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

• 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
• 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

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，青少年过渡与自杀念头的患病率的急剧增加有关，以及几种形式的自我伤害，包括非杀伤性自我伤害（NSSI; I.E.，自我保险），自杀手势，威胁，威胁和尝试。这项研究提出，并将测试一个理论模型，表明对社会压力源的生物学和认知反应解释了心理病理学（即抑郁症）和自我伤害（即调解）之间的关联，以及压力反应（即节制）之间的特定相互作用（即适度）将有助于确定哪些女孩与心理病理学最有可能自我自我差异。提出了认知和生物压力反应的特定组合，以唯一确定不同类型的自我伤害/自杀性的风险（即NSSI与自杀念头）。此外，这项研究将研究自我伤害构造之间的轨迹和关联，以解决过去工作的几个局限性。因此，这项研究的目的涉及PA＃07-079中概述的几个目标，关于自杀性的减少和预防的研究以及许多阐明NIMH战略计划的目标（NIMH，2008年）和《 NAMHC工作集团关于变革性神经开发研究》（NAMHC Work Group报告）（NAMHC，2008年）。这项研究将使用创新的，基于实验室的方法学范式来检查认知（即归因，社会问题解决）和生物学（即神经内分泌，心血管）对体内社会压力的反应。参与者将包括来自门诊和住院临床引用样本的250名女性青少年。数据将从多个线人（青少年，父母）和多个来源（观察方法，结构化访谈，问卷，生物学分析）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的经验相互作用，以预测在18个月间隔内进行自伤。换句话说，这项研究将解决有关为什么和/或压力的经历与自我伤害行为有关的长期以来但探索较少的问题。 公共卫生相关性： 尽管大量研究表明，具有心理病理史的青少年有自我伤害的风险增加（例如自我救助；自杀企图），但人们对为什么或如何导致自我伤害的原因或如何导致自杀。因此，几乎没有循证预防/干预的方向。这项研究将检查对社会压力的特定心理和生物学反应，这可能会增加女孩自我伤害的风险，并通过在敏感和关键的发展时期探索这些行为的过程来帮助阐明自我伤害行为的发展。