Stress, Inflammation, Aggression and Emotion Regulation in Suicidal Behavior

自杀行为中的压力、炎症、攻击性和情绪调节

• 批准号: 10207367
• 负责人: BARBARA STANLEY
• 金额: $ 15.95万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-19 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10207367
• 关键词: Aggressive behavior; Amygdaloid structure; Anti-Inflammatory Agents; Behavioral; Binding; Biochemical; Biological Markers; C-reactive protein; Characteristics; Cognitive; Complement component C5; Concept Formation; Data; Depressed mood; Disease susceptibility; Docosahexaenoic Acids; Ecological momentary assessment; Elements; Exhibits; Family history of; Feeling suicidal; Hippocampus (Brain); Hydrocortisone; Image; Impulsive Behavior; Impulsivity; Individual; Inflammation; Inflammatory; Interleukin-6; Kynurenine; Literature; Maintenance; Measurement; Measures; Mental Tests; Modeling; Neopterin; Neurobiology; Neurocognition; Omega-3 Fatty Acids; Outcome; Pathway interactions; Patient Self-Report; Pattern; Peripheral; Physiological; Plasma; Polyunsaturated Fatty Acids; Prevention; Psyche structure; Quinolinic Acid; Recording of previous events; Risk; Risk Factors; Role; Salivary; Sampling; Sorting - Cell Movement; Stress; Stress Tests; Suicide; Suicide attempt; Testing; Time; Trier Social Stress Test; Tryptophan; Wisconsin; Work; alpha-amylase; biological adaptation to stress; childhood adversity; cytokine; emotion dysregulation; emotion regulation; executive function; flexibility; healthy volunteer; high risk; improved; in vivo; indexing; neurocognitive test; neuroinflammation; noradrenergic; performance tests; personalized approach; recruit; response; social stress; stressor; suicidal; suicidal behavior; suicidal morbidity; suicidal risk; suicide attempter; trait impulsivity

SUMMARY – PROJECT 5 Conte Center Project 5 investigates the stress-diathesis model of suicidal behavior. Specifically, we examined stress response using the Trier Social Stress Test (TSST) and Ecological Momentary Assessment of daily stressors (EMA), and studied the role of childhood adversity (CA) and impulsive aggression in depressed suicide attempters, depressed nonattempters and healthy volunteers. We found that while aggression was higher in attempters, stress responsivity was heightened only in attempters with high reactive/impulsive aggression. We also observed that this highly stress responsive, impulsive group displayed a cluster of characteristics: a pattern of frequent brief, highly variable suicidal ideation (SI) that correlated to a history of CA and increased in response to daily stressors, together with poorer emotion regulation. In contrast, we found that high planning of suicide attempts was related to family history of suicide and persistent SI. Thus, we observe different sets of characteristics associated with suicidal outcomes at opposite ends of a continuum from very impulsive to highly planned and deliberate suicidal behaviors. In this application, we expand our work by further exploring the neurobiological and cognitive underpinnings of impulsivity/planning of suicide attempts. Specifically, we will examine executive functioning and emotion regulation strategies (in vivo during the TSST and EMA) and determine their relationships with suicidal behavior, SI variability and stress response. A second promising extension of our work is to study related stress response mechanisms, particularly inflammation, which is associated with suicide risk factors of CA and aggression. We have shown that the cytokine-activated kynurenine pathway is upregulated in attempters, and that lower levels of the anti-inflammatory polyunsaturated fatty acid (PUFA) docosahexaenoic acid predict suicide attempts, and we have pilot data on elevated IL-6 in high risk attempters, consistent with previous literature. A clearer delineation of the behavioral and physiological pathways to suicidal behavior will improve prevention by identifying a more personalized approach depending on the risk profile.

摘要-项目5 康特中心项目5研究自杀行为的压力素质模型。具体来说，我们检查了 使用特里尔社会压力测试（TSST）和日常生态瞬时评估的压力反应 压力源（EMA），并研究了童年逆境（CA）和冲动性攻击在抑郁症自杀中的作用 抑郁症患者和健康志愿者。我们发现，虽然侵略性更高， 压力反应只有在反应性/冲动性攻击性高的学生中才能提高。我们 我还观察到，这一高度应激反应、冲动的群体表现出一系列特征： 频繁的短暂的，高度可变的自杀意念（SI），与CA病史相关， 日常压力以及较差的情绪调节。相比之下，我们发现高自杀计划 自杀未遂与家族自杀史和持续性SI有关。因此，我们观察到不同的 从非常冲动到高度冲动的连续体的两端，与自杀结果相关的特征 有计划和蓄意的自杀行为在这个应用程序中，我们通过进一步探索 神经生物学和认知基础的冲动/计划自杀企图。具体来说，我们将 检查执行功能和情绪调节策略（在TSST和EMA期间的体内）， 确定其与自杀行为、SI变异性和应激反应的关系。第二个有希望的 我们工作的延伸是研究相关的应激反应机制，特别是炎症， 与CA和攻击性自杀危险因素相关。我们已经证明，马尿氨酸激活的犬尿氨酸 尝试者的途径上调，并且抗炎多不饱和脂肪酸水平较低 （PUFA）二十二碳六烯酸预测自杀企图，我们有关于高风险患者IL-6升高的初步数据。 这与以前的文献一致。更清晰地描绘了行为和生理途径 将通过根据风险确定更个性化的方法来改善预防 profile.