Measurement of Social-Cognitive Risk Factors for Suicidal Ideation and Behavior

描述（由申请人提供）：作为青少年和年轻人死亡的三大主要原因之一，自杀已成为一个日益受到公众关注的公共卫生问题。绝望已被确定为自杀想法和行为的认知风险因素，但绝望产生和导致自杀想法和行为的确切思维方式尚不清楚。本次SCORE研究进步奖提案旨在通过以下方式填补这一文献空白：1)识别两种不同类型的反思性如何在有自杀企图者和无自杀企图者中预测自杀意念；2)将对未来的反思性作为另一种类型的过程进行研究，通过这种过程，个体会产生绝望，并建立一个过程模型，通过这个过程，这些想法可能会改变；3)研究无望的具体认知内容特征，预测未来自杀想法和行为的风险。这些目标将通过一项对年轻人样本的纵向研究来解决——筛选自杀意念和企图的历史——他们在6个月、12个月和18个月的时间里完成了一系列认知测量。数据将通过混合模型回归来分析两种语言形式的反刍导致自杀意念和行为的途径。这些数据也将通过多层次建模来分析，以检验对未来的沉思——用一种新开发的测量方法来评估——是否是抑郁预测确定性和绝望发展的一个过程。为了检验第三个目标，本研究将利用认知流畅性范式来检验这样一个假设，即在预期积极未来结果方面认知流畅性降低的年轻人，以及对缺乏积极结果的确定性，未来自杀意念和尝试的风险会增加。最后，有或没有自杀意念或企图史的个体将接受训练，在心理上排练乐观的未来事件预测，以确定在有自杀史的个体中，诱导乐观的未来预期是否会减少抑郁预测的确定性和绝望。

DESCRIPTION (provided by applicant): As one of the top three leading causes of death among teenagers and young adults, suicide has become an issue of increasing public health concern. Hopelessness has been identified as a cognitive risk factor for suicidal thinking and behavior, but the precise ways of thinking through which hopelessness arises and through which it leads to suicidal thoughts and behaviors is not well understood. This proposal for a SCORE Research Advancement Award seeks to fill this gap in the literature by 1) identifying differences in how two different subtypes of rumination prospectively predict suicidal ideation among previous suicide attempters and non- attempters, 2) examining rumination about the future as another type of process through which individuals develop hopelessness, along with modeling a procedure through which these thoughts might be changed; and 3) examining the specific cognitive content characteristic of hopeless that predicts risk for future suicidal thoughts and behavior. These aims will be addressed via a longitudinal study of a sample of young adults - screened for a history of suicidal ideation and attempts - who complete a battery of cognitive measures over 6, 12, and 18 months. Data will be analyzed via mixed model regression to examine the pathways through which two verbal-linguistic forms of rumination lead to suicidal ideation and behavior. These data will also be analyzed via multi-level modeling to examine whether rumination about the future - assessed with a newly- developed measure - is a procedure through which depressive predictive certainty and hopelessness develop. To examine the third aim, this study will utilize a cognitive fluency paradigm to test the hypothesis that young adults with reduced cognitive fluency in expecting positive future outcomes, along with certainty about an absence of positive outcomes -- are at increased risk of future suicidal ideation and attempts. Finally, individuals with and without a history of suicidal ideation or attempts will be trained to mentally rehearse making optimistic future-event predictions, to determine whether inducing optimistic future expectations leads to reduced depressive predictive certainty and hopelessness among individuals with a history of suicidality. PUBLIC HEALTH RELEVANCE: This research will contribute to the understanding of thinking processes that result in suicidal behavior. In addition, it has implications for the assessment and treatment of suicidality.