Social Cognitive Mechanisms Underlying Disclosure and Help Seeking Behavior in Late-Life Suicide

晚年自杀中披露和寻求帮助行为背后的社会认知机制

• 批准号: 10592120
• 负责人: Colin A. Depp
• 金额: $ 74.51万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2027-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10592120
• 关键词: Affect; Aging; Area; Behavior; Characteristics; Clinical; Code; Cognitive; Coupled; Data; Disclosure; Ecological momentary assessment; Elderly; Elements; Emotions; Ethnic Origin; Evaluation; Face; Feeling suicidal; Gender; Goals; Health Professional; Hypersensitivity; Impaired cognition; Individual; Influentials; Intervention; Language; Link; Loneliness; Longitudinal Studies; Measurement; Measures; Mediating; Mental Health Services; Methods; Mind; Modeling; Motivation; National Institute of Mental Health; Natural Language Processing; Negative Valence; Outcome; Participant; Pathway Analysis; Patient Self-Report; Pattern; Positive Valence; Prevention approach; Prevention strategy; Primary Health Care; Process; Recording of previous events; Research; Research Domain Criteria; Risk; Safety; Sampling; Series; Social Behavior; Social Network; Social isolation; Specific qualifier value; Speech; Strategic Planning; Structure; Subgroup; Suicide; Suicide attempt; Suicide prevention; System; Task Performances; Time; Translating; Work; cognitive ability; cognitive process; depressive symptoms; digital mental health; dyadic interaction; health care settings; help-seeking behavior; ideation; improved; mHealth; motivational processes; multimodality; novel; personalized intervention; predictive marker; prospective; recruit; safety net; social; social cognition; social contact; social engagement; social factors; social inclusion; social structure; suicidal behavior; suicidal risk; theories; tool; young adult

PROJECT SUMMARY/ABSTRACT This proposal responds to RFA-MH-22-135. Non-disclosure of suicide ideation prior to attempt is normative and even more common in later life. Similarly, our preliminary data indicates lower inclusion of social contacts in suicide safety plans among at-risk older adults. Unfortunately, interventions to increase informal help seeking are ineffective to date. Therefore, major roadblocks exist in the interpersonal processes seen as essential to late-life suicide prevention, and new targets are needed for increasing help-seeking behavior. The purpose of this longitudinal observational project is to understand why older adults do not disclose suicide ideation or seek help from others amidst suicide crises. We focus on social cognitive abilities and biases, which influence how individuals perceive (or misperceive) others and have previously been associated with loneliness, suicidal ideation and behavior. The premise of this research is that social cognitive impairments impact the positive and negative valence systems involved in affiliation and the social structures that determine help seeking in suicide. Facilitating this research, our group has developed and validated a dyadic social affiliation task that objectively quantifies RDoC positive and negative valence systems involved in support seeking. This task enables evaluation of valence systems across multiple units of analysis, including behavior, self-report, facial affect and natural language processing. Measurement of these intrinsic processes will be integrated with quantification of extrinsic help-seeking opportunity, via structural social network assessment. A translational aspect of our proposed social network analyses is to augment network measurement with the social elements of suicide safety planning. In a longitudinal study, we will recruit a sample of diverse older adults from a variety of urgent, primary, and mental health care settings. Recruitment will be stratified by groups defined by current active suicide ideation, depressive symptoms without ideation or attempt histories, and healthy comparators. In Aim 1 of the study, we will compare groups on social cognition, positive and negative valence indicators from our social affiliation task, along with social network structure, including past help seeking and disclosure in the subgroup with current suicide ideation. In Aim 2, we will administer mobile emotion recognition tasks and social affiliation in predicting in real-time suicide disclosure through ecological momentary assessment over 30 days. We will then evaluate whether social cognition and affiliation markers predict trajectories of help seeking and suicide ideation through longitudinal data gathered over one year. Exploratory analyses will leverage the data derived by applying time series network analyses and natural language processing to model processes underlying non-disclosure. Our long-term goal is to translate this research to novel personalized interventions that improve interpersonal processes embedded in both current and novel suicide prevention approaches for older adults. This proposal responds directly to NIMH Strategic Plan, Aim 2.2 and 3.2, and the NIMH’s Priority Area in Digital Mental Health.

项目概要/摘要 该提案响应 RFA-MH-22-135，在尝试之前不披露自杀意念是规范性的。 同样，我们的初步数据表明社会交往的包容性较低 不幸的是，增加非正式帮助的干预措施。 因此，迄今为止，人际交往过程中存在着主要障碍。 这对于预防晚年自杀至关重要，并且需要新的目标来增加寻求帮助的行为。 这个纵向观察项目的目的是了解为什么老年人不透露自杀事件 我们关注社会认知能力和偏见， 影响个人如何看待（或误解）他人，并且之前曾与 孤独感、自杀意念和行为。这项研究的前提是社会认知障碍。 影响参与归属的正价和负价系统以及决定的社会结构 为了促进这项研究，我们的小组开发并验证了二元社会。 客观量化参与支持的 RDoC 正负价系统的隶属任务 该任务可以跨多个分析单元评估价系统，包括行为、 自我报告、面部情感和自然语言处理这些内在过程将被测量。 通过结构性社交网络评估与外部寻求帮助机会的量化相结合。 我们提出的社交网络分析的转化方面是通过以下方式增强网络测量 在一项纵向研究中，我们将招募不同的老年人样本。 来自各种紧急、初级和精神卫生保健机构的成年人的招募将按以下条件进行分层。 由当前活跃的自杀意念、没有意念或企图历史的抑郁症状定义的群体， 在研究的目标 1 中，我们将比较各组的社会认知、积极认知和健康认知。 来自我们的社会归属任务的负价指标，以及社会网络结构，包括过去的 帮助在当前有自杀意念的小组中寻求和披露。在目标 2 中，我们将管理移动设备。 情绪识别任务和社会归属感通过生态学预测实时自杀披露 然后我们将评估社会认知和归属标记是否超过 30 天。 通过一年多收集的纵向数据预测寻求帮助和自杀意念的轨迹。 探索性分析将利用通过应用时间序列网络分析和自然分析得出的数据 我们的长期目标是翻译这一点。 研究新颖的个性化干预措施，以改善当前和未来的人际关系过程 以及针对老年人的新颖的自杀预防方法 该提案直接响应 NIMH 战略。 计划、目标 2.2 和 3.2，以及 NIMH 在数字心理健康方面的优先领域。