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

揭示自杀行为的风险架构：高风险的代表性样本

• 批准号: 10669911
• 负责人: Christina W. Hoven
• 金额: $ 9.07万
• 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 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10669911
• 关键词: African; Age; Age-Years; Amerindian; Architecture; Attention; Autopsy; Barbados; Behavior; Black race; Cause of Death; Characteristics; Clinical; Cohort Studies; Collaborations; Communities; Complex; Country; DNA analysis; Data; Data Collection; Databases; Development; East Indian; Ethnic Origin; Ethnic group; Event; Feeling suicidal; Female; France; Future; Gender; Genetic; Geographic Locations; Geography; Guyana; Hindu; Individual; Infrastructure; Institutes; International; Intervention; Investigation; Leadership; Location; Muslim population group; New York; Pan American Health Organization; Patient Self-Report; Persons; Population; Population Heterogeneity; Poverty; Prevalence; Prevention program; Probability; Psychiatric epidemiology; Psychopathology; Public Health; Race; Religion; Religion and Spirituality; Reporting; Research; Resources; Risk; Risk Factors; Saliva; Sample Size; Sampling; Social Environment; Sri Lanka; Stress; Suicide; Suicide attempt; Suicide prevention; Time; Training; United States; Universities; World Health Organization; arm; biobank; case control; cohort; completed suicide; contextual factors; cost; design; experience; follow-up; high risk; ideation; insight; longitudinal design; low and middle-income countries; multi-ethnic; multi-racial; prevent; prospective; psychologic; racial and ethnic; religious group; sociodemographics; 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）报告说，大约有80万人自杀死亡 每年，每100,000的费率从0.3（巴巴多斯）到34.6（斯里兰卡），圭亚那为30.6， 任何国家的自杀率第二高；大约是全球平均水平的三倍。全球，自杀是 这15-29岁的第二大死亡原因。美国的利率（13.4）已经 尽管付出了巨大的努力，但仍比法国稍差（12.3）。心理病理学， 贫困，压力，年龄和性别是与自杀相关的最常见的危险因素。然而， 因为这是一个罕见的事件，因此自杀研究通常缺乏足够的统计能力来有效检查 甚至最常见的风险因素的关联和互动。另一方面，大多数国家 具有很高的自杀率也缺乏足够的基础设施来支持良好的研究和/或 同质种群，从而限制了风险因素关联和相互作用的分析。此外， 由于其稀有性，获得足够样本量以有效研究自杀的成本是 通常过于刺激。为了克服这些局限性并向前进自杀风险研究，我们有 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）和国际合作 公认的自称学家。我们建议在这个团队中，以独特的， 多收益的方法。首先，我们将彻底评估全国代表性的社区队列 最近和终身自杀的律师，以及其个人和社区级别的风险因素。 然后，我们将在另外两个评估浪潮中以纵向设计进行此类队列，从而允许 对自杀律师的前瞻性分析。其次，我们将确定并评估所有自杀的人 在临床上，第三，我们将在自杀完成者的一部分上进行心理尸检。我们 还将收集和生物银行唾液以进行未来的DNA分析。这些样品一起将允许病例对照 分析，区分主要种族/种族的尝试和完成的风险因素 宗教团体。最后，圭亚那的自杀率在这10个地理区域各不相同 主要的宗教团体（印度教徒，基督教和穆斯林）以及四个主要种族/种族之一 尚未解释。这项研究旨在帮助了解关键的关系如何 特征，与个人风险因素相互作用以影响自杀行为。通过协作 整个过程中都利用培训和数据驱动输入的设计，这项研究有可能进行批判性的 在任何情况下，对更有针对性的自杀计划制定的重要贡献， 特别是在多种族/种族和多宗教的环境中，例如圭亚那和美国。