Dispositional Affect, Family Environment, Adolescent Sui

描述(由申请人提供)：这项以患者为导向的研究职业发展奖(K-23)指导申请是为了支持严博士作为一名独立研究科学家的发展，他的研究方向是研究自杀行为的现象学。严博士寻求进一步的培训，以便将她之前在成人边缘性人格障碍(BPD)患者中的临床和研究经验应用到青少年工作中。BPD是重复自杀企图和自杀死亡的重要危险因素，然而，目前还没有关于青少年自杀未遂者BPD的前瞻性研究。这项拟议的研究试图检验与BPD一致的情感特征、家庭功能和青少年自杀倾向之间的联系。为了促进她的职业目标，严博士提出了一项培训计划，其中包括：1)由青少年自杀、人格障碍和前瞻性研究方面的专家团队提供指导和临床监督；2)完成正式的课程、研讨会和工作坊；3)参与布朗大学医学院正在进行的相关项目；以及4)实施拟议的研究项目。这项计划将使她能够增加她对青少年发展和精神病理学的概念性知识，获得关于青少年评估和治疗的额外培训，并进一步发展她在研究设计和数据分析方面的技能。严博士建议检验一个模型，该模型受到Linehan的BPD生物社会理论和著名发展理论的严重影响，在该模型中，假设结合个人倾向因素(与BPD一致的情感处理)和环境因素(使家庭环境无效)来预测青少年的自杀行为(意念和企图)。一项自然主义的、描述性的、为期6个月的跟踪研究将对120名因自杀行为住院的青少年进行研究，以检验这一模式。每周或每月对关键预测和结果变量的评级将通过在6个月的间隔内进行四次评估来获得，以便进行时变分析。这项拟议的研究将解决知识上的重大差距，因为这将是第一项检查自杀青少年BPD特征的前瞻性研究，也是第一项动态检查关键预测变量的研究。

DESCRIPTION (provided by applicant): This Mentored Patient-Oriented Research Career Development Award (K-23) application is to support Dr. Yen's development as an independent research scientist with a programmatic line of research that examines the phenomenology of suicidal behaviors. Dr. Yen seeks further training to apply her previous clinical and research experiences with adult borderline personality disorder (BPD) patients, to work with adolescents. BPD represents a significant risk factor for repeat suicide attempts and suicide deaths, yet there has been no prospective study of BPD among adolescent suicide attempters. The proposed study seeks to examine the associations between affective traits consistent with BPD, family functioning, and adolescent suicidality. To facilitate her career goals, Dr. Yen proposes a training plan which consists of: 1) mentorship and clinical supervision provided by a team of experts in adolescent suicidality, personality disorders, and prospective studies; 2) completion of formal coursework, seminars, and workshops; 3) participation in relevant, ongoing projects at Brown University Medical School; and 4) implementation of the proposed research project. This plan will enable her to increase her conceptual knowledge of adolescent development and psychopathology, obtain additional training in assessment and treatment of adolescents, and further develop her skills in research design and data analyses. Dr. Yen proposes to examine a model, heavily influenced by Linehan's biosocial theory of BPD and by prominent developmental theories, in which the combination of individual dispositional factors (affective processing consistent with BPD) and environmental factors (invalidating family environment) is hypothesized to predict adolescent suicidal behavior (ideation and attempts). A naturalistic, descriptive, 6-month follow-up study of 120 adolescents after being hospitalized for suicidal behavior will be implemented to examine this model. Weekly or monthly ratings on key predictor and outcome variables will be obtained via four assessments over the 6-month interval to allow for time-varying analyses. The proposed study would address a significant gap in knowledge, as it would be the first prospective study to examine BPD traits as well as the first study to examine key predictor variables dynamically, in suicidal adolescents.