Opioid Use and Acute Suicide Risk: The Real-Time Influence of Trauma Context"

阿片类药物的使用和急性自杀风险：创伤背景的实时影响”

• 批准号: 10674342
• 负责人: Alexa Raudales
• 金额: $ 4.23万
• 依托单位: UNIVERSITY OF RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-22 至 2025-05-21
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10674342
• 关键词: Acute; Address; Adult; Anxiety; Area; Attention; Behavior; Behavioral; Cessation of life; Communities; Coupled; Distal; Ecological momentary assessment; Environment; Ethics; Feasibility Studies; Feeling suicidal; Funding; Future; Goals; Grant; Health; Impulsivity; Individual; Institution; Intervention; Knowledge; Link; Literature; Measures; Mentors; Mentorship; Methodology; Methods; Modeling; Myopia; National Institute of Drug Abuse; Nature; Numbness; Opioid; Outcome; Overdose; Pattern; Persons; Pharmaceutical Preparations; Phase; Policies; Population; Positioning Attribute; Prevalence; Prevention; Process; Protocols documentation; Psyche structure; Public Health; Recording of previous events; Reporting; Research; Rhode Island; Risk; Risk Factors; Role; Sampling; Self Destructive Behavior; Specific qualifier value; Statistical Models; Suicide; Surveys; Technology; Time; Training; Trauma; Typology; United States; United States National Institutes of Health; Universities; Work; adaptive intervention; associated symptom; cognitive interview; common symptom; comorbidity; coping; craving; death anxiety; design; dysphoria; evidence base; experience; follow-up; high risk; high risk population; individualized medicine; innovation; longitudinal design; multilevel analysis; novel; opioid epidemic; opioid overdose; opioid use; post-traumatic symptoms; premature; psychosocial; public health priorities; recruit; risk sharing; suicidal; suicidal behavior; suicidal risk; suicide rate; tenure track; trauma exposure

Project Summary/Abstract The ongoing opioid epidemic is among the worst public health crises in United States history, with over 200 people dying daily from opioid overdose. Opioid use and suicide co-occur at an alarmingly high rate, and despite large-scale efforts, this rate of co-occurrence continues to escalate. Moreover, the co-occurrence of opioid use and suicide is associated with a wide array of deleterious outcomes, most notably pre-mature death. Consistent with recent NIDA initiatives, co-occurring opioid use and suicide is receiving growing attention as an increasingly urgent public health priority. However, empirical examinations in this area continue to lag behind, with no studies explicating the real-time longitudinal associations between opioid use and acute suicide risk; this information is needed to inform targeted intervention and policy. Furthermore, it remains unknown how an individualized trauma context—notably, proximal posttraumatic stress symptoms (PTSS)—may serve as a trigger for co-occurring opioid use and acute suicide risk. Understanding the momentary associations among PTSS, opioid use, and acute suicide risk is necessary for targeted and timely interventions for co-occurring opioid use and acute suicide risk. This study addresses a critical gap in knowledge by using an ecological momentary assessment (EMA) approach among 60 trauma-exposed adults who currently use opioids and report suicidal thoughts and behaviors (STBs). Specifically, this project will use a novel intensive longitudinal design to examine the unique influence of trauma context on immediate (acute) risk for co-occurring opioid use and suicide risk. This project is significant in that the knowledge to be gained via ecologically valid EMA will specify proximal and context-dependent risk for co-occurring opioid use and suicidality to advance intervention efforts among this vulnerable trauma-exposed population. It is innovative because it utilizes a cutting-edge EMA methodology and advanced quantitative methods to delineate the context-dependent nature of the momentary relations among PTSS, opioid use, and suicide risk, with a focus on personalized statistical models (idiographic) that can inform individualized treatment. The goal of this F31 is to train the Applicant for successful independent research using novel intensive longitudinal designs to examine the time-sensitive associations among PTSS, opioid use, acute suicide risk, with the overarching aim of informing mechanistically driven, real-time interventions. Thus, this project will provide the Applicant imperative training and experience in repeated assessment research, sophisticated multi-level analyses, grantsmanship, dissemination of findings, networking, mentoring, and ethics. The research environment at the University of Rhode Island, including office space, technology, and grant support, along with excellent Sponsors and Consultants with expertise in relevant content areas, provide the ideal setting and mentorship to successfully conduct the proposed project.

项目概要/摘要 持续的阿片类药物流行病是美国历史上最严重的公共卫生危机之一，已造成 200 多个阿片类药物滥用。 每天都有因阿片类药物过量使用和自杀而死亡的人以惊人的高比例发生。 尽管做出了大规模的努力，这种共现率仍在不断上升。 阿片类药物的使用和自杀与多种有害结果相关，最明显的是过早死亡。 与最近的 NIDA 倡议一致，同时发生的阿片类药物使用和自杀作为一种 然而，这一领域的实证研究仍然滞后， 没有研究解释阿片类药物使用与急性自杀风险之间的实时纵向关联； 需要这些信息来为有针对性的干预和政策提供信息。此外，目前尚不清楚如何实现这一目标。 个体化的创伤背景——尤其是近端创伤后应激症状（PTSS）——可以作为 了解同时发生的阿片类药物使用和急性自杀风险之间的瞬时关联。 PTSS、阿片类药物使用和急性自杀风险对于同时发生的有针对性和及时的干预措施是必要的 阿片类药物的使用和急性自杀风险这项研究通过使用生态学解决了知识上的一个关键差距。 对 60 名目前使用阿片类药物和遭受创伤的成年人进行瞬时评估 (EMA) 方法 具体来说，该项目将使用新颖的强化纵向报告。 旨在检查创伤背景对同时发生阿片类药物使用的直接（急性）风险的独特影响 该项目意义重大，因为通过生态有效的 EMA 获得的知识将 明确同时发生的阿片类药物使用和自杀的近期和情境相关风险，以推进干预 在这些易受创伤的人群中，它是创新的，因为它利用了尖端技术。 EMA 方法和先进的定量方法来描述环境的依赖性质 PTSS、阿片类药物使用和自杀风险之间的瞬时关系，重点是个性化统计模型 （具体）可以为个体化治疗提供信息。此 F31 的目标是培训申请人。 成功的独立研究使用新颖的密集纵向设计来检查时间敏感 PTSS、阿片类药物使用、急性自杀风险之间的关联，总体目标是机械地提供信息 因此，该项目将为申请人提供必要的培训和经验。 在重复的评估研究、复杂的多层次分析、资助、研究结果的传播中， 罗德岛大学的网络、指导和道德规范，包括办公室。 空间、技术和拨款支持，以及具有相关专业知识的优秀赞助商和顾问 内容领域，为成功开展拟议项目提供理想的环境和指导。