Cognitive and Affective Mechanisms of Risk for Suicidal Thoughts and Behaviors

自杀想法和行为风险的认知和情感机制

基本信息

批准号：
9101846
负责人：
DAVID B. GOLDSTON
金额：
$ 27.67万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
1993
资助国家：
美国
起止时间：
1993-05-01 至 2018-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9101846
关键词：
Adolescence Adult Affect Affective Alcohol or Other Drugs use Anxiety Behavior Behavior Therapy Behavioral Behavioral Model Behavioral Research Blinking Clinical Cognitive Data Decision Making Development Ethnic Origin Family Feeling hopeless Feeling suicidal Foundations Gambling Gender Grant Health Hospitalized Adolescent Impulsivity Individual Intervention Iowa Knowledge Lead Learning Light Maintenance Measures Mediation Mental Depression Mental disorders National Institute of Mental Health Outcome Pattern Pharmaceutical Preparations Physiological Population Process Prevention Procedures Process Psychophysiology Recording of previous events Recurrence Reflex action Research Domain Criteria Rewards Risk Risk Factors Sampling Severities Sexual abuse Short-Term Memory Stimulus Strategic Planning Substance Use Disorder Suicide Suicide attempt Suicide prevention Thinking Time Traumatic Brain Injury United States National Institutes of Health United States Public Health Service affective neuroscience brain behavior cognitive neuroscience cohort depressive symptoms discounting follow-up high risk interest novel prospective public health priorities response success suicidal behavior suicidal morbidity therapy development young adult

项目摘要

DESCRIPTION (provided by applicant): Over the last 15 years, we have had great success in following a sample of formerly psychiatrically hospitalized adolescents (n=180) through adulthood to help us better understand the risk and course of suicidal thoughts and behavior. Using longitudinal data from this study, we have recently examined sensitization as a process that may contribute to recurrent suicidal behavior, the predictive validity of clinical characterisics of suicidal behavior, and differing developmental trajectories of suicide ideation and attempts from adolescence through adulthood. With this revised renewal application, we propose a behavioral model of the recurrence or maintenance of suicidal thoughts and behavior. Four cognitive and affective mechanisms are hypothesized to reflect underlying behavioral processes: (a) delay discounting (a decision-making bias characterized by greater focus on immediate rewards rather than delayed consequences, assessed with the Iowa Gambling Task), and (b) implicit affect (assessed with the Affect Misattribution Procedure), (c) eye blink startle reflex (a physiological indicant of defensive responding), and (d) postauricular reflex (a physiological indicant of approach or appetitive responding) in response to suicide-related stimuli. Using an approach consistent with the Research Domain Criteria (RDoC) initiative of NIH and cognitive and affective neuroscience, we propose to examine these four mechanisms in relation to severity of suicidal thoughts and behavior over time in this longitudinal sample. Th first specific aim of this grant is examine these four mechanisms in relation to severity of suicidl thoughts and behavior from adolescence through young adulthood (i.e., in relation to longitudinal data from 15 years of follow-up). The second aim of this grant is to examine the stability of the mechanisms over time, and the degree to which these variables covary with severity of depression and substance use, as well as psychiatric disorders. The third aim of the grant is to examine the utility of these mechanisms in predicting severity of subsequent suicide ideation and behavior over an additional three years of follow-up. Exploratory aims of this study are to explore (a) the degree to which these cognitive and affective mechanisms are associated with established risk factors for suicidal thoughts/behavior, and (b) the degree to which possible patterns of developmental mediation leading to suicidal ideation/attempts are associated with the hypothesized cognitive and affective mechanisms. For all Aims, we will explore gender and ethnicity effects and the possibility of gender and ethnicity moderation. This study also has clear translational implications for prediction of suicidal thoughts and behavior, and for intervention development for individuals with differing histories of suicidal thoughts and behavior.

描述（由申请人提供）：在过去的15年中，我们在遵循以前的精神病院住院青少年（n = 180）之前取得了巨大成功，以帮助我们更好地了解自杀思想和行为的风险和过程。使用本研究的纵向数据，我们最近研究了一种可能有助于自杀行为的自杀行为的过程，自杀行为的临床特征的预测有效性以及自杀念头的不同发展轨迹以及从崇拜到青春期的尝试。通过此修订后的更新应用，我们提出了自杀思想和行为的复发或维护的行为模型。 Four cognitive and affective mechanisms are hypothesized to reflect underlying behavioral processes: (a) delay discounting (a decision-making bias characterized by greater focus on immediate rewards rather than delayed consequences, assessed with the Iowa Gambling Task), and (b) implicit affect (assessed with the Affect Misattribution Procedure), (c) eye blink startle reflex (a physiological indicant of defensive responding), and (d)后脑反射（a 对自杀相关刺激的响应的方法或食欲反应的生理指示。我们使用与NIH和认知和情感神经科学的研究领域标准（RDOC）计划一致的方法，我们建议在这个纵向样本中检查这四种机制与自杀思想和行为的严重性有关。这笔赠款的第一个具体目的是检查这四种机制与Suicidl思想和行为的严重性有关（即与15年随访的纵向数据有关）。这笔赠款的第二个目的是检查机制随着时间的流逝的稳定性，以及这些变量与抑郁和药物使用的严重程度以及精神疾病的大量变量的程度。该赠款的第三个目的是检查这些机制在预测随后的自杀意念和行为的严重程度中的效用，在另外三年的随访中。这项研究的探索性目的是探索（a）这些认知和情感机制与自杀思想/行为的既定风险因素相关的程度，以及（b）导致自杀构想/尝试的可能模式与假设的认知和情感机制相关的程度。对于所有目的，我们将探讨性别和种族影响以及性别和种族审核的可能性。这项研究也清楚对自杀思想和行为的预测以及对具有自杀思想和行为历史不同的个人的干预发展的翻译意义。