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

描述（由申请人提供）：尽管在理解和治疗自杀行为方面取得了进步，但在过去的十年里，这个国家的自杀率并没有明显下降。我们有效治疗自杀的能力有限的一个解释可能是我们对现实世界中发生的自杀现象的理解有限。这项名为US-TREAT（理解自杀：情绪反应性评估技术的转化研究）的研究首次将多方法住院评估和出院后的生态瞬间评估（EMA）程序相结合，对情绪反应性的转化表型、对自杀行为的临床和理论重要影响及其对未来自杀意念和行为的预测进行建模。300名因自杀意念和行为住院的个体样本以及50名非自杀精神病学比较者将参与实验室范例，以评估对标准化环境刺激的生理反应（即心率变异性、皮肤电导和惊吓）、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（如血清素系统、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（即动力系统）的分析模型，允许对受经验（即EMA评估）生活压力源影响的情感离散方面（即强度、情感变化速率、周期性和阻尼）进行非线性建模。US-TREAT方法将提供关于自杀现象学的关键见解，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.