Suicidality in Young Children: Social and Cognitive Developmental Markers of Risk and Resiliency

幼儿自杀：风险和弹性的社会和认知发展标志

• 批准号: 10449539
• 负责人: LAURA HENNEFIELD
• 金额: $ 17.94万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-12 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10449539
• 关键词: 6 year old; 7 year old; Address; Adolescent; Adult; Age; Area; Behavior; Behavioral; Cessation of life; Child; Childhood; Choking; Clinical; Cognitive; Conceptions; Data; Depressed mood; Development; Electroencephalography; Emotional; Environment; Event-Related Potentials; Exhibits; Family Violence; Feeling hopeless; Feeling suicidal; Future; Impairment; Interview; Life; Link; Measures; Mental Depression; Mental disorders; Mentors; Meta-Analysis; Motivation; National Institute of Mental Health; Neurosciences; Nursery Schools; Outcome; P300 Event-Related Potentials; Parents; Pathway interactions; Play; Prevention; Process; Psychopathology; Public Health; Recording of previous events; Reporting; Research; Research Activity; Research Design; Research Priority; Risk; Risk Factors; Risk Marker; Role; School-Age Population; Science; Severities; Social Functioning; Specificity; Stimulus; Suicide; Suicide attempt; Symptoms; Techniques; Training; Training Activity; Victimization; Violence; Withdrawal; Work; Youth; bullying; conflict resolution; depressive symptoms; early childhood; early onset; expectation; modifiable risk; mortality; multidisciplinary; novel; novel strategies; optimism; peer; peer victimization; preventive intervention; programs; racial diversity; recruit; relating to nervous system; resilience; response; social; social culture; social relationships; socioeconomics; suicidal behavior; suicidal risk; suicide rate; theories; violence exposure

Project Summary Suicidality in children is a pressing and understudied public health concern. Rates of suicide in youth have tripled in recent years, yet little is known about the early emergence or development of suicidal ideation and behaviors (SI/SB). Suicidal ideation (e.g., wishing to be dead, expressing desire to kill oneself) and behaviors (e.g., choking oneself) have been identified as early as the preschool period in the context of early-onset depression. However, if and how suicidality presents in non-depressed young children is unknown. Importantly, early suicidality remains stable into school-age and confers risk for later psychopathology, suggesting lasting impact and continuity of this early manifestation. Consistent with the NIMH Strategic Objective 2, to “chart mental illness trajectories to determine when, where, and how to intervene,” the overarching aim of this K01 application is to understand the developmental contexts in which suicidality emerges in order to identify at-risk youth and to inform preventative intervention efforts. The proposed study will address a number of questions central to understanding the development of suicidality in early childhood including how SI/SB is expressed at this early age, the normative development of the understanding of suicide, if children with SI/SB exhibit lack of optimism and/or pessimism, and how children with SI/SB process peer acceptance and rejection. A variety of measures, including child interview and narrative approaches, behavioral tasks, and event related potentials (ERPs) will be administered to three groups of 4- to 7-year-olds from diverse racial and socioeconomic backgrounds: 1) children with a history of SI/SB, 2) children with or at risk for psychopathology but no history of SI/SB, and 3) low-risk healthy children. The inclusion of children with or at risk for psychopathology with no history of SI/SB will address the specificity of risk factors for suicidality relative to depressive symptoms and other forms of psychopathology. This approach has the potential to identify transdiagnostic risk-factors of suicidality in young children. The inclusion of low-risk healthy children will inform our understanding of typical and atypical trajectories of suicide understanding and provide guidance regarding how and when to address expressions of suicidality in childhood as a clinical concern. This will be the first study of children this young with SI/SB to be targeted for a study designed to investigate the developmental antecedents of risk and resilience for SI/SB. Suicide research and prevention is a high priority research area for NIMH and the described research and training activities will enable the candidate to develop an independent research program that addresses the rising rates of childhood suicidality. Specifically, the execution of the proposed project will provide the candidate with training and expertise in suicide research and prevention, child psychopathology, and ERP techniques. A rich training environment and a multidisciplinary team of mentors in each of these areas is detailed. Data from this project will be used in a planned R01 to more deeply investigate racial and/or sociocultural differences in risk factors and developmental trajectories of early- onset suicidality.

项目概要 儿童自杀是一个紧迫且未被充分研究的公共卫生问题，青少年自杀率增加了两倍。 近年来，人们对自杀意念和行为的早期出现或发展知之甚少 (SI/SB) 自杀意念（例如，希望死、表达自杀的愿望）和行为（例如，窒息）。 早在学龄前时期就已发现早发性抑郁症。 非抑郁儿童是否会出现自杀倾向以及如何出现自杀倾向尚不清楚。重要的是，早期自杀倾向仍然存在。 稳定到学龄并带来以后发生精神病理学的风险，表明这种情况的持久影响和连续性 与 NIMH 战略目标 2 一致，即“绘制精神疾病轨迹 确定何时、何地以及如何进行干预”，该 K01 应用程序的首要目标是了解 自杀出现的发展背景，以识别高危青少年并为预防性预防提供信息 拟议的研究将解决一些对于理解干预至关重要的问题。 儿童早期自杀倾向的发展，包括 SI/SB 在这个早期阶段的表达方式，规范性的 如果患有 SI/SB 的儿童表现出缺乏乐观和/或悲观情绪，则对自杀的理解会发展， 以及患有 SI/SB 的儿童如何处理同伴的接受和拒绝 各种措施，包括儿童。 将管理访谈和叙述方法、行为任务和事件相关电位（ERP） 来自不同种族和社会经济背景的三组 4 至 7 岁儿童：1) 有病史的儿童 SI/SB，2) 患有精神病理学或有精神病理学风险但没有 SI/SB 病史的儿童，以及 3) 低风险健康儿童。 将没有 SI/SB 病史的患有精神病理学或有精神病理学风险的儿童纳入进来将解决特殊性 与抑郁症状和其他形式的精神病理学相关的自杀危险因素。 有潜力识别幼儿自杀的跨诊断危险因素。 健康的儿童将帮助我们了解典型和非典型的自杀轨迹 提供关于如何以及何时将儿童时期自杀倾向的表现作为临床治疗方法的指导 这将是第一项针对这么小的患有 SI/SB 的儿童进行的研究，旨在旨在 调查 SI/SB 的风险和复原力的发展前因是自杀研究和预防的一项工作。 NIMH 的高度优先研究领域以及所描述的研究和培训活动将使候选人能够 具体来说，制定一项独立的研究计划来解决儿童自杀率上升的问题。 拟议项目的执行将为候选人提供自杀研究方面的培训和专业知识 和预防、儿童精神病理学和 ERP 技术。丰富的培训环境和多学科。 每个领域的导师团队都有详细介绍，该项目的数据将用于计划的 R01 至更多内容。 深入调查早期风险因素和发展轨迹的种族和/或社会文化差异 出现自杀倾向。