Behavioral and Physiological Predictors of Suicidal Behavior in Adolescents

描述(由申请人提供)：拟议的研究和培训计划旨在增进我们对青少年自杀行为风险标志的了解，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段的自杀风险标记或预测因素。这项拟议研究的目标是确定青少年自杀行为的多个行为和生物(心理生理学)危险标记。重要的是，这些目标也与国家精神卫生研究所(NIMH)战略计划一致，该战略计划强调了确定与临床相关问题相关的生物和行为标记的必要性。这一目标将通过以下具体目标来实现：目的1.考察两种自杀行为任务(死亡/自杀IAT和自杀Stroop测验)与青少年自杀行为的关系。目的2.探讨青少年自杀相关刺激(心理生理学测量)中恐惧反应减弱与自杀行为的关系。目的3.检验青少年自杀行为的行为和心理生理预测因子之间的相加和交互关系。这项工作有可能更好地识别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可用于客观评估青少年自杀风险的测试。这些措施是理想的，因为它们简单、易于管理和评分，因此可以可行地用于急诊科或住院环境中，为青少年入院和出院的决定提供信息。因此，这项研究计划有可能显著推进临床科学，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，申请者精心组建了一支由赞助商和顾问组成的团队来指导和支持这一项目。马修·诺克博士(赞助商)在自杀研究和青少年精神病理学方面拥有专业知识。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·布鲁门撒尔博士在惊吓反射方法学方面拥有专业知识--这是为该项目选择的生理测量方法。总之，F32培训将提高申请者在三个新领域的知识和专业技能，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.