cohorts of 2953 young adults (300 with a prior suicide attempt) originally recruited upon entry to first grade in 28 inner city Public Schools in Baltimore, Maryland. This project will assess the influence of individual psychiatric, familial (parenting, family history), environmental (exposure to violence, sexual/physical abuse), social, and high risk behaviors (sexual, drug use) during the course of development on distinct pathways to suicide attempt. Research has shown that it is very difficult to predict suicide deaths and suicide attempt, perhaps because there are multiple pathways or subtypes. The identification of subtypes is highly significant because appropriate intervention approaches for subtypes may differ. It is also possible that the SA subtypes could represent more homogenous genetic groups yielding greater ability to detect genetic variation in vulnerability for SA. Studies have identified risk and protective factors but few have identified multiple factors prospectively through the course of development to identify processes or mechanisms. The majority of participants with SA in our community sample (~60%) have never met DSM-IV criteria for a major depressive episode. There is a growing literature on the importance of trait aggression/impulsivity as a strong indicator of suicide risk with a possible biological basis. It is unclear if there is a distinct subgroup defined by trait aggression with increased liability of SA. We will study multiple domains of childhood, adolescent and young adult experiences as reported by the participants, peers, parents, teachers, and public records (arrest records). The project will assess the effect of specific genetic markers of risk for suicide attempt (i.e., SLC6A4, TPH1, BDNF, FKBP5) overall and in subgroups, based upon the developmental pathways or trajectories identified. The results of this study will advance our current understanding of the processes and mechanisms associated with suicide attempts among ethnically diverse, urban community populations. PUBLIC HEALTH RELEVANCE: This R21 project entitled "Developmental Pathways to Suicide Attempt" aims to identify distinct pathways or trajectories to suicide attempt in 2953 young adults (300 suicide attempters) initially recruited upon entry to first grade in Baltimore City Public Schools. Improvement in the ability to predict suicide attempts through the identification of specific risk and protective factors experienced over the course of child and adolescent development is an important goal for the prevention of suicide.

描述（由申请人提供）：这项探索性研究将使用 13 波前瞻性纵向数据来检验是否存在独特的自杀企图途径，这些数据涉及两个正在进行的流行病学抽样队列，其中包括 2953 名年轻人（其中 300 名有自杀企图），这些年轻人最初是在进入研究项目时招募的。马里兰州巴尔的摩 28 所内城区公立学校的一年级。该项目将评估个体精神、家庭（养育、家族史）、环境（遭受暴力、性/身体虐待）、社会和高风险行为（性、吸毒）在发展过程中对不同途径的影响自杀未遂。研究表明，预测自杀死亡和自杀企图非常困难，可能是因为存在多种途径或亚型。亚型的识别非常重要，因为针对亚型的适当干预方法可能有所不同。 SA 亚型也可能代表更同质的遗传群体，从而具有更强的能力来检测 SA 易感性的遗传变异。研究已经确定了风险和保护因素，但很少有人在开发过程中前瞻性地确定多个因素以识别过程或机制。我们社区样本中的大多数患有 SA 的参与者 (~60%) 从未符合 DSM-IV 重度抑郁发作的标准。越来越多的文献表明，攻击性/冲动性特质作为自杀风险的有力指标具有重要意义，并可能具有生物学基础。目前尚不清楚是否存在一个由具有增加的 SA 责任的攻击特质定义的独特亚组。我们将研究参与者、同龄人、父母、教师和公共记录（逮捕记录）报告的童年、青少年和年轻人经历的多个领域。该项目将根据确定的发展途径或轨迹，全面评估自杀未遂风险的特定遗传标记（即 SLC6A4、TPH1、BDNF、FKBP5）的影响。这项研究的结果将增进我们目前对多种族城市社区人口自杀未遂相关过程和机制的理解。 公共健康相关性：这个题为“自杀未遂的发展路径”的 R21 项目旨在确定巴尔的摩市公立学校最初招收的 2953 名年轻人（300 名自杀未遂者）的自杀未遂的不同路径或轨迹。通过识别儿童和青少年发展过程中经历的特定风险和保护因素来提高预测自杀企图的能力是预防自杀的一个重要目标。