The Developmental Psychopathology of Suicidal Ideations and Cognitions in Childhood

童年自杀意念和认知的发展精神病理学

• 批准号: 10112758
• 负责人: Deanna Barch
• 金额: $ 68.2万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-15 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10112758
• 关键词: 11 year old; 7 year old; Accounting; Adolescence; Adolescent; African American; Age; Award; Behavior assessment; Behavioral; Bipolar Disorder; Brain; Case Study; Cause of Death; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Child; Child Rearing; Childhood; Climacteric; Cognition; Corpus striatum structure; Data; Death Rate; Depressed mood; Development; Early Intervention; Event; Event-Related Potentials; Evolution; Exhibits; Family; Family history of; Feedback; Feeling; Feeling hopeless; Feeling suicidal; Frequencies; Funding; Guilt; Hospitals; Impulsivity; Injury; Investigation; Life; Literature; Longitudinal Studies; Maps; Measures; Mediating; Mediator of activation protein; Mental Depression; Methods; Modeling; National Institute of Mental Health; Nursery Schools; Pain Threshold; Parents; Preschool Child; Prevalence; Prevention; Psychopathology; Psychosocial Factor; Publishing; Recording of previous events; Reporting; Research Domain Criteria; Rewards; Risk; Risk Factors; Sampling; School-Age Population; Self-Injurious Behavior; Severities; Shame; Stimulus; Suicide; Suicide attempt; Testing; Thinking; Time; Visit; aged; boys; bullying; design; early adolescence; early childhood; early onset; emotion dysregulation; experience; follow-up; girls; indexing; longitudinal course; middle childhood; neural correlate; non-suicidal self injury; peer; peer victimization; prepuberty; prospective; protective factors; psychologic; psychosocial; relating to nervous system; response; risk sharing; social; suicidal behavior; suicidal morbidity

Abstract: A marked increase in suicidal thoughts and behaviors (STB) among pre-pubertal children over the last decade has been reported by the CDC. Death by suicide in children ages 10-14 more than doubled between 2007 and 2014 with rates of non-lethal self-inflicted injuries doubling during the same period. Despite these dramatic rises in STB rates, there has been little investigation of the prevalence, timing of onset, or correlates and causes of STB or non-suicidal self-injury (NSSI) in pre-pubertal children. In a longitudinal study of preschool depression, we reported that preschool-onset STB shows stability across childhood. Outside of case reports, there are no other published data on STB or NSSI in early childhood. Our findings, taken together with the CDC data, support the critical need for studies of STB and NSSI that start in early childhood to identify the predictors of STB and NSSI in middle childhood and adolescence. In a sample of 3-7 year olds screened for a treatment study of depression we again found alarmingly high rates of NSSI (21.3%) and STB (19.4%) at baseline. Supplemental NIMH funding was awarded to investigate the characteristics and neural and behavioral correlates of STB and NSSI in this depressed sample, and to add age matched healthy controls. We found both common and unique risk factors for STB and NSSI in young children, consistent with the extant adolescent literature. Building on these findings, we propose to follow this well characterized sample into school age and early adolescence to test developmental models of these phenomena. We will investigate the longitudinal course, mediators and moderators, and neural correlates of early onset STB and NSSI. We will conduct behavioral and ERP assessments at two time points, 18-months apart in our sample of N=314 who have data from the preschool period. We will also sample the frequency, intensity, and proximal precipitants of STB/NSSI using weekly mini-assessments (WMA). Building on preliminary findings, we will use ERPs to test hypotheses about RDoC constructs that map to the risk factors that may contribute to STB and NSSI, including responses to negative and positive feedback to reward, errors, and peer rejection. We will test specific hypotheses about both shared risk factors for NSSI and STB (greater depression, peer rejection, adverse life events, and harsh parenting, as well as stronger ERP responses to loss and peer rejection, and blunted ERP responses to wins and social acceptance) as well as risk factors that may be more selective for NSSI (greater shame, irritability, self-criticism and higher pain tolerance) versus STB (reduced belongingness, greater hopelessness and a family history of suicide). Given the young age of the ascertained sample at baseline, we also have the opportunity to investigate differences in risk as a function of developmental stage. The proposed study provides an unprecedented opportunity to follow the largest ever sample of young children with STB and NSSI to investigate developmental trajectories into school age and early adolescence, potentially identifying early developmental targets for earlier intervention.

摘要：假设前儿童的自杀思想和行为（STB）明显增加 疾病预防控制中心已经报道了最近的十年。自杀死亡10-14岁的儿童增加了一倍以上 在2007年至2014年之间，同一时期的非致命性自我伤害率加倍。尽管 这些戏剧性的STB率上升，几乎没有调查出发率，发病时机或 前儿童中STB或非自杀自伤（NSSI）的相关性和原因。在纵向研究中 在学龄前抑郁症中，我们报告说，学龄前的STB在整个儿童期都表现出稳定性。外面 病例报告，幼儿没有其他有关STB或NSSI的数据。我们的发现，采取了 与CDC数据一起，支持从童年开始的STB和NSSI研究的关键需求 在儿童期和青春期中确定STB和NSSI的预测因子。在3-7岁的样本中 筛选了一项抑郁症治疗研究，我们再次发现NSSI（21.3％）和STB的率很高 基线时（19.4％）。授予补充NIMH资金来调查特征和神经 在此抑郁样本中，STB和NSSI的行为相关性，并增加年龄匹配的健康 控件。我们发现幼儿中STB和NSSI的常见和独特的危险因素，与 现存的青少年文学。在这些发现的基础上，我们建议遵循这个良好的样本 进入学龄和青春期早期，以测试这些现象的发展模型。我们将调查 早期发作STB和NSSI的纵向过程，介体和主持人以及神经相关性。我们将 在两个时间点进行行为和ERP评估，在我们的n = 314样本中相距18个月 有学龄前时期的数据。我们还将采样的频率，强度和近端沉淀物 STB/NSSI使用每周的迷你评估（WMA）。在初步发现的基础上，我们将使用ERP进行测试 关于RDOC结构的假设，这些构造映射到可能导致STB和NSSI的风险因素，包括 对负面反馈和积极反馈的响应，对奖励，错误和同行排斥。我们将测试特定 关于NSSI和STB的共享风险因素的假设（更大的抑郁症，拒绝，不利生活 事件和严厉的育儿，以及对损失和同伴拒绝的更强的ERP反应，并钝化ERP 对胜利和社会接受的反应）以及可能对NSSI更具选择性的风险因素（更大的 羞耻，烦躁，自我批评和更高的疼痛耐受性）与STB（归属感降低，更大 绝望和自杀的家族史。考虑到基线时确定样本的年龄很小，我们 也有机会研究风险差异作为发展阶段的函数。提议 研究提供了一个前所未有的机会，可以追踪有史以来最大的STB和 NSSI调查开发轨迹到上学年龄和青春期早期，有可能识别 早期干预的早期发展目标。