Integrative Data Analysis of Coping Power: Effects on Adolescent Suicidality

项目总结/摘要 自杀是美国10-34岁人群的第二大死亡原因， 严重考虑自杀企图的学龄青年和8%企图自杀。正在形成 有证据表明，没有明确针对自杀的预防性干预措施具有“交叉”效应。 关于自杀倾向然而，大多数干预措施已被检查其对自杀目标的影响， 内化行为，这可能会错过一个重要的男孩子集，他们的自杀风险主要是 通过外化传播;这种担忧在最近的自杀预防文献中得到了回应， 解决缺乏关于以外化为重点的干预措施的自杀交叉效应的文献。 应对能力（CP）计划是一个经验支持，以儿童和家庭为重点的预防性 干预措施的重点是在表现出早期攻击性的青年中更广泛地减少外部化， 这使得它非常适合于解决上述在靶向外部化途径方面的差距， 自杀倾向拟议的研究将结合联合收割机的数据，从10个随机对照试验（RCT）的CP（共 个人层面N = 3，201;学校层面N = 188）并利用三种测量和数据分析 跨多个独立学科出现的框架：综合数据分析（IDA），Meta数据分析， 个体患者数据分析（MIPD）和倾向评分加权（PSW）。利用这些框架，我们 提出以下目标： 目标1：估计量表得分的关键结构，同时考虑到差异项目功能 跨研究、跨时间、跨人群、跨记者。 目的2：使用IDA估计的方法评估多种形式的应对能力（CP）的比较效应量。 CP作用机制、外化、内化和自杀倾向的量表评分。 目的3：检测CP对通过CP传播的自杀风险的影响的潜在介质 作用机制（MoAs）和/或中间终点。 目的4：探索个人，学校和研究层面的主持人CP的影响MoAs，中间 终点和自杀风险。 如果成功，拟议的研究将（1）成为第一个应用症状加权框架的研究之一（例如， MNLFA，项目反应理论）测量自杀倾向，同时考虑测量偏差 多个因素（例如，时间、发展、人口统计变量、报告者），（2）提供初步证据， 通过性别特异性途径（男孩外化， 女孩），（3）说明CP对减少自杀倾向的直接和/或间接影响在以下人群中更大 处于较高初始风险的青少年，以及（4）确定CP交付的最佳条件（例如，组， 个人，互联网）的不同青年特征（这不能在任何单一的随机对照试验的CP）。

PROJECT SUMMARY/ABSTRACT Suicide is the second leading cause of death among individuals aged 10-34 in the US, with 17% of high school-aged youth seriously considering a suicide attempt and 8% attempting suicide. There is emerging evidence to suggest that preventive interventions that do not explicitly target suicide have “crossover” effects on suicidality. However, the majority of interventions that have been examined for their impact on suicide target internalizing behaviors, which may miss a significant subset of boys, whose risk for suicidality is primarily transmitted through externalizing; this concern is echoed by calls in the recent suicide prevention literature for addressing the dearth of literature on suicide crossover effects from externalizing-focused interventions. The Coping Power (CP) program is an empirically supported, child- and family-focused preventive intervention that focuses on reducing externalizing more broadly among youth who exhibit early aggression, which makes it ideally suited to addressing the above-mentioned gaps in targeting externalizing pathways to suicidality. The proposed study will combine data from 10 randomized controlled trials (RCTs) of CP (total individual-level N = 3,201; total school-level N = 188) and utilize three measurement and data analysis frameworks that have emerged across multiple independent disciplines: integrative data analysis (IDA), meta- analysis of individual patient data (MIPD), and propensity score weighting (PSW). Using these frameworks, we propose the following aims: Aim 1: Estimate scale scores for key constructs while accounting for differential item functioning across studies, time, populations, and reporters. Aim 2: Assess comparative effect sizes for multiple forms of Coping Power (CP) using IDA-estimated scale scores for CP mechanisms of action, externalizing, internalizing, and suicidality. Aim 3: Test for potential mediators of CP effects on risk for suicidality as transmitted through CP's mechanisms of action (MoAs) and/or intermediate endpoints. Aim 4: Explore individual-, school- and study-level moderators of CP's effects on MoAs, intermediate endpoints, and risk for suicidality. If successful, the proposed study will (1) be one of the first to apply a symptom weighting framework (e.g., MNLFA, item response theory) for measuring suicidality, while accounting for measurement bias across multiple factors (e.g., time, development, demographic variables, reporters), (2) provide initial evidence for preventive effects on suicidality through gender-specific pathways (externalizing for boys, internalizing for girls), (3) illustrate evidence that CP's direct and/or indirect impact on reductions in suicidality is greater among youth who are at higher initial risk, and (4) identify the optimal conditions for CP delivery (e.g., group, individual, internet) for different youth characteristics (which could not be examined in any single RCT of CP).