Biomarkers, Social and Affective Predictors of Suicidal Thoughts and Behaviors in Adolescents

青少年自杀想法和行为的生物标志物、社会和情感预测因素

基本信息

批准号：
9249360
负责人：
NICOLE R NUGENT
金额：
$ 13.32万
依托单位：
RHODE ISLAND HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-03-01 至 2020-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9249360
关键词：
Acoustics Adolescent Adrenal Glands Affect Affective Assessment tool Behavior Biological Markers Blood specimen Cause of Death Child Abuse Child Abuse and Neglect Code Conflict (Psychology)Coupled Coupling DNA DNA Methylation Devices Early-life trauma Ecological momentary assessment Emotional Emotions Enhancers Family Family psychotherapy Feeling suicidal Genes Genetic Genetic Transcription Handheld Computers Health Hospitalization Hospitalized Adolescent Hospitals Hour Hypothalamic structure Individual Individual Differences Interpersonal Relations Intervention Investigation Life Literature Mediating Methodology Methods Modeling Modification Nature Non-linear Models Pathway interactions Patient Self-Report Perception Pituitary Gland Play Process Psychiatric therapeutic procedure Recording of previous events Records Regulation Research Respondent Risk Role Sampling Self-Injurious Behavior Social Environment Social Interaction Stress Suicide Suicide attempt System Translational Research Trauma United States Withdrawal Youth accomplished suicide base behavior prediction dynamic system epigenetic marker experience field study follow-up handheld mobile device high risk hypothalamic-pituitary-adrenal axis in vivo innovation interpersonal conflict maltreatment methylation biomarker negative affect novel pediatric trauma rate of change social sound stressor suicidal adolescent suicidal behavior suicidal risk therapy development

项目摘要

DESCRIPTION (provided by applicant): One third to one half of psychiatrically hospitalized youth is readmitted, with highest readmission risk 15-30 days post discharge and more than 80% readmitted within three months. The proposed study involves in vivo characterization of naturalistic phenomena associated with suicide risk after discharge adolescents using ecological methods and devices that allow acoustic capture of an individual's social environment and self-reports of experienced affect. We propose that social context and experienced affect are reciprocally reinforcing and that a reactive style involving close coupling of stressful social context (isolation, conflictual or high affect interactions) with affect reactivity (rapidly changig, intense affect, with slow return to baseline) increases risk for suicidal thoughts and behaviors. We also examine childhood maltreatment and epigenetic markers as predictors of post-discharge reactivity. Two hundred youth hospitalized for suicidal thoughts and behaviors will be followed prospectively using ecological methods and devices for three weeks following psychiatric discharge; suicidal thoughts and behaviors will be reassessed at 6 months. The present study further innovates through the incorporation of affect reactivity biomarkers (in-hospital blood samples for assessment of DNA/DNAm/expression). The proposed study merges multiple fields of study and permits an innovative and thorough characterization of the real-world interplay of affect and social context. Results of this investigation will inform a number of intervention approaches including family therapy, EMA-based adjunctive intervention, and pharmacological approaches.

描述（由申请人提供）：入院后15-30天，重新入院风险最高，三个月内重新入院，三分之一至一半被重新入院。拟议的研究涉及使用生态方法和设备出院青少年后自杀风险相关的自然现象的体内表征，从而使个人的社会环境和经验丰富的情感的自我报告进行声学捕获。我们建议社会环境和经验丰富的情感是相互加强的，而反应性的风格涉及紧张的社会背景（隔离，冲突或高度影响相互作用）与反应性（快速变化，强烈影响，基线恢复缓慢）会增加自杀思想和行为的风险。我们还将儿童虐待和表观遗传标志物视为放电后反应性的预测指标。在精神病出院后，将使用生态学方法和设备前瞻性地遵循两百名因自杀思想和行为而住院的青年。自杀思想和行为将在6个月后重新评估。本研究通过掺入影响反应性生物标志物（用于评估DNA/DNAM/表达的院内血液样本）进一步创新。拟议的研究将多个研究领域融合在一起，并允许对情感和社会环境的现实世界相互作用的创新和彻底表征。这项研究的结果将为多种干预方法提供信息，包括家庭疗法，基于EMA的辅助干预和药理学方法。