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

青春期的自杀企图比生命中的任何其他时期都要多。然而，测量 青少年自杀意念的研究一直受到未能理解 预测从自杀想法到实际自杀行为转变的自杀意念。最近的研究 这表明，了解青少年如何看待自杀-即，自杀意念的形式-就 频率，持续时间和模式等特征-不仅可以帮助预测青少年是否会 继续进行未来的尝试，但也要考虑他们会在多长时间内这样做，不管他们以前是否有过这样的尝试。 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意念的形式。这份关于更新SCORE SC 1的提案 格兰特试图测试1）特征为发生在更持久的， 长期发作与未来12个月内自杀企图的短期风险较高相关 随访期，与在短暂发作的背景下发生的自杀意念相比; 2）是否为慢性 自杀意念的特点是更多的干扰和难以脱离自杀相关的 思想，通过实验室测量评估;和3）是否这种干扰和困难脱离 从自杀相关的想法解释了更大的风险，未来的自杀企图之间的持续与短暂的 自杀意念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解决， 年龄12-19岁，从纽约市两家医院招募。青少年将接受采访， 导致他们自杀意念和企图使用新开发的半结构化 采访他们还将完成对他们脱离自杀相关疾病的能力的实验室测量。 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，以评估自杀倾向 在随访期间进行的构思和尝试。本研究将联合收割机与一种新研制的半导体激光切割机相结合， 结构化自杀意念访谈与结构化诊断访谈，智力功能测试，自我评估， 报告对认知偏差的评估，以及对自杀相关认知偏差的客观测量。数据将 使用多层次模型进行分析。了解自杀意念的模式及其潜在的 认知特征是确定干预目标以预防这一人群自杀的关键步骤。 这项研究有可能改变如何自杀风险评估进行儿科急诊室， 在青少年的临床评估中确定哪些自杀意念特征值得关注。

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.