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The Acute Alcohol-Suicide Attempt Relation as a Function of Alcohol Use Disorders

急性酒精与自杀企图的关系与酒精使用障碍的关系

基本信息

批准号：
8515737
负责人：
COURTNEY L BAGGE
金额：
$ 16.51万
依托单位：
UNIVERSITY OF MISSISSIPPI MED CTR
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-08-01 至 2015-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8515737
关键词：
Acute Aggressive behavior Alcohol consumption Alcohol or Other Drugs use Alcohols Bipolar Disorder Characteristics Chronic Clinical Complex Consumption Cross-Over Studies Crossover Design Data Development Diagnosis Diagnostic Distal Drug usage Evaluation Event Exercise Exploratory/Developmental Grant Feeling suicidal Frequencies Future Gender Hour Identification (Psychology)Impulsivity Individual Injury Interview Life Major Depressive Disorder Measures Medical Methods Modification Mood Disorders Myocardial Infarction Participant Patient Self-Report Pattern Physiological Prevalence Prevention Public Health Quality of life Questionnaires Recording of previous events Recruitment Activity Recurrence Reporting Research Risk Risk Factors Role Severities Subgroup Suicide Suicide attempt Theoretical model Time Typology United States accomplished suicide alcohol abuse therapy alcohol effect alcohol risk alcohol use disorder base chronic alcohol ingestion clinically relevant demographics depressive symptoms design drinking experience interest male meetings psychologic suicidal suicidal behavior suicidal morbidity suicide attempter trait trend

项目摘要

DESCRIPTION (provided by applicant): In the United States alone, more than 32,000 people commit suicide each year and it is estimated that for every death by suicide there are 8-25 nonfatal suicide attempts. Given the clinical and public health significance of suicide, there is considerable interest in identifying proximal factors that increase the risk for suicide attempts and that determine the timing of suicide attempts among individuals who often report persistent suicidal ideation. Despite consistent findings of an elevated prevalence of alcohol use surrounding suicide attempts, little is known about whether acute alcohol use serves as a trigger to suicide attempts, or whether the effect of acute alcohol use on suicide attempt differs as a function of chronic alcohol use. Disentangling the effects of acute alcohol use and risk of injury according to an individual's usual consumption pattern is a matter of great public health interest, and there are known differences in psychological characteristics (e.g., mood disorders, previous treatment history) between those who attempt suicide with and without alcohol use disorders (AUD), as well as between individuals who drink alcohol (A+) and who do not drink alcohol (A-) prior to their attempt. However, little is known about differences on such factors between suicide attempters with AUD+ (who do or do not use alcohol immediately prior to their attempt), AUD- individuals who use alcohol before their attempt, and AUD- individuals who do not consume alcohol prior to their attempt. In the proposed exploratory/ developmental study (R21), we will examine the unique triggering role of acute alcohol use on suicide attempts as a function of an individual's baseline AUD status, and will also examine distal psychological characteristics of distinct groups of attempters characterized by acute and chronic alcohol use. To this end, we will employ a case-crossover design with a between-subject comparison, recruiting 150 individuals presenting for medical evaluation after a suicide attempt. The one-session assessment will comprise a diagnostic measure of AUD, a battery of questionnaires assessing psychological characteristics, and a standard interview assessing substance use and other time-varying proximal risk factors during the six hours prior to the suicide attempt, as well as during two matched controls periods. This exploratory/developmental study will provide preliminary data on the magnitude of the unique within-subject relation between acute alcohol use and attempt among individuals with and without AUD, and will aid in identifying distinguishing characteristics of groups of attempters characterized by different patterns of acute and chronic alcohol use. These preliminary data and effect sizes will be used to inform the development of a larger study. Gaining a better understanding of the triggering effects of acute alcohol use on suicide attempts among those with and without AUD, and identifying psychological characteristics of individuals with different acute and chronic alcohol use patterns will facilitate future identification and treatment of alcohol-related suicide attempts.

描述（由申请人提供）：仅在美国，每年就有超过 32,000 人自杀，据估计，每一次自杀死亡都会有 8-25 次非致命性自杀企图。鉴于自杀的临床和公共卫生意义，人们对确定经常报告持续自杀意念的个体增加自杀企图风险并确定自杀企图时间的近端因素非常感兴趣。尽管研究结果一致表明自杀未遂的饮酒率较高，但对于急性饮酒是否会引发自杀未遂，或者急性饮酒对自杀未遂的影响是否因长期饮酒而异，人们知之甚少。根据个人通常的消费模式来区分急性饮酒的影响和受伤风险是一个具有重大公共卫生利益的问题，已知患有和未患有酒精使用障碍 (AUD) 的自杀者之间，以及自杀前饮酒者 (A+) 和不饮酒者 (A-) 之间的心理特征存在差异（例如情绪障碍、既往治疗史）。然而，对于 AUD+ 自杀未遂者（在尝试自杀之前立即饮酒或不饮酒）、AUD- 在尝试自杀之前饮酒的人以及 AUD- 在尝试自杀之前不饮酒的人之间这些因素的差异知之甚少。在拟议的探索性/发展性研究（R21）中，我们将研究急性饮酒对自杀企图的独特触发作用，作为个人基线 AUD 状态的函数，还将研究以急性和慢性饮酒为特征的不同自杀企图者群体的远端心理特征。为此，我们将采用病例交叉设计进行受试者间比较，招募 150 名自杀未遂后接受医学评估的人。单次评估将包括 AUD 诊断措施、评估心理特征的一系列问卷以及评估自杀未遂前 6 小时内以及两个匹配对照期间的药物使用和其他随时间变化的近端风险因素的标准访谈。这项探索性/发展性研究将提供初步数据，说明患有和未患有 AUD 的个体中急性饮酒与尝试之间独特的受试者内关系的程度，并将有助于识别以不同急性饮酒模式为特征的尝试者群体的区别特征。和长期饮酒。这些初步数据和效应大小将用于为更大规模研究的开展提供信息。更好地了解急性饮酒对有或没有 AUD 的自杀未遂的触发影响，并确定具有不同急性和慢性饮酒模式的个体的心理特征，将有助于未来识别和治疗与酒精相关的自杀未遂。