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

摘要 自杀是14-24岁年轻人的第二大死因，这个年龄段的死亡率是 越来越多。大多数自杀风险因素都是远端的(即，长期存在的、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弱势群体的近期自杀风险 仍然严重不足。 研究一致地表明，主观睡眠障碍和自杀的连续体之间存在联系。 然而，睡眠是一种复杂的行为，可以沿着多个维度和不同的水平进行测量 分析。此外，规范的生物学和心理社会的作用几乎没有受到重视。 进一步促进与睡眠障碍相关的风险的动态变化的发育过程。是这样的 睡眠的变化在青春期尤其显著。研究也没有研究睡眠是如何 与其他已知的通路相互作用，如情感、认知和唤醒相关系统的失调， 导致弱势青年自杀。 因此，我们建议对睡眠健康和自杀念头进行一项为期8周的前瞻性多方法研究。 超高危青少年(14-18岁)的跨诊断样本中的行为 强化门诊或部分住院计划。我们将利用现有的临床和研究 比较睡眠与自杀之间的联系以及合理的情感、认知和性唤醒相关的基础设施 超高危青少年使用自我报告、行为、实验室任务范例和生理学的机制 自杀的罪名。

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.