Stress Responses as Prospective Predictors of Girls' Suicidality and Self-Injury

压力反应作为女孩自杀和自残的前瞻性预测因子

基本信息

批准号：
8197059
负责人：
MATTHEW K NOCK
金额：
$ 62.38万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-12-01 至 2014-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8197059
关键词：
Address Adolescence Adolescent Affective Arousal Attention Behavior Behavioral Biological Biological Assay Biological Factors Biological Markers Cardiovascular system Characteristics Cognitive Data Depressed mood Development Evidence based treatment Family Feeling suicidal Female Adolescents Gestures Goals Individual Inpatients Intervention Interview Investigation Knowledge Lead Life Literature Longitudinal Studies Measures Mediation Mediator of activation protein Mental Depression Mental disorders Methods Modeling National Institute of Mental Health Neurosecretory Systems Outcome Outpatients Parents Participant Pattern Performance Physiological Prevalence Preventive Intervention Problem Solving Process Psychopathology Questionnaires Recording of previous events Regulation Reporting Research Risk Risk Factors Sampling Self Mutilation Self-Injurious Behavior Social Problems Source Strategic Planning Stress Structure Suicide Suicide attempt Suicide prevention Symptoms System Testing Text Theoretical model United States National Institutes of Health Variant Work base behavior test biological adaptation to stress boys critical developmental period depressive symptoms evidence base experience follow-up girls in vivo informant innovation non-suicidal self injury predictive modeling prospective psychologic public health relevance response social social stress stressor suicidal suicidal behavior theories

项目摘要

DESCRIPTION (provided by applicant): Especially among girls, the adolescent transition is associated with dramatic increases in the prevalence of suicidal ideation, and several forms of self-injury, including non-suicidal self-injury (NSSI; i.e., self-mutilation), suicidal gestures, threats, and attempts. This study proposes, and will test a theoretical model suggesting that biological and cognitive responses to social stressors explain the association between psychopathology (i.e., depression) and self-injury (i.e., mediation) and that specific interactions between stress responses (i.e., moderation) will help identify which girls with psychopathology are most likely to engage in self-injury longitudinally. Specific combinations of cognitive and biological stress responses are proposed to uniquely identify risks for different types of self-injury/suicidality (i.e., NSSI vs. suicidal ideation). Moreover, this study will examine trajectories of, and associations among self-injury constructs, addressing several limitations of past work. The aims of this research thus address several of the goals outlined in PA # 07-079, Research on the Reduction and Prevention of Suicidality as well as many of the goals articulated the NIMH Strategic Plan (NIMH, 2008) and the NAMHC Workgroup report on Transformative Neurodevelopmental Research (NAMHC, 2008). This study will use an innovative, lab-based methodological paradigm to examine cognitive (i.e., attributions, social problem solving) and biological (i.e., neuroendocrine, cardiovascular) responses to an in vivo social stressor. Participants will include 250 female adolescents from both outpatient and inpatient clinically-referred samples. Data will be collected from multiple informants (adolescents, parents) and multiple sources (observational methods, structured interviews, questionnaires, biological assays). It is expected that observed stress responses in the lab will interact with the experience of actual social stress measured during follow-up to predict self-injury trajectories over an 18 month interval. In other words, this study will address long-standing, but under-explored questions regarding why and how psychological symptoms, and/or the experience of stress, are associated with self-injurious behaviors. PUBLIC HEALTH RELEVANCE: Although much research has indicated that adolescents with a history of psychopathology are at increased risk for self-injury (e.g., self-mutilation; suicide attempts), little is known about why or how psychological symptoms lead to self-injury. Thus, there are few directions for evidence-based prevention/intervention. This research will examine specific psychological and biological responses to social stress that may increase the risk for girls' self- injury, and help to elucidate the development of self-injurious behaviors by exploring the course of these behaviors across a sensitive and critical developmental period.

描述（由申请人提供）：尤其是在女孩中，青春期过渡与自杀意念和多种形式的自伤（包括非自杀性自伤（NSSI；即自残））的流行率急剧上升有关、自杀姿态、威胁和企图。这项研究提出并将测试一个理论模型，该模型表明对社会压力源的生物和认知反应解释了精神病理学（即抑郁）和自伤（即调解）之间的关联，以及压力反应之间的特定相互作用（即调节）将有助于确定哪些患有精神病理学的女孩最有可能进行纵向自残。提出了认知和生物应激反应的特定组合，以独特地识别不同类型自残/自杀的风险（即 NSSI 与自杀意念）。此外，这项研究将研究自伤结构的轨迹和关联，解决过去工作的一些局限性。因此，本研究的目的涉及 PA # 07-079《减少和预防自杀研究》中概述的几个目标，以及 NIMH 战略计划（NIMH，2008 年）和 NAMHC 工作组报告中阐述的许多目标。变革性神经发育研究（NAMHC，2008）。这项研究将使用一种创新的、基于实验室的方法范式来检查对体内社会压力源的认知（即归因、社会问题解决）和生物（即神经内分泌、心血管）反应。参与者将包括来自门诊和住院临床转诊样本的 250 名女性青少年。数据将从多个信息提供者（青少年、父母）和多个来源（观察方法、结构化访谈、问卷、生物测定）收集。预计实验室中观察到的压力反应将与随访期间测量的实际社会压力体验相互作用，以预测 18 个月间隔内的自残轨迹。换句话说，这项研究将解决长期存在但尚未充分探讨的问题，即心理症状和/或压力体验为何以及如何与自残行为相关。公共卫生相关性：尽管许多研究表明，有精神病理学史的青少年自残（例如自残；自杀企图）的风险增加，但人们对心理症状为何或如何导致自残知之甚少。因此，基于证据的预防/干预的方向很少。这项研究将考察对可能增加女孩自伤风险的社会压力的具体心理和生物反应，并通过探索敏感和关键发展时期自伤行为的过程，帮助阐明自伤行为的发展。