Mechanisms underlying the association of firearm availability and vulnerability to suicide

摘要 在过去的20年里，美国的自杀率上升了35%以上。火器 在同一时间段内，自杀率上升了15%，占美国自杀人数的大多数， 近三分之二的枪支相关死亡枪支的可用性导致自杀死亡率的部分原因是 增加自杀行为后致命结局的可能性。枪支的可用性也可能有助于 通过对预期焦虑和认知控制的影响间接影响自杀死亡率， 生物行为过程可能会增加自杀行为的脆弱性。我们的首要目标是 确定旨在防止枪支自杀的干预措施和方案的候选目标。实现这一 目的：我们将招募三个目标群体，其中一半有自杀意念史：（a）手枪 经常携带枪支的拥有者，（B）不经常携带枪支的手枪拥有者，以及（c）非 枪支拥有者然后，我们将比较这些群体的各种自我报告，心理生理，行为， 生态评估方法。我们将（目标1）揭示与以下相关的生物行为过程： 使用NPU威胁惊吓范式和停止信号反应时间的枪支可用性和自杀风险 识别在不确定威胁条件下行为反应差异的测试（即，预期焦虑） 和抑制控制的差异。我们假设手枪拥有者和有 自杀意念与预期焦虑增加和抑制控制减少有关。我们将 (Aim 2）研究枪支持有，情绪反应和自杀风险之间的联系 使用视频社交情感信息处理（V-SEIP）跟踪社交模糊情况 任务，以评估在社会模糊的情况下，负面情绪反应的差异。我们 假设想象自己拥有枪支的受试者会表现出更高的情绪化， 在社会上模棱两可的情况下的反应。我们将（目标3）确定影响 使用生态瞬时评估（EMA）的手枪拥有者的情绪反应。我们 假设手枪拥有者和有自杀意念史的受试者在以下方面表现出更多的变异性： 消极情绪状态我们进一步假设，当一个人处于消极情绪状态时， 目标持有枪支拟议的项目将提供有关发展的新信息， 有助于枪支自杀的个人和背景因素，并将确定潜在的干预措施 可以加强的目标，以减少与枪支供应有关的风险。这项研究也将 为后续的研究提供信息，这些研究将严格调查枪支与自杀的相关性。最后，我们的结果 可以为提高火器伤害和死亡预防计划的有效性提供新的线索。

ABSTRACT The U.S. general population suicide rate has increased by more than 35% over the past 20 years. Firearm suicides have risen by 15% during this same timeframe, and account for the majority of U.S. suicides and nearly two-thirds of all firearm-related deaths. Firearm availability contributes to suicide mortality in part by increasing the probability of a fatal outcome following suicidal behavior. Firearm availability may also contribute to suicide mortality indirectly through its influence on anticipatory anxiety and cognitive control, two biobehavioral processes that can increase vulnerability to suicidal behaviors. Our primary objective is to identify candidate targets for interventions and programs intended to prevent firearm suicide. To achieve this objective, we will enroll three target groups, half of whom will have a history of suicide ideation: (a) handgun owners who regularly carry a firearm, (b) handgun owners who do not regularly carry a firearm, and (c) non- gun owners. We will then compare these groups on a variety of self-report, psychophysiological, behavioral, and ecological assessment methods. We will (Aim 1) reveal biobehavioral processes associated with firearm availability and suicide risk using the NPU-threat startle paradigm and the stop-signal reaction time test to identify differences in behavioral reactivity under conditions of uncertain threat (i.e., anticipatory anxiety) and differences in inhibitory control. We hypothesize that handgun owners and subjects with a history of suicide ideation will be associated with increased anticipatory anxiety and decreased inhibitory control. We will (Aim 2) examine associations among firearm possession, emotional reactivity, and suicide risk following socially ambiguous situations using the Video Social Emotional Information Processing (V-SEIP) task to assess differences in negative emotional reactivity during socially ambiguous situations. We hypothesize that subjects who imagine they are in possession of a firearm will show increased emotional reactivity during socially ambiguous situations. We will (Aim 3) identify contextual factors that influence emotional reactivity among handgun owners using ecological momentary assessment (EMA). We hypothesize that handgun owners and subjects with a history of suicide ideation will show more variability in negative mood state. We further hypothesize that variability in negative mood state will be increased when a subject is in possession of a firearm. The proposed project will provide novel information about developmental, individual, and contextual factors that contribute to firearm suicide, and will identify potential intervention targets that could be strengthened to reduce the risk associated with firearm availability. This research will also inform subsequent studies that will rigorously investigate the firearm-suicide correlation. Finally, our results could reveal new clues for improving the effectiveness of firearm injury and mortality prevention programs.