Multimodal Assessment of Social Disconnection as a Proximal Risk for Suicide Ideation in Late Life

社会脱节作为晚年自杀意念的近端风险的多模式评估

• 批准号: 10852290
• 负责人: Nicole M Cain
• 金额: $ 63.97万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10852290
• 关键词: Address; Affective; Age; Aging; Assisted Living Facilities; Back; Behavior assessment; Bereavement; Cessation of life; Cognitive; Conflict (Psychology); Development; Dimensions; Ecological momentary assessment; Elderly; Evaluation; Event; Exhibits; Expectancy; Feeling suicidal; Funding; Goals; Hour; Individual; Interview; Laboratories; Life; Link; Loneliness; Measures; Mediating; Mediator; Methods; National Institute of Mental Health; Outcome; Participant; Patient Self-Report; Persons; Population; Predisposition; Primary Care; Protocols documentation; Public Health; Reaction; Recommendation; Reporting; Research; Research Domain Criteria; Risk Assessment; Sampling; Services; Social Network; Social Processes; Suicide; Suicide prevention; Time; United States; Woman; Work; anxious; base; evidence base; experience; follow-up; human old age (65+); improved; innovation; insight; longitudinal design; medical specialties; men; multilevel analysis; multimodality; personalized medicine; recruit; response; social; social exclusion; suicidal behavior; suicidal morbidity; suicidal risk; suicide rate

Abstract/Project Summary Globally and in the United States, older adults exhibit the highest rates of suicide deaths. Research has shown that social disconnection and interpersonal negative life events (NLEs) are both significantly linked with suicide ideation, attempts, and deaths in late life, yet few studies have examined moderators of the relationship between social disconnection and suicide in late life or considered social disconnection as a mediator of the relationship between interpersonal NLEs and suicide outcomes, despite compelling evidence to do so. In addition, existing studies are mostly cross-sectional and provide little insight into how suicide risk unfolds over hours, days, weeks, and months in older adults. The overarching goal of this proposal is to leverage a multimodal assessment of behavioral and social mechanisms to improve our ability to identify specific predictors relating social disconnection to suicidal ideation in late life. We will examine how a crucial social- cognitive vulnerability, rejection sensitivity (RS), contributes to the link between social disconnection and suicidal ideation in late life. RS is the predisposition to subjectively perceive, anxiously expect, and intensely react to social rejection, and reflects the Research Domain Criteria (RDoC) of Social Processes: Affiliation and Attachment. Using an intensive longitudinal design, including three 21-day EMA bursts and follow-back interviews over a 1-year period, we will also examine social disconnection as a mediator of the relationship between interpersonal NLEs and suicidal ideation over different timescales. Participants will include a diagnostically diverse sample of 250 men and women ages 60 and older who report elevated suicidal ideation. Multimodal assessments at baseline will include interviews, self-reports, a laboratory-based social rejection paradigm, and a 21-day random and event-based ecological momentary assessment (EMA) protocol. Follow- up interviews will be conducted every 3 months for 1-year to fully assess rare, low base rate interpersonal NLEs (e.g., deaths illnesses, loss of relationships), and the 21-day EMA protocol will be repeated at 6-months and 12-months. The proposed project has three specific aims: 1) to examine within-person variability in social disconnection as a proximal predictor of momentary increases in suicidal ideation in late life; 2) to investigate RS as a static and time-varying moderator of the relationship between social disconnection and suicidal ideation in late life; and 3) to examine the mediating effect of social disconnection on the relationship between interpersonal NLEs and suicidal ideation in late life over the course of hours, days, weeks, and months. Results will aid in the development of evidence-based personalized treatment recommendations targeting key dimensions of social disconnection, social exclusion, interpersonal NLEs, and suicidal ideation in late life.

摘要/项目摘要 在全球和美国，老年人的自杀死亡率最高。研究表明 社会脱节和人际关系负面的生活事件（NLE）都与自杀密切相关 在后期生活中的念头，尝试和死亡，但很少有研究检查了这种关系的主持人 在后期生活中的社会脱节和自杀之间，或认为社会脱节是 尽管有令人信服的证据这样做，但人际NLE与自杀结果之间的关系。在 此外，现有研究主要是横截面，几乎没有洞察自杀风险如何展开 老年人的小时，天数，几周和几个月。该提案的总体目标是利用 对行为和社会机制的多模式评估，以提高我们识别特定的能力 在后期生活中，社会脱节与自杀念头有关的预测因素。我们将研究至关重要的社会 - 认知脆弱性，拒绝敏感性（RS）有助于社会脱节与 后期的自杀念头。 RS是主观感知，焦虑和强烈的倾向 对社会拒绝的反应，并反映了社会过程的研究领域标准（RDOC）：隶属关系和 依恋。使用密集的纵向设计，包括三个21天EMA爆发和跟随后卫 访谈在1年的时间内，我们还将研究社会脱节作为这种关系的调解人 在人际关系和自杀念头之间的不同时间尺度之间。参与者将包括 250名60岁及60岁以上的男女的诊断样本报告了自杀念头升高。 基线时多模式评估将包括访谈，自我报告，一个基于实验室的社会拒绝 范式，以及21天的随机和基于事件的生态瞬时评估（EMA）方案。跟随- 1年将每3个月进行一次UP访谈，以完全评估稀有的，低的基本率互生 NLE（例如，死亡疾病，关系丧失）和21天EMA方案将在6个月后重复 和12个月。拟议的项目具有三个特定的目的：1）检查社会内部变异性 脱节是后期自杀意念的暂时增长的近端预测指标； 2）调查 RS作为社会脱节与自杀之间关系的静态和时变的主持人 晚年的念头； 3）检查社会脱节对之间关系的中介作用 在几个小时，几天，几周和几个月的过程中，人际NLE和自杀念头。 结果将有助于制定针对关键的基于证据的个性化治疗建议 社会脱节，社会排斥，人际关系和自杀念头的层面。