The Role of Sleep Health in Proximal Suicide Risk among Ultra-High Risk Adolescents

摘要 自杀是14-24岁年轻人死亡的第二大原因， 增加。大多数自杀风险因素是远端的（即，长期的，静态的），因此关于谁在 风险，但不是什么时候。因此，我们能够可靠地预测脆弱人群的近期自杀风险， 仍然严重不足。 研究一致表明主观睡眠障碍和连续自杀之间的联系。 然而，睡眠是一个复杂的行为，可以沿着沿着多个维度和不同的水平来测量。 分析.此外，很少有人注意到规范性的生物和心理社会因素的作用， 这些发展过程进一步导致与睡眠障碍相关的风险的动态变化。等 在青春期，睡眠的变化尤其剧烈。研究也没有调查睡眠是如何 与其他已知的途径相互作用，如情感，认知和唤醒相关系统中的失调， 导致脆弱青年的自杀倾向 因此，我们建议进行一项为期8周的前瞻性多方法研究睡眠健康和自杀念头 在最近参加了一项研究的超高风险青少年（14-18岁）的跨诊断样本中， 强化门诊或部分住院计划。我们将利用现有的临床和研究 基础设施比较睡眠自杀协会和合理的情感，认知和觉醒相关 在超高风险青少年中使用自我报告、行为、实验室任务范式和生理学的机制 自杀

ABSTRACT Suicide is the second leading cause of death among young people age 14–24, and rates in this age group are increasing. Most suicide risk factors are distal (i.e., long-standing, static), thus informative regarding who is at risk, but not when. As such, our ability to reliably predict near-term suicide risk among vulnerable populations remains grossly inadequate. Studies consistently demonstrate a link between subjective sleep disturbances and the continuum of suicidality. Yet, sleep is a complex behavior that can be measured along multiple dimensions and at varying levels of analysis. Furthermore, little attention has been paid to the role of normative biological and psychosocial developmental processes that further contribute to dynamic changes in risk related to sleep disturbance. Such changes in sleep are particularly dramatic during adolescence. Studies also have not examined how sleep interacts with other known pathways, such as dysregulation in affective, cognitive and arousal-related systems, to lead to suicidality in vulnerable youth. We thus propose to conduct an 8-week prospective multi-method study of sleep health and suicidal thoughts and behavior in a transdiagnostic sample of ultra-high risk adolescents (14-18) who have recently enrolled in an Intensive Outpatient or Partial Hospitalization Program. We will capitalize on the extant clinical and research infrastructures to compare sleep-suicide associations and plausible affective, cognitive and arousal-related mechanisms using self-report, behavioral, lab task paradigms and physiology in adolescents at ultra-high risk for suicide.