Uncovering the Risk Architecture of Suicidal Behaviors: a Representative Sample at High Risk: Diversity Supplement

揭示自杀行为的风险架构：高风险的代表性样本：多样性补充

• 批准号: 10469863
• 负责人: Christina W. Hoven
• 金额: $ 5.49万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-02 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10469863
• 关键词: Age; Age-Years; Architecture; Autopsy; Barbados; Cause of Death; Characteristics; Clinical; Cohort Studies; Collaborations; Communities; Complex; Country; DNA analysis; Data; Development; Ethnic Origin; Ethnic group; Event; France; Future; Gender; Geographic Locations; Guyana; Hindu; Individual; Infrastructure; International; Intervention; Location; Muslim population group; Pan American Health Organization; Persons; Population; Poverty; Prevention program; Psychopathology; Public Health; Race; Religion; Religion and Spirituality; Reporting; Research; Risk; Risk Factors; Saliva; Sample Size; Sampling; Social Environment; Sri Lanka; Stress; Suicide; Suicide prevention; Time; Training; United States; World Health Organization; biobank; case control; cohort; completed suicide; cost; design; high risk; longitudinal design; multi-racial; prospective; psychologic; racial and ethnic; religious group; socioeconomics; statistics; suicidal; suicidal behavior; suicidal risk; suicide attempter; suicide rate

The World Health Organization (WHO) reports that approximately 800,000 people die by suicide every year, with rates per 100,000 varying from 0.3 (Barbados) to 34.6 (Sri Lanka), with Guyana at 30.6, the second highest suicide rate of any country; about three times the global average. Worldwide, suicide is the second leading cause of death among those 15 - 29 years of age. The United States rate (13.4) has been rising significantly, in spite of great effort, and remains slightly worse than France (12.3). Psychopathology, poverty, stress, age and gender are among the most often cited risk factors associated with suicide. However, because it is a rare event, suicide research often lacks adequate statistical power to effectively examine the associations and interactions of even the most common risk factors. On the other hand, most countries that have very high suicide rates also lack adequate infrastructure to support good research and/or have homogenous populations, thus limiting analysis of risk factor associations and interactions. Furthermore, because of its rarity, the cost of obtaining an adequate sample size to effectively investigate suicide is generally prohibitive. To overcome these limitations and to move suicide risk research forward, we have developed a partnership with the Guyanese Ministry of Public Health, the Guyanese National Bureau of Statistics, the Pan American Health Organization (PAHO-WHO) and the collaboration of an internationally recognized group of suicidologists. With this team, we propose, to study suicide risk factors in a unique, multipronged approach. First, we will thoroughly assess a nationally representative community cohort for recent and lifetime suicidal behviors, as well as characterize their individual and community level risk factors. We will then follow this cohort in a longitudinal design over two additional waves of assessment, allowing for prospective analyses of suicidal behviors. Second, we will ascertain and assess all suicide attempters who present clinically, and, third, we will conduct psychological autopsies on a subset of suicide completers. We will also collect and biobank saliva for future DNA analysis. Together these samples will allow for case-control analyses, differentiating risk factors specific to attempts and completions across major racial/ethnic and religious groups. Finally, suicide rates in Guyana vary across the 10 geographic regions, among the three major religious groups (Hindu, Christian and Muslim) and among the four major races/ethnicities, in ways that have yet to be explained. This study is designed to help understand how the relationships of key characteristics, interact with individual risk factors to influence suicidal behaviors. Through a collaborative design that utilizes training and data-driven input throughout, this study has the potential to make critically important contributions to the development of more targeted suicide prevention programs in any setting, particularly in multi-racial/ethnic and multi-religious settings, such as Guyana and the United States.

世界卫生组织(WHO)报告称，约有80万人死于自杀 每年，每10万人的比率从0.3%(巴巴多斯)到34.6%(斯里兰卡)不等，圭亚那为30.6%。 自杀率在所有国家中排名第二；大约是全球平均水平的三倍。在世界范围内，自杀是 15-29岁人群的第二大死因。美国的利率(13.4)一直是 尽管付出了很大努力，但仍显著上升，仍略低于法国(12.3)。精神病理学， 贫穷、压力、年龄和性别是与自杀有关的最常被提及的风险因素。然而， 由于这是一种罕见的事件，自杀研究往往缺乏足够的统计能力来有效地检查 甚至是最常见的风险因素之间的关联和相互作用。另一方面，大多数国家 自杀率非常高的人也缺乏足够的基础设施来支持良好的研究和/或 人群同质性，从而限制了对风险因素关联和相互作用的分析。此外， 由于它的稀有，获得足够大小的样本来有效调查自杀的成本是 总体上令人望而却步。为了克服这些限制并推动自杀风险研究向前发展，我们有 与圭亚那公共卫生部、圭亚那国家局 统计、泛美卫生组织(泛美卫生组织)和国际 一群公认的自杀专家。有了这个团队，我们建议，以一种独特的、 多管齐下。首先，我们将彻底评估具有全国代表性的社区队列 最近和终生的自杀行为，以及其个人和社区层面的风险因素的特征。 然后，我们将在纵向设计中遵循该队列，进行两个额外的评估浪潮，以允许 自杀行为的前瞻性分析。第二，我们将查明和评估所有自杀未遂者 第三，我们将对自杀完成者的一部分进行心理尸检。我们 还将收集唾液并将其存入生物库，用于未来的DNA分析。这些样本加在一起就可以进行病例对照。 分析，区分主要种族/民族和地区特定于未遂和完成的风险因素 宗教团体。最后，圭亚那的自杀率在10个地理区域不同，在这三个地区中 主要宗教团体(印度教、基督教和穆斯林)和四个主要种族/族裔之间在以下方面 这一点尚未得到解释。这项研究旨在帮助理解关键字之间的关系 特征，与个体危险因素相互作用，影响自杀行为。通过协作 在整个设计中使用培训和数据驱动的输入，这项研究有可能做出批判性的 在任何情况下对制定更有针对性的自杀预防方案作出重要贡献， 特别是在多种族/族裔和多宗教环境中，如圭亚那和美国。