Executive Dysfunction and Suicide in Psychiatric Outpatients and Inpatients

精神科门诊和住院患者的执行功能障碍和自杀

• 批准号: 8466758
• 负责人: Lisa A Brenner
• 金额: --
• 依托单位: VA EASTERN COLORADO HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8466758
• 关键词: Aggressive behavior; Anger; Applications Grants; Area; Behavior; Cognition; Concept Formation; Decision Making; Delayed Memory; Disease; Equipment and supply inventories; Evaluation; Executive Dysfunction; Foundations; Gambling; Goals; Impairment; Impulsivity; Individual; Inpatients; Intervention; Iowa; Life; Measures; Modeling; Neurologic; Outcome; Outpatients; Pattern; Performance; Population Research; Populations at Risk; Questionnaires; Recording of previous events; Recovery; Recovery of Function; Rehabilitation Research; Research; Research Personnel; Risk; Risk Factors; Safety; Short-Term Memory; Sorting - Cell Movement; Suicide; Survivors; Techniques; Testing; Traumatic Brain Injury; Veterans; Vulnerable Populations; Wisconsin; base; design; emotional distress; executive function; high risk; indexing; innovation; neuropsychological; performance tests; psychological distress; psychosocial; research and development; sound; suicidal behavior; suicidal risk; tool; trait; treatment response

DESCRIPTION (provided by applicant): Project Summary Recent studies indicate that veterans who engage in suicidal behavior have a history of traumatic brain injury (TBI), and veterans with a history of TBI engage in suicidal behavior. Existing research also suggests an association between suicidality and executive dysfunction (e.g., impaired decision making). To date a clearly defined study has not been conducted to explore the relationship between executive dysfunction as a multidimensional construct (i.e., decision making, impulsivity, concept formation, and aggression) and suicidal behavior in the vulnerable population of those with a history of moderate to severe TBI. Increased understanding regarding this at-risk population is necessary to facilitate the creation of appropriate assessment strategies and interventions. This study will assess decision making in the context of an interaction between suicide and TBI. Findings will also allow for exploratory analyses aimed at identifying associations between performance on measures of executive functioning and psychological distress. Toward this end, the present study seeks to compare test performance among four well-defined groups of veterans: (1) those with moderate to severe TBI and a history of suicidal behavior; (2) those with moderate to severe TBI and no history of suicidal behavior; (3) those with no TBI and a history of suicidal behavior; (4) and those with no TBI and no history of suicidal behavior. This grant proposal is in direct support of the Rehabilitation Research and Development goal of maximizing functional recovery in those with TBI by potentially: 1) increasing clinicians' ability to identify neuropsychological correlates of suicidal behavior for those with moderate to severe TBI; 2) identifying psychometrically sound measures of executive functioning that correspond to real-life behaviors that impact treatment response and recovery; 3) facilitating the creation of innovative assessment techniques and psychosocial interventions (e.g., safety planning) to minimize complications in the management of suicidal behavior due to TBI-related impairments; and 4) creating a basis for further and much-needed research in this area. Ultimately, findings from this study would both contribute to clinicians' ability to identify veterans with TBI who are at risk for suicidal behavior, and create a foundation on which to base further research regarding the relationships between cognition, emotional distress, and suicidality in TBI survivors.

描述（由申请人提供）： 最近的研究表明，从事自杀行为的退伍军人有创伤性脑损伤（TBI）的历史，有TBI历史的退伍军人从事自杀行为。现有的研究还表明自杀倾向和执行功能障碍之间存在关联（例如，决策障碍）。迄今为止，还没有进行明确定义的研究来探索执行功能障碍作为一个多维度结构（即，决策、冲动、概念形成和攻击性）和自杀行为。有必要增进对这一高危人群的了解，以促进制定适当的评估战略和干预措施。这项研究将评估自杀和TBI之间相互作用的背景下的决策。调查结果还将允许进行探索性分析，旨在确定执行功能指标的表现与心理困扰之间的关联。为此，本研究旨在比较四组定义明确的退伍军人的测试表现：（1）中度至重度TBI和自杀行为史;（2）中度至重度TBI和无自杀行为史;（3）无TBI和自杀行为史;（4）和无TBI和无自杀行为史。该拨款提案直接支持康复研究与发展目标，即最大限度地提高TBI患者的功能恢复，可能通过：1）提高临床医生识别中度至重度TBI患者自杀行为的神经心理学相关性的能力; 2）识别与影响治疗反应和恢复的现实生活行为相对应的执行功能的心理测量学合理措施; 3）促进创新评估技术和心理社会干预措施的创建（例如，安全计划），以尽量减少并发症的管理自杀行为由于创伤性脑损伤相关的损害;和4）创建一个基础，进一步和急需的研究在这一领域。最终，这项研究的结果将有助于临床医生识别有自杀行为风险的TBI退伍军人的能力，并为进一步研究TBI幸存者的认知，情绪困扰和自杀倾向之间的关系奠定基础。