Behavioral and Physiological Predictors of Suicidal Behavior in Adolescents

拟议的研究和培训计划旨在促进我们对青少年自杀行为风险标志的理解，并使申请人具备在发展精神病理学和自杀领域进行独立纵向研究所需的技能。迫切需要找到降低青少年自杀率的方法，重要的第一步是建立这一年龄组自杀的风险标志物或预测因子。这项研究的目的是确定青少年自杀行为的多重行为和生物（心理生理）风险标志。重要的是，这些目标也符合国家精神卫生研究所（NIMH）的战略计划，该计划强调需要确定与临床相关问题相关的生物和行为标志物。这一目标将通过以下具体目标实现：目标1。为了检验自杀的两个行为任务之间的关系（即，死亡/自杀IAT和自杀Stroop测试）和青少年自杀行为。 目标二。探讨青少年对自杀相关刺激的恐惧反应降低（心理生理学测量）与自杀行为之间的关系。 目标3。探讨青少年自杀行为的行为和心理生理学预测因素之间的加性和交互作用关系。 这项工作有可能更好地确定那些自杀风险最大的青少年，他们迫切需要干预。与用于诊断身体状况的最先进方法相一致，这一系列研究的最终目的是确定一系列简短的测试，可用于客观评估青少年自杀风险。这些措施是理想的，因为它们是简短的，易于管理和评分，因此可以切实可行地用于急诊科或住院设置，以告知青少年的入院和出院护理的决定。因此，这项研究计划有可能显着推进临床科学，并使该领域评估自杀行为风险的方式现代化。 本申请中的培训计划扩展了申请人在以下领域的先前研究和临床经验：发展性精神病理学，自杀和纵向研究设计和分析。为了实现这些目标，申请人精心组建了一个由赞助商和顾问组成的团队来指导和支持这个项目。Matthew Nock博士（赞助商）在自杀研究和青少年精神病理学方面具有专业知识。罗纳德达尔博士（顾问）是青少年大脑和青春期发育以及早期干预方面的专家。最后，特里布卢门塔尔博士在惊吓反射方法学方面有专业知识--这是本项目选择的生理测量方法。总之，F32培训将提高申请人在三个新领域的知识和专业知识，并为独立临床科学家的职业生涯奠定基础。

DESCRIPTION (provided by applicant): The proposed research and training plan aims to advance our understanding of risk markers for suicidal behavior in adolescents, and to equip the applicant with the skills necessary to carry out independent longitudinal research in the areas of developmental psychopathology and suicide. There is an urgent need to identify ways to reduce rates of suicide among adolescents, and an important first step is to establish risk markers - or predictors - of suicide in this age group. The goal of the proposed research is to identify multipl behavioral and biological (psychophysiological) risk markers for suicidal behavior in adolescents. Importantly, these goals are also consistent with the National Institute of Mental Health (NIMH) Strategic Plan, which highlights the need for identifying biological and behavioral markers associated with clinically relevant problems. This goal will be achieved through the following specific aims: Aim 1. To examine the relation between two behavioral tasks for suicide (i.e., death/suicide IAT and suicide Stroop test) and suicidal behavior in adolescents. Aim 2. To examine the relation between reduced fear responding during suicide-related stimuli (psychophysiological measure) and suicidal behavior in adolescents. Aim 3. To examine additive and interactive associations between behavioral and psychophysiological predictors of suicidal behavior in adolescents. This work has the potential to better identify those adolescents at greatest suicide risk, who are in critical need of intervention. In line with state f the art methods used to diagnose physical conditions, this line of research aims ultimately to identify a short battery of tests that can be used to objectively assess risk for suicide in adolescents. These measures are ideal because they are brief, easily administered and scored, and thus could feasibly be used in an emergency department or inpatient setting to inform decisions about adolescents' admission and discharge from hospital care. Therefore, this program of research has the potential to significantly advance clinical science and to modernize the way the field assesses risk for suicidal behavior. The training plan in this application extends the applicant's previous research and clinical experiences in the following areas: developmental psychopathology, suicide, and longitudinal research design and analysis. In order to achieve these goals, the applicant has carefully assembled a team of sponsors and consultants to guide and support this project. Dr. Matthew Nock (sponsor) has expertise in suicide research and adolescent psychopathology. Dr. Ronald Dahl (consultant) is an expert in adolescent brain and pubertal development, as well as in early interventions. Finally, Dr. Terry Blumenthal has expertise in the startle reflex methodology - the physiological measure chosen for this project. In sum, the F32 training will advance the applicant's knowledge and expertise in three new areas and provide the foundation for a career as an independent clinical scientist.