Social-Affective Vulnerability to Suicidality among LGBTQ Young Adults: Proximal and Distal Factors

项目总结/摘要 年轻人的自杀想法和行为（STB）率已达到危机水平，特别是 在LGBTQ（即，女同性恋者、男同性恋者、双性恋者、酷儿、质疑者和/或变性者）人口， 除了典型的发展挑战之外，还有社会耻辱。虽然我们知道一般的风险因素， 自杀，这些在预测自杀如何，何时以及在谁身上发生的效用有限。至关 重要的是要考虑社会背景的作用，因为STB经常发生在应对最近的社会威胁 这种情况可能发生在那些神经社会回路敏感性改变的人身上。 响应RFA MH-20-327的拟议R 01研究建立在少数民族压力等社会模型基础上 理论和自杀的人际关系理论，并从远端到近端检查STB的社会危险因素 程度.总体目标是预测STB的变化，包括STB的累积强度和转换 从自杀的想法到行为，从几小时到几天到几个月的时间尺度。在LGBTQ中， 在年轻人中，STB是通过社会处理和调节社会产生的负面影响（例如， 羞耻）。具体来说，我们研究了社交脑回路中敏感性的远端脆弱性因素， 消极的紧迫感，或面对痛苦的消极情绪时冲动行为的倾向，以及 睡眠失调和社会经历的近端、时变因素（例如，拒绝）。这项研究将测试 这些远端和近端因素与STB的关联; LGBTQ之间这些因素的差异 有与没有STB的年轻人;远端和近端因素的相互作用;以及LGBTQ相关的 特性（例如，受害，outness）在STB。 这项研究将包括130名年龄在18-30岁之间的参与者，他们都是LGBTQ，其中2/3有 复发性自杀意念和自杀行为的终身史。参与者将完成一个详细的 STB访谈、使用社会威胁范例的功能磁共振成像扫描、3个月的体动记录仪方案， 基于智能手机的评估，并在6个月时进行随访。智能手机数据将包括生态 社交威胁体验和STB的瞬时评估，以及被动收集的传感器数据（例如， 社交媒体应用程序使用、短信活动）。传统和机器学习定量技术将在 应用于确定远端和近端因素对STB的贡献（例如，自杀行为的发生）， 危险因素的个体差异，以及神经、睡眠、社会、临床和人口统计学因素的贡献 的因素STB。该研究将阐明可改变的危险因素在STB中的作用，并与临床相关。 神经科学、自杀学和预防工作。

Project Summary/Abstract Rates of suicidal thoughts and behaviors (STB) among young adults have reached a crisis level, especially for those in the LGBTQ (i.e., lesbian, gay, bisexual, queer, questioning and/or transgender) population, who face social stigma in addition to the typical developmental challenges. Although we know the general risk factors for suicide, those have limited utility in predicting how, when, and in whom suicide occurs. It is critically important to consider the role of social context because STB often occurs in response to a recent social threat event such as rejection and could be more likely in those who have altered sensitivity of neural social circuitry. The proposed R01 study in response to RFA MH-20-327 builds on social models such as Minority Stress Theory and the Interpersonal Theory of Suicide and examines social risk factors of STB from distal to proximal levels. The overarching goal is to predict change in STB, including cumulative intensity of STB and transition from suicidal thoughts to behaviors, on a time scale from hours to days to months. We propose that in LGBTQ young adults, STB occurs through social processing and regulation of socially generated negative affect (e.g., shame). Specifically, we examine the distal vulnerability factors of sensitivity in social brain circuitry and negative urgency, or the tendency toward impulsive behavior in the face of painful negative affect, and the proximal, time-varying factors of sleep dysregulation and social experiences (e.g., rejection). The study will test the association of these distal and proximal factors with STB; differences in these factors between LGBTQ young adults with vs. without STB; the interplay of distal and proximal factors; and the role of LGBTQ-related characteristics (e.g., victimization, outness) in STB. The study will include 130 participants age 18-30, all of whom identify as LGBTQ and 2/3 of whom have recurrent suicidal ideation and lifetime history of suicidal behavior. Participants will complete a detailed interview of STB, an fMRI scan using social threat paradigms, a 3-month protocol of actigraphy and smartphone-based assessment, and a follow-up interview at 6 months. Smartphone data will include ecological momentary assessment of social threat experiences and STB, as well as passively collected sensor data (e.g., social media app use, texting activity). Traditional and machine learning quantitative techniques will be applied to determine contributions of distal and proximal factors to STB (e.g., occurrence of suicidal behavior), individual differences in risk factors, and contributions of neural, sleep, social, clinical, and demographic factors to STB. The study will elucidate the role of modifiable risk factors in STB and have relevance to clinical neuroscience, suicidology, and prevention efforts.