A fine-grained EEG/ERP examination of reward processing in suicide attempters

项目摘要 自杀是19至34岁人群的第二大死因， 35-54岁的美国人。尽管1999年至2014年间自杀率上升了24%， 菲尔德预测自杀死亡风险的能力在过去50年里没有提高，这表明迫切需要 需要进行研究，以确定新的，具体的风险机制。鉴于最近的证据表明 自杀企图（SA）是一个更大的风险因素，后来完成自杀比以前认为，一个关键 重点应放在增加SA风险的因素上。尽管SA是跨诊断发生的（即， 广泛的诊断以及在没有可诊断的疾病），迄今为止，大多数研究 采取了一种疾病特异性的方法来理解SA。此外，尽管有证据表明，奖励的异常， 在自杀者中，奖赏处理的哪些具体成分可能是 在有SA史的人中受损最严重，特别是（即预期快乐，圆满快乐， 奖励学习）。此外，虽然有证据表明，一些人口和其他变量， 差异与SA的存在和特征相关，这些变量对 自杀者的奖赏加工机制尚不清楚。为了解决先前研究的局限性， 拟议的研究将提供一个细粒度的transdiagnosis调查奖励处理在那些与 在没有跨多个分析单元的SA历史的情况下（例如，脑电图/事件相关电位， 行为，自我报告）。具体目标1是采用细粒度的多单元分析方法来检查 具有SA史的个体的预期和完善性奖励加工和奖励学习， 与那些没有这种历史的人相比。具体目标2是确定奖励加工的特殊性 个体的SA史与其当前或过去的精神病理学史的损伤。最后通过一个 探索性的目的是研究性别、性取向、种族/民族和SA的潜在调节作用 特性（即，单次与多次尝试、致死率和最后一次尝试的新近度）。拟建项目 直接解决了NIMH战略计划2016中概述的四个战略目标中的第一个-“定义 复杂行为的机制。”该项目也有可能提供宝贵的 这是符合NIMH第四个战略目标的信息-“努力预防和治疗”。的确， 在自杀者中识别特定的奖励系统中断可能提供重要的信息 需要改善对这一特定的极高危人群的干预或预防工作。

Project Summary Suicide is the second leading cause of death for 19- to 34-year-olds and the third leading cause of death for 35- to 54-year olds in the United States. Despite a 24% increase in suicide rates between 1999 and 2014, the field’s ability to predict risk for death by suicide has not improved in the past 50 years, indicating an urgent need for studies to identify novel, specific mechanisms of risk. Given recent evidence that a history of prior suicide attempt (SA) is an even greater risk factor for later completed suicide than previously thought, a key focus should be on factors that increase risk for SA. Although SAs occur transdiagnostically (i.e. across a broad range of diagnoses as well as in the absence of a diagnosable disorder), most research to date has taken a disorder-specific approach to understanding SAs. Further, despite evidence for abnormalities in reward functioning in suicide attempters, little is known about which specific components of reward processing may be most impaired in those with a history of SA, specifically (i.e. anticipatory pleasure, consummatory pleasure, reward learning). In addition, although there is evidence that a number of demographic and other variables are differentially linked with the presence and characteristics of SAs, the potential impact of these variables on reward processing in suicide attempters remains unclear. To address the limitations of prior research, the proposed study will provide a fine-grained transdiagnostic investigation of reward processing in those with and without a history of SA across multiple units of analysis (e.g., electroencephalography/event-related potentials, behavior, self-report). Specific Aim 1 is to take a fine-grained multiple-units-of-analysis approach to examine anticipatory and consummatory reward processing and reward learning in individuals with a history of SA, compared to those without such history. Specific Aim 2 is to determine the specificity of reward-processing impairments to individuals’ history of SA versus their current or past histories of psychopathology. Finally, an exploratory aim is to examine the potential moderating roles of sex, sexual orientation, race/ethnicity, and SA characteristics (i.e., single vs. multiple attempt, lethality, and recency of last attempt). The proposed project directly addresses the first of the four Strategic Objectives outlined in the NIMH Strategic Plan 2016 - “Define the mechanisms of complex behaviors.” The proposed project also has the potential to provide valuable information that is in line with the fourth NIMH Strategic Objective – “Strive for prevention and cures.” Indeed, identification of specific reward system disruptions in suicide attempters might provide important information needed to improve intervention or prevention efforts with this specific, extremely high-risk population.