Effects of parental history of suicidal behavior on middle/late childhood: Longitudinal assessment of early markers of suicide risk

项目总结/摘要 自杀是美国5至12岁儿童死亡的第五大原因，但对儿童的研究有限 自杀和自杀行为（SB）。国家心理健康研究所（NIMH）承认， 这一关键差距作为一个高度优先的研究。第一次自杀企图早期发作的一个重要风险因素 (SA)虽然SB的家庭传播是有据可查的，但研究 对与家族性风险相关的具体机制的研究是有限的。我们正在进行的NIMH-R21研究 （队列1）正在研究与6-9岁儿童SB家族风险相关的因素，（PH+; n=100）， 没有SA的父母病史（PH-; n=100）。这项拟议的R 01研究将继续进行年度随访， 队列1，并增加额外300个新入组的家庭（队列2;年龄9-11岁;每个PH组150个）， 总共有500个亲子配对样本。将对青少年进行为期四年的跟踪调查，从童年中期/晚期到 青春期早期/中期。使用研究领域标准（RDoC）框架，我们将检查 神经认知功能（NF）、情绪反应/调节（ERR）、非自杀性自伤的轨迹 （NSSI），自杀意念（SI），和SA在PH+和PH-青年沿着与性别和种族的贡献。研究 第一次评估的参与者包括7-12岁的青年。在最后一次评估中，青少年的年龄将在10-15岁之间 年PH+和PH-两组将按性别和人种进行平衡。两个主要的研究目标和一个 探索性目标将得到检验。目标1：纵向检查PH状态如何与 NF和ERR结构在儿童中期/晚期到青春期早期/中期测量。目标二： 研究NF和ERR结构对PH状态和EAE之间关系的潜在介导作用。 后代NSSI、SI和SA。探索性目的：检验性别和人种是否为ERR和NF的潜在调节因素 轨迹，以及PH状态与后代NSSI，SI和SA之间的关联。这个提议的核心 假设是：（1）PH+状态增加了以NF为特征的发展轨迹的脆弱性 缺陷和情绪功能障碍/失调;（2）这些轨迹将介导PH 状态和青年NSSI，SI和SA;（3）轨迹和SB/NSSI之间的这些关联将被 受性别和种族的影响。这些假设是根据正在进行的NIMH的初步研究结果得出的， R21研究，其中发现ERR、SB和NF存在组间差异。拟议的R 01研究与 NIMH 2020研究战略计划，重点是目标2-调查心理健康轨迹 包括不同的样本。完成拟议的研究将有助于确定具体的 与SB的家族风险相关的机制，确定性别和种族是否调节这种关联 风险与青少年SB之间的关系，并为针对高危青少年的预防策略提供方向。

PROJECT SUMMARY/ABSTRACT Suicide is the fifth leading cause of death among U.S. children 5 to 12 years, yet limited research on childhood suicide and suicidal behavior (SB) exists. The National Institute of Mental Health (NIMH) has acknowledged this critical gap as a high research priority. A significant risk factor for the early onset of a first suicide attempt (SA) is a parental history of SB. Although the familial transmission of SB is well documented, research examining the specific mechanisms associated with familial risk is limited. Our ongoing NIMH-R21 study (Cohort 1) is investigating factors related to the familial risk of SB in children, 6-9 years, with (PH+; n=100) and without (PH-; n=100) a parental history of SA. This proposed R01 study will continue annual follow-ups for Cohort 1 and add an additional 300 newly enrolled families (Cohort 2; ages 9-11 years; 150 per PH group) for a total sample of 500 parent-child dyads. Youth will be followed for four years from mid/late-childhood through early/mid-adolescence. Using the Research Domain Criteria (RDoC) framework, we will examine the trajectories of neurocognitive function (NF), emotional reactivity/regulation (ERR), non-suicidal self-injury (NSSI), suicidal ideation (SI), and SA in PH+ and PH- youth along with contributions by sex and race. Study participants at first assessment include youth 7-12 years. At last assessment, youth ages will range from 10-15 years. Both groups, PH+ and PH-, will be balanced by sex and race. Two main research aims and one exploratory aim will be tested. Aim 1: Examine longitudinally how PH status is associated with trajectories of NF and ERR constructs measured during mid/late-childhood through early/mid-adolescence. Aim 2: Investigate the potential mediating role of NF and ERR constructs on the association between PH status and offspring NSSI, SI, and SA. Exploratory Aim: Test sex and race as potential moderators of ERR and NF trajectories, and on the association between PH status and offspring NSSI, SI, and SA. This proposal’s central hypotheses are that (1) PH+ status increases vulnerability for developmental trajectories characterized by NF deficits and emotional dysfunction/dysregulation; (2) these trajectories will mediate the association between PH status and youth NSSI, SI, and SA; and (3) these associations between trajectories and SB/NSSI will be moderated by both sex and race. The hypotheses are informed by preliminary findings from the ongoing NIMH- R21 study, where group differences were found for ERR, SB, and NF. The proposed R01 study aligns well with the NIMH 2020 Strategic Plan for Research with emphasis on Goal 2-investigating mental health trajectories and inclusion of diverse samples. Completing the proposed study will assist with the identification of specific mechanisms associated with the familial risk of SB, determine if sex and race moderate the associations between risks and youth SB, and provide direction for targeted prevention strategies for high-risk youth.