Multimodal Assessment of Near-term Risk Processes for Suicide Ideation and Behavior

自杀意念和行为的近期风险过程的多模式评估

• 批准号: 10054973
• 负责人: Lori N Scott
• 金额: $ 67.04万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-01-05 至 2023-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10054973
• 关键词: Acute; Adult; Affect; Affective; Age; Arousal; Assessment tool; Back; Biological; Cause of Death; Cessation of life; Characteristics; Childhood; Clinical; Cognition; Cognitive; Data; Development; Diagnostic; Distal; Ecological momentary assessment; Event; Exclusion; Exposure to; Feeling suicidal; Future; Goals; Heterogeneity; Hour; Implicit Association Test; Individual; Intake; Intervention; Interview; Laboratories; Life; Longitudinal Studies; Machine Learning; Measures; Methods; Pain; Participant; Patient Self-Report; Pattern; Persons; Physiological; Process; Protocols documentation; Psychophysiology; Public Health; Recording of previous events; Reporting; Research; Research Personnel; Risk; Risk Assessment; Risk Factors; Role; Sampling; Self-Direction; Self-Injurious Behavior; Signal Transduction; Sinus Arrhythmia; Social Environment; Social Processes; Standardization; Stress; Suicide; Suicide attempt; Suicide prevention; Techniques; Thinking; Time; TimeLine; Trauma; Violence; Withdrawal; Woman; Work; aged; base; clinical predictors; clinically significant; experience; follow-up; high risk; ideation; improved; individual response; men; multimodality; negative affect; novel; person centered; personalized intervention; physical abuse; prospective; recruit; reducing suicide; respiratory; response; risk stratification; social; social exclusion; suicidal; suicidal behavior; suicidal morbidity; suicidal risk; suicide rate; young adult

Abstract/Project Summary The suicide rate among young adults aged 18-25 has risen to the highest level in more than 30 years, yet our ability to accurately predict suicide attempts remains limited to distal, static risk factors. There is an urgent need for research to identify ways to assess who is most at risk for suicide in the near future, consistent with Aspirational Goal 3 of the National Action Alliance’s Prioritized Research Agenda. Accordingly, the overarching goal of this R01 from an Early Stage Investigator is to improve our ability to identify specific near-term, dynamic within-person processes that predict acute increases in a vulnerable individual’s risk for suicide. Social processes related to affiliation and attachment (e.g., social rejection or exclusion), as well as painful and provocative events (PPE; e.g., violent trauma and self-injury), are well-known distal risk factors for suicide. However, the role of dynamic cognitive-affective and biological responses to experiences of rejection for predicting near-term suicide risk in any individual is poorly understood. In addition, it is not known how the influence of rejection-related processes on near-term suicide risk may vary as a function of distal risk factors such as exposure to PPE. The current application outlines a multimethod intensive longitudinal study to examine dynamic affective and physiological responses to rejection as near-term risk factors for temporal fluctuations in suicidal thoughts and behaviors (STB) over the course of hours to days, weeks, and months. We will also examine exposure to PPE as a moderator that amplifies intraindividual reactivity to social rejection, thereby further increasing suicide risk. Participants will include a diagnostically diverse clinical sample of 150 young adult men and women (ages 18 to 35) with clinically significant STB in the past 4 months. Multimodal assessments at baseline will include a 21-day random and event-based ecological momentary assessment (EMA) protocol; laboratory paradigms with psychophysiological measures, self-reports, and assessment of implicit suicide-related cognition; and interviews using timeline follow-back (TLFB) methods. Assessments at 4-month intervals over the course of 12 months will include repeated laboratory tasks, physiological and implicit assessments, self-reports, and TLFB interviews to assess changes in responses to rejection, PPE, and STB over time. The proposed project has three specific aims: (1) Examine multimodal measures of within- individual affective and physiological responses to rejection as near-term, prospective predictors of within- person fluctuations in STB over time; (2) Examine exposure to PPE as between-persons distal moderators of within-person processes leading to near-term increases in STB at the individual level; and (3) Apply machine learning techniques to identify combinations of multiple time-varying within-person processes and static between-person differences that are most predictive of suicide risk over time. Results of this study will lead to advances in suicide risk assessment, identification of novel points of intervention, and development of personalized interventions to prevent suicide attempts among vulnerable individuals.

摘要/项目摘要 18-25岁的年轻人的自杀率已在30多年中提高到最高水平，但 我们准确预测自杀尝试的能力仍然限于静态，静态风险因素。有紧急 需要进行研究以确定评估谁在不久的将来有自杀风险的方法，这是一致的 国家行动联盟优先的研究议程的理想目标3。根据总体 早期研究者的R01的目标是提高我们识别特定快入的特定的能力， 预测急性自杀风险的动态内部过程会增加急性增加。 与会员和依恋相关的社会过程（例如，社会拒绝或排斥），以及痛苦和痛苦和 挑衅性事件（PPE；例如，暴力创伤和自我伤害）是自杀的远端风险因素。 但是，动态认知影响和生物学反应对拒绝经历的作用 对任何个人的近期自杀风险进行预测。另外，尚不知道 与排斥相关的过程对近期自杀风险的影响可能因远端风险因素而异 例如暴露于PPE。当前的应用概述了一项多方法密集的纵向研究 将动态的情感和身体对拒绝的反应作为临时风险因素 自杀思想和行为的波动（STB）在几个小时到几天，几周和几个月的过程中。我们 还将检查对PPE的接触，作为主持人，放大对社会拒绝的个体反应性， 从而进一步增加自杀风险。参与者将包括150个诊断多样的临床样本 在过去的4个月中，年轻的成年男女（18至35岁）具有临床意义的STB。多模式 基线时的评估将包括21天的随机和基于事件的生态瞬时评估 （EMA）协议；具有心理生理​​措施，自我报告和评估的实验室范例 隐式自杀相关的认知；以及使用时间轴跟随（TLFB）方法的访谈。评估 在12个月的时间内4个月的间隔将包括重复的实验室任务，身体和 隐性评估，自我报告和TLFB访谈，以评估对拒绝，PPE和 随着时间的流逝。拟议的项目具有三个具体目标：（1）检查内部的多模式测量 个人情感和身体对拒绝的反应，是近期的，前瞻性的预测指标 随着时间的流逝，人体波动在STB中的波动； （2）检查对PPE的接触 人身内部的过程导致单个级别的STB近期增加； （3）应用机器 学习技术以识别多个时间变化的内部过程和静态的组合 随着时间的推移，最可预测自杀风险的人之间的差异。这项研究的结果将导致 自杀风险评估的进步，新的干预点的识别以及发展 个性化干预措施，以防止弱势个人自杀企图。