Parent-adolescent informant discrepancies: Predicting suicide risk and treatment outcomes

父母与青少年信息差异：预测自杀风险和治疗结果

基本信息

批准号：
10751263
负责人：
Angela Page Spears
金额：
$ 4.13万
依托单位：
COLUMBIA UNIVERSITY TEACHERS COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2024
资助国家：
美国
起止时间：
2024-01-01 至 2026-12-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10751263
关键词：
Adolescence Adolescent Adult Affect Aftercare Agreement Anxiety Area Attitude Behavior Cause of Death Clinical Communication Communities Complex Data Development Disease Effectiveness of Interventions Evaluation Exhibits Family Feeling suicidal Future Goals Individual Inpatients Intake Intention Intervention Interview Investigation Knowledge Life Mental Depression Mental Health Mental Health Services Methods Modeling Outcome Parents Patient Self-Report Pattern Polynomial Models Prognosis Proxy Psychopathology Randomized, Controlled Trials Reporting Research Research Personnel Risk Risk Factors Severities Subgroup Suicide Suicide attempt Surface Symptoms Testing Thinking Treatment Efficacy Treatment outcome United States Work Writing Youth adolescent suicide autism spectrum disorder behavior prediction cost effective design early adolescence effective therapy effectiveness testing experience follow-up health care settings high risk high-risk adolescents informant insight novel operation peer personalized intervention prevent prognostic value psychiatric symptom reducing suicide response skills suicidal suicidal adolescent suicidal behavior suicidal morbidity suicidal risk therapy resistant treatment as usual treatment response

项目摘要

PROJECT SUMMARY Suicide is the 2nd leading cause of death among adolescents in the United States. Research suggests that the onset of suicidal ideation usually arises in early adolescence and these individuals are approximately 12 times more likely than their non-suicidal peers to exhibit suicidal behavior by middle adulthood, highlighting adolescence as a key developmental period for intervention. Yet, these precipitants of suicide death (i.e., suicidal thoughts and behaviors) remain difficult to predict and treat. Comprehensive assessments often include reports from parents and self-reports from adolescents to identify those in need of intervention and examine treatment responses. Historically, these assessments have been interpreted based on highly convergent parent-adolescent reports, or the prioritization of one informants' report over another. There remains a critical knowledge gap around how to best interpret and utilize inconsistent informant reports. Decades of research in youth psychopathology suggest multi-informant discrepant reporting patterns (DRPs) are not synonymous with poor assessment, but may indicate clinically meaningful information. In the present study, we draw from Co-Sponsor De Los Reyes' Operations Triad Model, a set of principles that elucidate the function of converging and discrepant reports, to examine multi-informant DRPs across two contexts. In pursuit of Aim 1, we will initially examine a non-treatment context by drawing data from a completed `Assessment Study' featuring baseline reports from parent-adolescent dyads (n=96 dyads) on the Self-Injurious Thoughts and Behaviors Interview-Revised (R15MH113076; PI/Primary Sponsor Cha). We will test whether baseline parent-adolescent DRPs about community-based adolescents' suicidal thoughts and behaviors predict their future suicidal ideation occurring 3- and 6-months later. In pursuit of Aim 2, we will then examine a treatment context by drawing data from an ongoing randomized controlled trial (i.e., `Treatment Study') featuring pre- treatment reports from parent-adolescent dyads (n=100 dyads) on the Columbia-Suicide Severity Rating Scale (R01MH123556; MPI/Co-Sponsor Yen). We will test whether pre-treatment parent-adolescent DRPs about inpatient adolescents' suicidal thoughts and behaviors predict their post-treatment suicidal ideation and behavior, and whether these effects are moderated by treatment assignment (active `Skills to Enhance Positivity' intervention vs. enhanced Treatment as Usual). Polynomial regression and response surface analyses will be used to probe the directionality and degree of parent-adolescent DRPs (Aims 1-2). With the intention of testing whether multi-informant DRPs predict adolescents' future risk across treatment and non- treatment settings, the long-term goal of this work is to maximize the prognostic value of information that is readily collected as a part of standard mental health evaluations for youth.

项目摘要自杀是美国青少年的第二大死亡原因。研究表明自杀念头的发作通常在青春期早期出现，这些人约为12次比非杀害同龄人更有可能在成年中表现出自杀行为青春期是干预的关键发展时期。然而，这些自杀死亡的沉淀因子（即自杀思想和行为）仍然很难预测和治疗。经常进行全面评估包括父母的报告和青少年的自我报告，以确定需要干预和需要干预的人检查治疗反应。从历史上看，这些评估是根据高度解释的融合父母 - 青春期的报告，或一个线人报告优先级。那里关于如何最好地解释和利用不一致的线人报告，仍然是一个关键的知识差距。几十年的青年心理病理学研究表明多种形式的差异报告模式（DRP）不是评估不良的代名词，但可能表明临床上有意义的信息。现在研究，我们借鉴了共同发起人de los Reyes的运营三合会模型，这是一组阐明该原则的原则收敛和差异报告的功能，以检查两种情况下的多信息DRP。追求在AIM 1中，我们最初将通过从完成的评估中绘制数据来检查非治疗环境研究'由亲生二元组（n = 96个二元组）的基线报告介绍了自我伤害的思想和行为访谈审查（R15MH113076; PI/PRICICE赞助商CHA）。我们将测试是否基线关于基于社区的青少年的自杀思想和行为的父母 - 成年的DRP预测他们未来的自杀念头发生了3个月和6个月。为了追求目标2，我们将检查一种治疗方法通过从正在进行的随机对照试验（即“治疗研究”）中绘制数据，以预期来自哥伦比亚自由卫生的严重程度评级量表的父母青年二元组（n = 100个二元）的治疗报告（R01MH123556; MPI/共同赞助商日元）。我们将测试是否有关父母青春期的DRP 住院青少年的自杀思想和行为预测了他们的后治疗自杀念头和行为，以及这些影响是否通过治疗分配来调节（积极的技能以增强阳性干预与往常一样增强治疗）。多项式回归和响应表面分析将用于探测父培养子的方向性和程度（AIMS 1-2）。与测试多种知识的DRP是否预测青少年在治疗和非 - 治疗环境，这项工作的长期目标是最大化信息的预后价值很容易作为青少年标准心理健康评估的一部分收集。