Integrative Data Analysis of Coping Power: Effects on Adolescent Suicidality

应对能力的综合数据分析：对青少年自杀的影响

• 批准号: 10078678
• 负责人: JOHN E LOCHMAN
• 金额: $ 49.19万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10078678
• 关键词: Accounting; Address; Adolescence; Adolescent; Aggressive behavior; Alcohol or Other Drugs use; Area; Behavior; Cause of Death; Characteristics; Child; Childhood; Data; Data Analyses; Development; Discipline; Exhibits; Factor Analysis; Family; Gender; Human; Individual; Internet; Intervention; Life; Literature; Measurement; Measures; Mediator of activation protein; Meta-Analysis; Modeling; Outcome; Pathway interactions; Patient-Focused Outcomes; Population; Population Intervention; Prevention; Prevention approach; Preventive; Preventive Intervention; Psychopathology; Randomized; Randomized Controlled Trials; Reporter; Research Personnel; Risk; Risk Factors; School-Age Population; Schools; Specificity; Suicide; Suicide attempt; Suicide prevention; Symptoms; Testing; Time; Variant; Weight; Youth; aged; boys; comparative; coping; critical period; emotion regulation; girls; high school; individual patient; innovation; intervention effect; novel; post intervention; programs; response; suicidal behavior; suicidal morbidity; suicidal risk; suicide rate; theories; young adult

PROJECT SUMMARY/ABSTRACT Suicide is the second leading cause of death among individuals aged 10-34 in the US, with 17% of high school-aged youth seriously considering a suicide attempt and 8% attempting suicide. There is emerging evidence to suggest that preventive interventions that do not explicitly target suicide have “crossover” effects on suicidality. However, the majority of interventions that have been examined for their impact on suicide target internalizing behaviors, which may miss a significant subset of boys, whose risk for suicidality is primarily transmitted through externalizing; this concern is echoed by calls in the recent suicide prevention literature for addressing the dearth of literature on suicide crossover effects from externalizing-focused interventions. The Coping Power (CP) program is an empirically supported, child- and family-focused preventive intervention that focuses on reducing externalizing more broadly among youth who exhibit early aggression, which makes it ideally suited to addressing the above-mentioned gaps in targeting externalizing pathways to suicidality. The proposed study will combine data from 10 randomized controlled trials (RCTs) of CP (total individual-level N = 3,201; total school-level N = 188) and utilize three measurement and data analysis frameworks that have emerged across multiple independent disciplines: integrative data analysis (IDA), meta- analysis of individual patient data (MIPD), and propensity score weighting (PSW). Using these frameworks, we propose the following aims: Aim 1: Estimate scale scores for key constructs while accounting for differential item functioning across studies, time, populations, and reporters. Aim 2: Assess comparative effect sizes for multiple forms of Coping Power (CP) using IDA-estimated scale scores for CP mechanisms of action, externalizing, internalizing, and suicidality. Aim 3: Test for potential mediators of CP effects on risk for suicidality as transmitted through CP's mechanisms of action (MoAs) and/or intermediate endpoints. Aim 4: Explore individual-, school- and study-level moderators of CP's effects on MoAs, intermediate endpoints, and risk for suicidality. If successful, the proposed study will (1) be one of the first to apply a symptom weighting framework (e.g., MNLFA, item response theory) for measuring suicidality, while accounting for measurement bias across multiple factors (e.g., time, development, demographic variables, reporters), (2) provide initial evidence for preventive effects on suicidality through gender-specific pathways (externalizing for boys, internalizing for girls), (3) illustrate evidence that CP's direct and/or indirect impact on reductions in suicidality is greater among youth who are at higher initial risk, and (4) identify the optimal conditions for CP delivery (e.g., group, individual, internet) for different youth characteristics (which could not be examined in any single RCT of CP).

项目概要/摘要 自杀是美国 10-34 岁人群的第二大死因，其中自杀率高达 17% 学龄青少年正在认真考虑自杀企图，并且有 8% 的人正在尝试自杀。 有证据表明，不明确针对自杀的预防性干预措施具有“交叉”效应 然而，大多数干预措施对自杀目标的影响都已得到检验。 内化行为，这可能会遗漏男孩的一个重要子集，他们的自杀风险主要是 通过外在化传播；最近的自杀预防文献中也呼应了这一担忧 探讨以外在化为重点的干预措施中自杀交叉效应的文献深度。 应对能力 (CP) 计划是一项以经验为支持、以儿童和家庭为中心的预防性计划 干预措施的重点是更广泛地减少表现出早期攻击性的青少年的外化， 这使得它非常适合解决上述针对外部化途径的差距 拟议的研究将结合 10 项 CP 随机对照试验 (RCT) 的数据（总计）。 个人层面 N = 3,201；学校层面总 N = 188）并利用三项测量和数据分析 跨多个独立学科出现的框架：综合数据分析（IDA）、元数据分析 我们使用这些框架对个体患者数据（MIPD）和倾向评分加权（PSW）进行分析。 提出以下目标： 目标 1：估计关键结构的量表分数，同时考虑差异项目功能 跨越研究、时间、人群和生产者。 目标 2：使用 IDA 估计来评估多种形式的应对能力 (CP) 的比较效应大小 CP 作用机制、外化、内化和自杀的量表得分。 目标 3：测试通过 CP 传播的 CP 对自杀风险影响的潜在中介因素 作用机制 (MoAs) 和/或中间终点。 目标 4：探索 CP 对 MoAs、中间层影响的个人、学校和研究层面的调节因素 终点和自杀风险。 如果成功，拟议的研究将 (1) 成为首批应用症状加权框架的研究之一（例如， MNLFA（项目反应理论）用于测量自杀率，同时考虑到测量偏差 多种因素（例如时间、发展、人口变量、生产者），(2) 提供初步证据 通过针对特定性别的途径对自杀产生预防作用（男孩外化，男孩内化） 女孩），（3）说明了 CP 对减少自杀率的直接和/或间接影响在以下人群中更大的证据： 初始风险较高的青少年，以及 (4) 确定 CP 实施的最佳条件（例如，分组、 个人、互联网）针对不同的青少年特征（无法在任何单一的 CP 随机对照试验中进行检验）。