Social Media as a Predictor of Proximal Risk in Youth Suicide Attempt Study

自杀是年轻人死亡的第二大原因， 在过去10年中稳步增长。新出现的人口统计数据也表明自杀率上升 尤其是女性和非裔美国人。不幸的是， 青年自杀率上升和这些令人担忧的人口趋势的根本原因是 还不明白。虽然还没有建立因果关系，但社交媒体的上升趋势 过去十年的使用与自杀率的上升相吻合。在发展时期， 童年后期和青春期，此时个体变得敏锐地适应社会地位和反馈 从同龄人的角度来看，社交媒体的使用可能会改变人际交往的积极和消极经验， 方式，包括更频繁地获得社会支持的机会，以及同伴受害和社会 对比值得注意的是，报告每天使用社交媒体网站超过2小时的青少年 可能报告不良的心理健康结果，如心理困扰和自杀意念。 消极向上的社会比较和网络欺凌与抑郁，焦虑， 以及青少年的自杀意念。社交媒体使用，24/7可用性，也可能有助于睡眠 困难本R21申请的目的是检查自杀企图的近因 在100名10-17岁的青少年中，自杀企图需要住院治疗， 将他们与同样数量的非慢性疾病或受伤的对照组进行比较， 与自杀未遂有关。除了评估已知的风险因素外，本研究还将研究 在索引自杀企图之前SM使用的频率、持续时间、时间和内容的模式： 客观地使用创新的方法来收集带有时间戳的SM文本和表情符号， 父和子报告。我们将探讨精神病理学的变化，SM的使用，积极和消极的 SM使用的后果，以及自杀意念和行为之前，在整个组中， 一年前的尝试。我们还将探讨不同年龄[（青少年前期和早期（10-13岁） vs.中晚期青少年（14-17岁）]、种族、生理性别和自我报告的性别 这项R21申请中提出的研究是解决科学中主要差距的第一步， 确定数字风险因素，并在可能 导致青少年自杀率上升。这项研究的结果将提供可行性 以及未来在更大样本中提交的前瞻性R 01的初步数据。这些发现可能会增加 与目前已知的自杀行为的临床预测因子显著相关，并有助于早期识别 和自杀风险的管理。

Suicide is the second leading cause of death among young people and suicide rates in youth have been steadily increasing over the past 10 years. Emerging demographic data also point to rising suicide rates in pre-teens and early adolescents, particularly among females and African Americans. Unfortunately, the underlying reasons for the rising rates of youth suicide and these alarming demographic trends are not yet understood. While no causal association has been established, the upward trend in social media usage over the past decade coincides with the rise in suicide rates. During the developmental periods of late childhood and adolescence, when individuals become acutely attuned to social status and feedback from peers, social media use may transform interpersonal experiences in both positive and negative ways, including more frequent opportunities for social support as well as peer victimization and social comparison. Notably, teens who report using social media sites greater than 2 hours a day are more likely to report poor mental health outcomes, such as psychological distress and suicidal ideation. Negative upward social comparison and cyberbullying have been associated with depression, anxiety, and suicidal ideation in adolescents. Social media use, 24/7 availability, may also contribute to sleep difficulties. The objective of this R21 application is to examine proximal antecedents of suicidal attempt in 100 youth between the ages of 10-17 with suicide attempts requiring medical hospitalization and compare them to an equal number of controls who were admitted for non-chronic illness or injury not related to suicide attempt. In addition to assessment of known risk factors, this study will examine patterns in the frequency, duration, timing and content of SM use prior to the index suicide attempt: objectively using innovative methods to collect time-stamped SM text and emojis, and subjectively from parent and child report. We will explore variations in psychopathology, SM use, positive and negative consequences of SM use, and suicidal ideation and behavior prior to attempt across the groups over the year prior to attempt. We will also explore differences by age [(pre-and early adolescents (age 10-13) vs. middle and late adolescents (age 14-17)], race, biological sex and self-reported gender The research proposed in this R21 application is the first step to address a major gap in the science by identifying digital risk factors and characterizing youth suicide attempters in domains that may contribute to increased rates of youth suicidal behavior. Findings from this study will provide feasibility and preliminary data for a future prospective R01 submission in a larger sample. The findings could add significantly to currently known clinical predictors of suicidal behavior and aid in earlier identification and management of suicidal risk.