Examining Suicide Risk from a Biopsychosocial Framework: A Large-Scale Cross-Sectional Study

项目摘要/摘要 自杀仍然是一个严重的国家和全球公共卫生危机。与自杀有关的想法和行为 跨诊断现象与不同的生物心理社会风险指标有关。发现 提示自杀风险与不同的静息状态功能连接、结构大脑有关 差异，以及多基因风险得分(PRS)概况。我们对……的理解有明显的差距。 自杀的生物、心理和社会脆弱性。第一个研究空白涉及对以下问题的深入了解 区分只考虑自我定向暴力的人和那些只考虑自我定向暴力的人的候选标记 最终企图自杀的人。第二个研究差距涉及缺乏对如何 生物风险指标与心理社会风险指标共同构成自杀风险。理解 最终自杀风险最高的个体的生物心理社会风险概况仍然对 加强自杀风险检测战略和制定有针对性的干预措施。为了解决这些差距， 拟议项目的总体目标是调查大脑结构和 自杀的连接性、遗传性和行为风险指标。来自估计的生物心理社会数据 将对来自英国生物库的4566名参与者进行分析，以区分那些有自杀行为风险的人 不受自我导向的暴力思想的影响。这项提议为汤普森先生的目标奠定了基础 研究自杀风险的生物、心理和社会标记物的计划。拟议项目的目标1是 比较两组成人的大脑结构和连接性、遗传和心理社会风险指标 有终生自杀未遂(S)和有终生自我定向暴力思想的成年人独身。目标2是 通过比较分类来确定生物和心理社会候选标记的相对重要性 利用生物学(即大脑结构和连通性、遗传变异)的算法 仅有心理社会风险指标，以区分这两组人。这些发现将推动我们的 了解与自杀有关的生物、心理和社会风险指标，以突出机制，改进 风险检测，并最终为有针对性的干预战略提供信息。总体而言，拟议项目的目标 将在旨在发展(1)专业知识的研究培训计划的背景下完成 自杀的生物心理社会基础，(2)高级统计和机器学习，(3)多模式 神经成像，(4)PR的产生，和(5)学术传播技巧。培训计划包括 参加选定的研讨会、科学写作和学术会议报告，以及个人 由具有互补专业领域的赞助商和合作者组成的团队进行监督和指导。

PROJECT SUMMARY/ABSTRACT Suicide remains a significant public health crisis nationally and globally. Suicide-related thoughts and behaviors are transdiagnostic phenomena associated with heterogeneous biopsychosocial risk indicators. Findings suggest that suicide risk is associated with distinct resting-state functional connectivity, structural brain differences, and polygenetic risk score (PRS) profiles. There are notable gaps in our understanding of biopsychosocial vulnerabilities for suicide. The first research gap involves a lack of in-depth understanding of candidate markers for differentiating between individuals who only think about self-directed violence versus those who ultimately attempt suicide. The second research gap involves a lack of an in-depth understanding of how biological risk indicators in combination with psychosocial risk indicators contribute to suicide risk. Understanding the biopsychosocial risk profile for individuals most at risk for eventual death by suicide remains critical for enhancing suicide risk detection strategies and developing targeted interventions. To address these gaps, the overall objective of the proposed project is to investigate the combined associations of brain structure and connectivity, genetic, and behavioral risk indicators for suicide. Biopsychosocial data from an estimated 4566 participants drawn from the UK Biobank will be analyzed to differentiate those at risk for suicidal behavior from self-directed violence thoughts alone. This proposal sets the stage for Mr. Thompson’s goal to develop a program of research investigating biopsychosocial markers of suicide risk. Aim 1 of the proposed project is to compare brain structure and connectivity, genetic, and psychosocial risk indicators between two groups: adults with lifetime suicide attempt(s) and adults with lifetime self-directed violence thoughts alone. Aim 2 is to determine the relative importance of biological and psychosocial candidate markers by comparing classification algorithms utilizing biological (i.e., brain structure and connectivity, genetic variance), above and beyond psychosocial risk indicators alone, in differentiating between these two groups. Findings will advance our understanding of the biopsychosocial risk indicators associated with suicide to highlight mechanisms, improve risk detection, and ultimately inform targeted intervention strategies. Overall, the goals of the proposed project will be accomplished within the context of a research training program aimed at developing expertise in (1) biopsychosocial underpinnings of suicidality, (2) advanced statistics and machine learning, (3) multimodal neuroimaging, (4) generation of PRS, and (5) scholarly dissemination skills. The training plan includes attendance at selected workshops, scientific writing and academic conference presentations, and individual supervision and mentorship by a team of sponsors and collaborators with complementary areas of expertise.