Attempted Suicide and Alcohol Dependence

自杀未遂和酒精依赖

• 批准号: 7232124
• 负责人: KENNETH R CONNER
• 金额: $ 30.86万
• 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/7232124
• 关键词: Accounting; Acute; Address; Affect; Age; Aggressive behavior; Alcohol dependence; Alcoholism; Area; Case-Control Studies; Chronic; Condition; Data; Disadvantaged; Disruption; Drug usage; Event; Funding; Gender; Genetic Research; Goals; Guide prevention; Heterogeneity; Individual; Inpatients; Interview; Lead; Life; Logistics; Loneliness; Measures; Mental Depression; Modeling; NIH Program Announcements; National Institute on Alcohol Abuse and Alcoholism; Neurobiology; Outcome; Partner in relationship; Patients; Pattern; Phenotype; Population; Positioning Attribute; Preparation; Prevention; Prevention program; Purpose; Race; Range; Recruitment Activity; Regression Analysis; Research; Research Design; Risk; Risk Factors; Role; Screening procedure; Series; Severities; Source; Suicide; Suicide attempt; Testing; Woman; Work; accomplished suicide; alcohol abuse therapy; alcohol use disorder; aloneness; case control; experience; follow-up; instrument; interest; interpersonal conflict; modifiable risk; problem drinker; response; single episode major depressive disorder; suicidal; suicidal act; suicidal behavior; suicidal individual; suicidal risk; suicide model; treatment duration

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）：本申请是对 NIH 计划公告 03 161“减少和预防自杀行为的研究”的回应，该计划由 NIAAA 共同赞助。酒精依赖者自杀未遂和自杀的风险都很高。接受酒精中毒强化治疗的患者风险尤其高。该项目的目的是通过阐明自杀者和非自杀者之间的主要差异以及检查尝试者的异质性来源，增强对寻求酒精依赖治疗的患者自杀行为的理解。在目标 1 中，研究了反应性和主动攻击性在自杀未遂中的作用，在目标 2 中，重点是孤独的体验，客观评估为独居，主观评估为“孤独”。在目标 3 中，评估了包含这些变量的自杀计划模型，该模型假设反应性攻击和严重的人际困难（例如，伴侣关系破裂）会导致该人群的低计划（冲动）自杀企图，而抑郁和孤独则为高计划自杀创造了条件。这些目标是通过回顾性病例对照研究设计来实现的。接受酒精依赖住院治疗的受试者在治疗后 90 天内曾试图自杀，通过统一的筛选进行识别，并对其进行详细的研究访谈，了解自杀行为、其情况和假设的风险因素（例如反应性攻击）。招募非尝试者对照进行比较。受试者包括 40% 的女性、39% 的黑人，而且大多数处于经济弱势地位。获得有关酒精依赖和其他药物使用严重程度的数据，并在所有分析中进行说明。多元逻辑回归分析用于比较目标 1 和 2 中的病例和对照，目标 3 中使用对在尝试计划的连续水平上评估的病例进行多元线性回归分析。还探讨了与年龄、性别和种族相关的模式。结果可能会推进针对反应性攻击表型的自杀和酗酒研究，强调迫切需要考虑可能有自杀风险的酗酒者寻求治疗的人的人际关系生活，并为寻求识别和影响该人群低计划和高计划自杀行为过程的治疗提供信息。