Multi-Method Assessment of Emotion Reactivity: Translational Research in Suicide

描述（由申请人提供）：虽然在理解和治疗自杀行为方面取得了进展，但在过去十年中，该国的自杀率并没有明显下降。我们有效治疗自杀倾向的能力有限的一个解释可能是我们对自杀倾向在真实的世界中发生的现象学的理解有限。拟议的研究，美国治疗（了解自杀：情绪反应性评估技术的转化研究），是第一个应用多方法院内评估和住院治疗出院后生态瞬时评估（EMA）程序相结合的方法来模拟情绪反应性的转化表型，这是一种对自杀具有临床和理论重要影响的方法，以及它对未来自杀想法和行为的预测。300名因自杀意念和行为住院的个体和50名非自杀性精神病对照的样本将参与实验室范例以评估生理反应（即，心率变异性，皮肤电导，和惊吓）对标准化环境刺激，情绪反应的EMA（即，情感、情感效价和情感随时间的变化率）和遗传生物标志物（例如，5-羟色胺系统、神经营养因子）。为了更好地描述和预测自杀现象，我们将使用周期性过程的分析模型（即，动态系统）以允许情感的离散方面的非线性建模（即，强度、影响变化率、周期性和阻尼）a受经验（即EMA评估的）生活压力源的影响。US-TREAT方法将提供关于自杀倾向现象学的重要见解，并具有明确的治疗意义。

DESCRIPTION (provided by applicant): Although advances have been made towards understanding and treating suicidal behavior, suicide rates in this country have not fallen appreciably over the last decade. One explanation for our limited ability to effectively treat suicidality may be our limited understanding of the phenomenology of suicidality as it occurs in the real world. The proposed study, US-TREAT (Understanding Suicide: Translational Research in Emotional Reactivity Assessment Technology), is the first to apply a combination of multimethod in-hospital assessments and ecological momentary assessment (EMA) procedures post-discharge from inpatient care to model a translational phenotype of emotional reactivity, a clinically- and theoretically-important influence on suicidality, and its prediction of future suicdal ideation and behavior. A sample of 300 individuals hospitalized for suicidal ideation and behavior and 50 non-suicidal psychiatric comparisons will participate in a laboratory paradigm to assess physiological response (i.e., heart rate variability, skin conductance, & startle) to standardized environmental stimuli, EMA of emotional reactivity (i.e., affect, affective valence, and rate of change in affect over time), and genetic biomarkers (e.g. serotonin system, neurotrophins). To better characterize and predict the phenomenology of suicidality, we will use analytical models of cyclical processes (i.e., dynamical systems) to permit non-linear modeling of discrete aspects of emotion (i.e., intensity, rate of affect change, cyclicality, and damping) a influenced by experienced (i.e. EMA assessed) life stressors. The US-TREAT approach will provide critical insight regarding the phenomenology of suicidality with clear treatment implications.