Impulsive Aggression, Neurocognition, and Suicidal Behavior in Depressed Youth

抑郁青少年的冲动攻击、神经认知和自杀行为

基本信息

批准号：
8835151
负责人：
JEFFREY A BRIDGE
金额：
$ 46.82万
依托单位：
RESEARCH INST NATIONWIDE CHILDREN'S HOSP
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-07-01 至 2017-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8835151
关键词：
Address Adolescence Adolescent Adolescent Psychiatry Aggressive behavior Algorithms American Area Award Behavioral Brain Child Psychiatry Clinical Clinical Research Cognitive deficits Containment Coupled Decision Making Depressed mood Development Diagnosis Early identification Environmental Risk Factor Epidemiology Evaluation Foundations Frustration Functional disorder Future Goals Hostility Individual Intervention Intervention Studies Investigation Knowledge Longitudinal Studies Major Depressive Disorder Measurable Measures Methods Mission Modeling Mood Disorders National Institute of Mental Health Neurocognition Neurocognitive Neurocognitive Deficit Neuropsychology Outcome Pathway interactions Play Predictive Value Preventive Intervention Prospective Studies Public Health Recording of previous events Research Research Personnel Risk Risk Assessment Risk Factors Risk Marker Role Staging Statistical Methods Suicide Suicide attempt Suicide prevention Supervision Testing Work Youth base child depression clinical risk computerized design developmental psychology executive function family genetics high risk improved innovation longitudinal design predictive modeling prevent prospective psychosocial reducing suicide statistics suicidal suicidal act suicidal behavior suicidal risk suicide attempter tool treatment strategy

项目摘要

DESCRIPTION (provided by applicant): Major Depressive Disorder (MDD) is the most potent psychiatric risk factor for suicidal behavior in adolescents, yet most depressed youth never attempt suicide, diminishing the positive predictive value of a diagnosis of MDD in gauging the risk of future suicidal acts. Efforts to prevent youth suicide would benefit greatly from a deeper understanding of precursors and pathways to suicidal behavior in depressed youth, particularly if such knowledge informs the development of effective risk evaluation and intervention strategies. Knowledge of measurable factors that increase the risk of future suicide attempts in depressed adolescents could prove critical to efforts to prevent youth suicide by virtue of: 1) aiding in the recognition of depressed youth at especially heightened risk for suicide, who at a minimum may require closer supervision and containment; 2) identifying targets for clinical intervention beyond the mood disorder per se; and, 3) contributing to the development of assessment tools and risk markers relevant to better gauging individual suicide risk and informing clinical intervention research with youth at risk for suicide. The proposed R01 application from an early stage investigator (ESI) will address critical gaps in knowledge by examining the role of impulsive aggression and neurocognitive functioning in the etiopathogenesis of suicidal behavior in adolescents with MDD. The central hypothesis is that impulsive aggression and deficits in executive function and decision making will contribute substantially to a model of future suicide attempts and add positive predictive value to traditional assessment approaches. Our hypothesis is informed by promising pilot work in which measures of impulsive aggression and decision making deficits sharply distinguished depressed adolescent suicide attempters from non-attempters. The design includes cross-sectional comparisons as well as a prospective longitudinal study of 300 depressed youth with and without a prior history of suicide attempt, followed from early to middle adolescence, the developmental period of highest risk for suicidal behavior. These results will contribute to the mission of the NIMH by improving our capacity to identify the temporal and likely causal sequence of antecedents to future suicidal acts in youth with MDD, thus framing targets for practical clinical risk assessment, intervention, and the prevention of suicidal behavior.

描述（由申请人提供）：重度抑郁症 (MDD) 是青少年自杀行为最有力的精神危险因素，但大多数抑郁青少年从未尝试自杀，这降低了 MDD 诊断在衡量未来风险方面的阳性预测价值自杀行为。更深入地了解抑郁青少年自杀行为的前兆和途径，将大大有助于预防青少年自杀的努力，特别是如果这些知识有助于制定有效的风险评估和干预策略。了解增加抑郁青少年未来自杀企图风险的可衡量因素，对于预防青少年自杀的努力至关重要，因为：1）帮助识别自杀风险特别高的抑郁青少年，他们至少可能需要加强监督和遏制； 2）确定情绪障碍本身之外的临床干预目标； 3) 有助于开发与更好地衡量个人自杀风险相关的评估工具和风险标记，并为有自杀风险的青少年的临床干预研究提供信息。早期研究者 (ESI) 提出的 R01 应用程序将通过检查冲动攻击和神经认知功能在 MDD 青少年自杀行为发病机制中的作用来解决关键的知识空白。中心假设是，冲动攻击以及执行功能和决策的缺陷将对未来自杀企图的模型做出重大贡献，并为传统的评估方法增加积极的预测价值。我们的假设是基于有希望的试点工作，其中冲动攻击和决策缺陷的衡量标准将抑郁的青少年自杀企图者与非自杀者区分开来。该设计包括横断面比较以及对 300 名有或没有自杀企图史的抑郁青少年进行的前瞻性纵向研究，研究对象是青春期早期到中期，即自杀行为风险最高的发育时期。这些结果将有助于 NIMH 的使命，提高我们识别 MDD 青少年未来自杀行为的时间和可能因果顺序的能力，从而制定实际临床风险评估、干预和预防自杀行为的目标。

项目成果

期刊论文数量（2）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Decision-making in adolescents with suicidal ideation: A case-control study.

有自杀意念的青少年的决策：病例对照研究。

DOI：
发表时间：
2015-08-30
期刊：
影响因子：
11.3
作者：
Sheftall, Arielle H;Davidson, Dustin J;McBee;Ackerman, John;Mendoza, Kristen;Reynolds, Brady;Bridge, Jeffrey A
通讯作者：
Bridge, Jeffrey A

Neurocognitive vulnerability to youth suicidal behavior.

青少年自杀行为的神经认知脆弱性。

DOI：
发表时间：
2020
期刊：
影响因子：
4.8
作者：
Ruch, Donna;Sheftall, Arielle H;Heck, Kendra;McBee;Tissue, Jaclyn;Reynolds, Brady;Ackerman, John;Brent, David A;Campo, John V;Bridge, Jeffrey A
通讯作者：
Bridge, Jeffrey A