Persistent versus brief suicidal ideation subtypes in risk for adolescent suicide attempts

青春期的自杀企图比一生中的任何时候都要多。然而，测量 青春期自杀意念的研究由于不了解自杀的细微方面而受到阻碍。 自杀意念预测从自杀念头到实际自杀行为的转变。最新研究 这表明，了解青少年如何看待自杀--即自杀意念的形式--在以下方面 频率、持续时间和模式等特征不仅有助于预测青少年是否会 继续进行未来的尝试，但也要考虑他们将在多长时间内进行尝试，无论他们以前是否已经尝试过 企图自杀。然而，目前的自杀意念措施和自杀风险的概念化 倾向于忽视青少年自杀念头的形式。这项更新分数SC1的建议 格兰特试图测试1)被描述为发生在更持久的、 长期发作与未来12个月内自杀未遂的短期风险较高相关 随访期，与发生在短暂发作背景下的自杀意念相比较；2)是否慢性 自杀意念的特征是更多地受到与自杀有关的干扰，并难以摆脱。 通过实验室测量评估的思想；以及3)这种干扰和脱离困难 从与自杀相关的想法中解释了持久型与短暂型之间未来自杀企图的更大风险 自杀意想者。这些目标将通过对150名青少年的不同样本进行纵向研究来实现， 年龄12-19岁，从纽约市的两家医院招募。青少年将接受采访，了解 自杀意念和企图使用新开发的半结构式自杀意念的环境 面试。他们还将完成与自杀相关的能力的实验室测试 思想。青少年(和他们的父母)将在3个月和12个月后再次接受采访，以评估是否有自杀倾向 在后续时间间隔内进行的构思和尝试。这项研究将结合一种新开发的半 结构化自杀意念访谈，结构化诊断性访谈，智力功能测试，自我 报告对认知偏差的评估，以及与自杀有关的认知偏差的客观测量。数据将 使用多层建模进行分析。了解自杀意念的模式及其背后的原因 在这个人群中，认知特征是确定干预目标以防止自杀的关键一步。 这项研究有可能改变儿科急救人员进行自杀风险评估的方式 在青少年的临床评估中，确定自杀意念的哪些特征值得关注。

More suicide attempts are made during adolescence than at any other time in life. However, the measurement of suicidal ideation in adolescence has been hampered by a failure to understand the fine-grained aspects of suicidal ideation that predict the transition from suicidal thoughts to actual suicidal behavior. Recent research suggests that knowing how adolescents think about suicide – i.e., the form of suicidal ideation – in terms of characteristics such as frequency, duration, and pattern – may help predict not only whether an adolescent will go on to make a future attempt but also how soon they will do so, regardless of whether they have previously made a suicide attempt. However, current suicidal ideation measures and conceptualizations of suicide risk tend to ignore the form of an adolescent's suicidal ideation. This proposal for a renewal of a SCORE SC1 grant seeks to test 1) whether suicidal ideation that is characterized as occurring within a more persistent, long-standing episode is associated with higher short-term risk for a future suicide attempt over a 12-month follow-up period, compared to suicidal ideation that occurs in the context of a brief episode; 2) whether chronic suicidal ideation is characterized by more interference from and difficulty disengaging from suicide-related thoughts, as assessed by laboratory measures; and 3) whether this interference from and difficulty disengaging from suicide-related thoughts explains the greater risk of future suicide attempts among persistent vs. brief suicide ideators. These aims will be addressed via a longitudinal study of a diverse sample of 150 adolescents, ages 12-19, recruited from two New York City hospitals. Adolescents will be interviewed about the circumstances leading to their suicidal ideation and attempts using a newly developed semi-structured interview. They will also complete laboratory measures of their ability to disengage from suicide-related thoughts. Adolescents (and their parents) will be interviewed again 3 and 12 months later to assess for suicidal ideation and attempts made within the follow-up interval. This research will combine a newly developed semi- structured suicidal ideation interview with structured diagnostic interviews, tests of intellectual functioning, self- report assessments of cognitive biases, and objective measures of suicide-related cognitive biases. Data will be analyzed using multilevel modeling. Understanding patterns of suicidal ideation and their underlying cognitive profiles is a critical step in identifying targets for intervention to prevent suicide in this population. This research has the potential to change how suicide risk assessments are conducted in pediatric EDs by identifying which characteristics of suicidal ideation merit focus in clinical assessments with adolescents.