Stress experiences as markers of person-level vulnerability and temporal risk for near-term suicidal ideation

压力体验是个人脆弱性和近期自杀意念暂时风险的标志

基本信息

批准号：
10825847
负责人：
Anne Knorr
金额：
$ 4.77万
依托单位：
UNIVERSITY OF NOTRE DAME
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-28 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10825847
关键词：
Accidents Accounting Adult Age Aging Cessation of life Cognitive Development Discrimination Ecological momentary assessment Emotional Environment Ethics Etiology Event Feeling suicidal Fellowship Frequencies Future Goals Impulsivity Individual Individual Differences Intervention Investments Joints Knowledge Maps Measures National Institute of Mental Health Pathway interactions Personality Persons Phase Predisposition Prevention Reaction Reporting Research Risk Risk Factors Risk Reduction Sampling Specific qualifier value Statistical Data Interpretation Strategic Planning Stress Stressful Event Suicide Testing Time Training United States Universities acute stress emotion dysregulation experience high risk high risk population improved longitudinal design men mortality next generation personalized care prevent prospective recruit response skills suicidal behavior suicidal risk suicide rate trait

项目摘要

PROJECT SUMMARY Suicide is a leading cause of global mortality and rising suicide rates have been particularly steep in the United States. Accordingly, NIMH is investing heavily in prevention, including calls for improved precision care— interventions delivered based on specific, granular understanding of person-level vulnerabilities and their interaction with local environments. Although stress, a well-established concurrent and prospective risk factor for suicidal ideation (SI), is experienced by all, it varies at both group- (e.g., discrimination, local events) and person- (e.g., arguments, accidents) levels in timing, frequency, and experience. Thus, there is a significant need to improve the accuracy in detailing the stressful events – SI relationship, as well as elucidate person-level markers that increase vulnerability to this association. Tonic (trait-like) and phasic (state) impulsivity (IMP) and emotion dysregulation (ED) are well-established predispositions for suicide risk. IMP and ED alone are insufficient markers of SI risk, yet each may increase risk for SI in the context of stressful life events. Their joint effects may also potentiate the relationship between changes in person-level stress and risk for momentary SI; however, this has yet to be tested, leaving little known about person-level, moment-to-moment SI prediction. The overarching objective of this research is to specify person-level conditions that portend imminent SI, information that has the potential to inform the development of effective just-in-time interventions, consistent with precision care objectives of the NIMH Strategic Plan. This research will: (1) evaluate the direct effect of real-time stressful events on concurrent and prospective momentary SI, (2) evaluate the moderating effects of tonic (trait-like) and phasic (state) IMP and ED on the prospective relationship between real-time stressful events and momentary SI, and (3) explore the propensity to experience SI in response to prior stress as a potential moderator of the proximal relationship between real-time stressful events and momentary SI. A sample of individuals at high risk for suicide (i.e., adults age ≥18 with persistent lifetime SI and SI during the past 6-months) will complete a baseline session and 30-day period of ecological momentary assessment to evaluate tonic and phasic IMP and ED, real-time stressful events, and momentary SI. Goals of the fellowship training plan, which will take place at the University of Notre Dame, include: (1) enhance knowledge of emotional, personality, and cognitive components of suicide risk; (2) develop advanced knowledge of the assessment of suicide risk factors; (3) enhance knowledge of advanced statistical analyses for within- and between-persons research; (4) engage in professional development activities and develop advanced research skills; (5) enhance knowledge of ethical research practices with high-risk populations.

项目概要自杀是全球死亡的主要原因，而美国的自杀率上升尤其急剧因此，NIMH 正在大力投资预防，包括呼吁改进精准护理—— 基于对个人层面的脆弱性及其具体、细致的了解而提供的干预措施与当地环境的相互作用。虽然压力是一个既定的并发和前瞻性风险因素。对于自杀意念（SI），所有人都会经历，它在两个群体中都有所不同（例如，歧视，当地事件）和因此，非常需要时间、频率和经验方面的人（例如争论、事故）水平。提高详细描述压力事件 – SI 关系的准确性，并阐明个人层面增加对这种关联的脆弱性的标记物（特质状）和阶段性（状态）冲动性（IMP）和情绪失调 (ED) 是公认的自杀风险倾向。 SI 风险的标志物不足，但在生活压力事件的背景下，每个指标都可能增加 SI 的风险。影响还可能增强个人压力变化与瞬时 SI 风险之间的关系；然而，这还有待测试，因此对个人层面的即时 SI 预测知之甚少。这项研究的首要目标是明确预示即将发生的 SI、信息的个人水平条件这有可能为制定有效的及时干预措施提供信息，同时保持精确性 NIMH 战略计划的护理目标本研究将： (1) 评估实时压力的直接影响。事件对并发和预期瞬时 SI 的影响，(2) 评估强直（特质状）和阶段性（状态）IMP 和 ED 关于实时压力事件与瞬时压力事件之间的预期关系 SI，以及（3）探索在应对先前压力时体验 SI 的倾向，作为潜在的调节因素实时压力事件和瞬时 SI 之间的近似关系高风险个体的样本。自杀者（即年龄≥18 岁且在过去 6 个月内有持续终生 SI 和 SI 的成年人）将完成一份基线会话和 30 天生态瞬时评估期，以评估强直性和阶段性 IMP 和 ED、实时压力事件和奖学金培训计划的目标，将在以下时间进行。圣母大学，包括：（1）增强情感、个性和认知方面的知识自杀风险的组成部分；(2) 发展自杀风险因素评估的高级知识； (4) 从事（五）增强道德知识高危人群的研究实践。