Attempted Suicide and Alcohol Dependence

自杀未遂和酒精依赖

• 批准号: 7077245
• 负责人: KENNETH R CONNER
• 金额: $ 32.7万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-15 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7077245
• 关键词: age difference; aggression; alcoholism /alcohol abuse; alcoholism /alcohol abuse therapy; behavioral /social science research tag; clinical research; depression; drug addiction; gender difference; high risk behavior /lifestyle; human subject; interpersonal relations; interview; isolation /deprivation; patient oriented research; perception; racial /ethnic difference; statistics /biometry; substance abuse related behavior; suicide

DESCRIPTION (provided by applicant): This application is in response to NIH Program Announcement 03 161 "Research on the reduction and prevention of suicidality" that was co-sponsored by NIAAA. Individuals with alcohol dependence are at high risk for both attempted and completed suicide. Patients in intensive treatment for alcoholism are at especially high risk. The purpose of this project is to enhance understanding of suicidal behavior among patients seeking treatment for alcohol dependence both by illuminating major differences between suicidal and non-suicidal individuals as well as by examining sources of heterogeneity within attempters. In Aim 1, the roles of reactive and proactive aggression in attempted suicide are examined, and in Aim 2, the focus is on the experience of aloneness, assessed objectively as living alone and subjectively as "loneliness." In Aim 3, a model of suicide planning that incorporates these variables is evaluated that posits reactive aggression and acute interpersonal difficulties (e.g., partner relationship break-ups) lead to low-planned (impulsive) suicide attempts in this population whereas depression and aloneness create the conditions for high-planned attempts. The aims are carried out using a retrospective case-control study design. Subjects in inpatient treatment for alcohol dependence who have made a suicide attempt within 90 days of treatment are identified using a uniform screen and followed up with a detailed research interview about the act of suicide, its circumstances, and hypothesized risk factors (e.g., reactive aggression). Non-attempter controls are recruited for comparison. Subjects include 40% women, 39% black individuals, and most are economically disadvantaged. Data on severity of alcohol dependence and other drug use are obtained, and accounted for in all analyses. Multivariate logistic regression analyses are used to compare cases and controls in Aims 1 and 2, and multivariate linear regression analyses of cases assessed on a continuum of level of planning of the attempt are used in Aim 3. Patterns related to age, gender, and race are also explored. Results may advance research on suicide and alcoholism focused on the reactive aggression phenotype, underscore the critical need to consider the interpersonal life of individuals seeking treatment for alcoholism who may be at risk for suicide, and inform treatments that seek to identify and affect the course of low-planned and high-planned suicidal behavior in this population.

描述（由申请人提供）：此申请响应NIH计划公告03 161“关于自杀的减少和预防自杀性的研究”，该申请由NIAAA共同赞助。饮酒依赖性的人对自杀和完成的自杀均处于高风险。接受酒精中毒的强化治疗的患者尤其高风险。该项目的目的是通过阐明自杀和非杀伤性个体之间的主要差异，以及通过检查Attempters中的异质性来源，以增强寻求酒精依赖治疗的患者的自杀行为的理解。在AIM 1中，检查了反应性和主动侵略在未遂自杀中的作用，而在AIM 2中，重点是孤独的经验，客观地评估与“孤独”一样独自生活和主观生活。在AIM 3中，评估了一种合并这些变量的自杀计划模型，该模型假定了反应性攻击性和急性人际关系困难（例如，伴侣关系分裂）导致该人群中较低的（冲动性）自杀尝试，而抑郁症和尊贵性为高计划的尝试带来了条件。目的是使用回顾性案例对照研究设计进行的。使用统一的屏幕确定了在治疗后90天内进行自杀尝试的住院治疗的受试者，并随后进行了有关自杀，其情况和假设危险因素的详细研究访谈（例如，反应性侵略）。募集非攻击控制器以进行比较。受试者包括40％的女性，39％的黑人个体，大多数在经济上处于不利地位。获得有关酒精依赖性和其他药物使用的严重程度的数据，并在所有分析中介绍。多元逻辑回归分析用于比较AIM 1和2中的案例和对照，并且在AIM 3中使用了在尝试的连续计划中评估的案例的多元线性回归分析。结果可能会提高对自杀和酒精中毒的研究，重点是反应性侵略表型，强调了考虑寻求对酒精中毒治疗的个人的人际生活，他们可能有可能有自杀的风险，并为识别和影响低计划的和影响该人群中的低计划和高计划的自杀行为的治疗方法。