Impulsive Aggression, Neurocognition, and Suicidal Behavior in Depressed Youth

抑郁青少年的冲动攻击、神经认知和自杀行为

基本信息

批准号：
8464277
负责人：
JEFFREY A BRIDGE
金额：
$ 41.01万
依托单位：
RESEARCH INST NATIONWIDE CHILDREN'S HOSP
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-07-01 至 2016-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8464277
关键词：
Address Adolescence Adolescent Adolescent Psychiatry Aggressive behavior Algorithms American Area Award Behavioral Brain Child Psychiatry Clinical Clinical Research Cognitive deficits Containment Coupled Decision Making Depressed mood Development Diagnosis Early identification Environmental Risk Factor Epidemiology Evaluation Foundations Frustration Functional disorder Future Goals Hostility Impairment Individual Intervention Intervention Studies Investigation Knowledge Longitudinal Studies Major Depressive Disorder Measurable Measures Methods Mission Modeling Mood Disorders National Institute of Mental Health Neurocognition Neurocognitive Neurocognitive Deficit Neuropsychology Outcome Pathway interactions Play Predictive Value Preventive Intervention Prospective Studies Public Health Recording of previous events Research Research Personnel Risk Risk Assessment Risk Factors Risk Marker Role Staging Statistical Methods Suicide Suicide attempt Suicide prevention Supervision Testing Work Youth base clinical risk computerized design developmental psychology executive function family genetics high risk improved innovation longitudinal design prevent prospective psychosocial reducing suicide statistics suicidal suicidal act suicidal behavior suicidal risk suicide attempter tool treatment strategy

项目摘要

DESCRIPTION (provided by applicant): Major Depressive Disorder (MDD) is the most potent psychiatric risk factor for suicidal behavior in adolescents, yet most depressed youth never attempt suicide, diminishing the positive predictive value of a diagnosis of MDD in gauging the risk of future suicidal acts. Efforts to prevent youth suicide would benefit greatly from a deeper understanding of precursors and pathways to suicidal behavior in depressed youth, particularly if such knowledge informs the development of effective risk evaluation and intervention strategies. Knowledge of measurable factors that increase the risk of future suicide attempts in depressed adolescents could prove critical to efforts to prevent youth suicide by virtue of: 1) aiding in the recognition of depressed youth at especially heightened risk for suicide, who at a minimum may require closer supervision and containment; 2) identifying targets for clinical intervention beyond the mood disorder per se; and, 3) contributing to the development of assessment tools and risk markers relevant to better gauging individual suicide risk and informing clinical intervention research with youth at risk for suicide. The proposed R01 application from an early stage investigator (ESI) will address critical gaps in knowledge by examining the role of impulsive aggression and neurocognitive functioning in the etiopathogenesis of suicidal behavior in adolescents with MDD. The central hypothesis is that impulsive aggression and deficits in executive function and decision making will contribute substantially to a model of future suicide attempts and add positive predictive value to traditional assessment approaches. Our hypothesis is informed by promising pilot work in which measures of impulsive aggression and decision making deficits sharply distinguished depressed adolescent suicide attempters from non-attempters. The design includes cross-sectional comparisons as well as a prospective longitudinal study of 300 depressed youth with and without a prior history of suicide attempt, followed from early to middle adolescence, the developmental period of highest risk for suicidal behavior. These results will contribute to the mission of the NIMH by improving our capacity to identify the temporal and likely causal sequence of antecedents to future suicidal acts in youth with MDD, thus framing targets for practical clinical risk assessment, intervention, and the prevention of suicidal behavior.

描述（由申请人提供）：重度抑郁症（MDD）是青少年自杀行为的最有效的精神病风险因素，但大多数抑郁症的青年从未尝试过自杀，从而降低了MDD诊断的积极预测价值，从而在衡量未来自杀行为的风险中。防止青年自杀的努力将从对沮丧的青年中的前体和自杀行为的途径的更深入的了解中受益匪浅，尤其是如果这种知识为有效的风险评估和干预策略的发展提供了发展。了解可衡量的因素的知识增加了未来自杀企图在沮丧的青少年中的风险，这对于通过以下方面的努力进行了努力，这对于防止青年自杀的努力至关重要：1）协助认识到抑郁症的青少年以特别提高自杀的风险，他们最少需要更紧密的监督和遏制； 2）确定超出情绪障碍的临床干预目标； 3）为开发评估工具的开发和风险标志物的发展与更好地衡量个人自杀风险相关，并向年轻人的临床干预研究告知有自杀风险的临床干预研究。早期研究者（ESI）提出的R01应用将通过检查MDD青少年自杀行为的患者发生在自杀行为中的脉冲攻击和神经认知功能的作用，来解决知识中的关键差距。中心假设是，执行功能和决策的冲动侵略和缺陷将对未来的自杀企图的模型产生重大贡献，并为传统评估方法增加积极的预测价值。我们的假设是通过有希望的试验工作来告知的，在这种工作中，冲动侵略和决策赤字的衡量标准与非侵害者的抑郁症抑郁症明显区分开。该设计包括横断面比较以及对300名抑郁症青年的前瞻性纵向研究，有和没有先前的自杀史，随后是青春期早期至中期，自杀行为的最高风险的发展期。这些结果将通过提高我们确定MDD青年未来自杀行为的时间和可能因果关系的能力来促进NIMH的使命，从而构建了实用临床风险评估，干预，干预和预防自杀行为的目标。