Biomarkers, social, and affective predictors of suicidal thoughts and behaviors in adolescents

描述（由申请人提供）：三分之一到一半的精神科住院青年再次入院，出院后15-30天再入院风险最高，超过80%的人在三个月内再次入院。这项拟议的研究涉及使用生态学方法和设备对青少年出院后自杀风险相关的自然现象进行体内表征，这些方法和设备允许对个人的社会环境和经验影响的自我报告进行声学捕获。我们认为，社会环境和经验情感是相互加强的，反应型风格涉及压力社会的紧密耦合

DESCRIPTION (provided by applicant): One third to one half of psychiatrically hospitalized youth is readmitted, with highest readmission risk 15-30 days post discharge and more than 80% readmitted within three months. The proposed study involves in vivo characterization of naturalistic phenomena associated with suicide risk after discharge adolescents using ecological methods and devices that allow acoustic capture of an individual's social environment and self-reports of experienced affect. We propose that social context and experienced affect are reciprocally reinforcing and that a reactive style involving close coupling of stressful social context (isolation, conflictual or high affect interactions) with affect reactivity (rapidly changig, intense affect, with slow return to baseline) increases risk for suicidal thoughts and behaviors. We also examine childhood maltreatment and epigenetic markers as predictors of post-discharge reactivity. Two hundred youth hospitalized for suicidal thoughts and behaviors will be followed prospectively using ecological methods and devices for three weeks following psychiatric discharge; suicidal thoughts and behaviors will be reassessed at 6 months. The present study further innovates through the incorporation of affect reactivity biomarkers (in-hospital blood samples for assessment of DNA/DNAm/expression). The proposed study merges multiple fields of study and permits an innovative and thorough characterization of the real-world interplay of affect and social context. Results of this investigation will inform a number of intervention approaches including family therapy, EMA-based adjunctive intervention, and pharmacological approaches.