Self-injurious Thoughts and Behaviors among Preteens in the Child Welfare System

摘要。 自杀是5-11岁儿童死亡的第八大原因，最近的证据表明， 黑人儿童的自杀率不成比例地上升。自我伤害的想法和行为（SITB） 这增加了自杀死亡的风险--占儿童医院急诊的比例不断上升 部门和住院访问。儿童福利系统（CWS）中的青少年自杀风险更大 比一般人多。然而，很少有研究调查风险和保护因素， 青少年的结果，或研究的变化，在SITB随着时间的推移，在青春期前参与CWS。理解 儿童虐待（CM）和SITB之间的途径，以及轨迹和青少年 青少年前SITB的结果对于识别和预防CWS涉及儿童的自杀至关重要。拟议 探索性/发展性研究将整合两个丰富的纵向数据集， 在CWS中，CWS是在报告时调查CM的实体。这些数据可以用来探索 风险途径，结果和纵向模式的变化在CWS涉及的儿童。此外，因为 这两项研究在设计和测量上是如此一致，数据整合将允许更细致的 调查CWS的青少年SITB。拟议的研究将确定赋予 儿童自杀风险的脆弱性，发现未来治疗干预的新靶点，并及早发现 这些风险迹象可能代表未来预防和治疗研究的目标。从这个研究结果 将推进对青少年自杀风险的科学研究，这是一个迫切需要调查的领域。重要的是 这项研究将有助于确定CWS儿童自杀预防的目标， 服务不足的群体

ABSTRACT. Suicide is the eighth leading cause of death in children ages 5-11, and recent evidence suggests that rates of suicide are rising disproportionately in Black children. Further, self-injurious thoughts and behaviors (SITB) – which increase risk for suicide death -- account for a rising proportion of children's hospital emergency department and inpatient visits. Preteens in the child welfare system (CWS) are at even greater risk for suicide than those in the general population. However, few studies have investigated risk and protective factors, adolescent outcomes, or examined change in SITB over time in preteens involved in the CWS. Understanding the pathways between child maltreatment (CM) and SITB in preteens, as well as trajectories and adolescent outcomes of preteen SITB is critical to identify and prevent suicide in CWS-involved children. The proposed exploratory/developmental study will integrate two rich, longitudinal datasets that followed children involved in the CWS, which is the entity that investigates CM when a report is made. These data allow for exploration of risk pathways, outcomes, and longitudinal patterns of change within CWS-involved children. Further, because the two studies were so consistent in design and measures, data integration will allow for more nuanced investigations of preteen SITB in the CWS. The proposed study will identify mechanisms that confer vulnerability to child suicide risk, discover novel targets for future therapeutic intervention, and identify early signs of risk that could represent targets for future prevention and treatment studies. Findings from this study will advance the science on preteen suicide risk—an area urgently in need of investigation. Importantly, the study will help to identify targets for suicide prevention among children in the CWS, a vulnerable and underserved group.