Dispositional Affect, Family Environment, and Adolescent Suicidality

描述（由申请人提供）：这项以患者为导向的指导研究职业发展奖（K-23）申请是为了支持Yen博士作为一名独立研究科学家的发展，研究自杀行为的现象学。Yen博士寻求进一步的培训，将她之前在成人边缘型人格障碍（BPD）患者方面的临床和研究经验应用到青少年的工作中。BPD是重复自杀企图和自杀死亡的重要危险因素，但目前还没有关于青少年自杀企图者中BPD的前瞻性研究。这项拟议的研究旨在检验与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。为了实现她的职业目标，Yen博士提出了一个培训计划，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；4)拟定研究项目的实施。这个计划将使她增加青少年发展和精神病理学的概念知识，获得青少年评估和治疗方面的额外培训，并进一步发展她在研究设计和数据分析方面的技能。Yen博士建议研究一个深受Linehan的BPD生物社会理论和著名的发展理论影响的模型，在这个模型中，个人性格因素（与BPD一致的情感处理）和环境因素（无效的家庭环境）的结合被假设为预测青少年自杀行为（意念和企图）。一项自然的、描述性的、为期6个月的随访研究将对120名因自杀行为住院的青少年实施，以检验这一模型。每周或每月对关键预测因子和结果变量的评分将在6个月的时间间隔内通过四次评估获得，以便进行时变分析。这项提议的研究将解决一个重要的知识空白，因为它将是第一个前瞻性研究，以检查BPD特征，以及第一个研究动态检查关键预测变量，在自杀的青少年。

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.