Clarifying proximal mechanisms linking interpersonal stressors to suicidal behavior in youth: A multi-informant real-time monitoring study

阐明人际压力源与青少年自杀行为之间的近端机制：一项多信息实时监测研究

• 批准号: 10407448
• 负责人: Catherine Rose Glenn
• 金额: $ 74.32万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10407448
• 关键词: Acute; Address; Adolescence; Adolescent; Affective; Agitation; Arousal; Awareness; Behavior; Behavioral; Cause of Death; Cellular Phone; Conflict (Psychology); Development; Ecological momentary assessment; Emotional; Emotions; Event; Family; Feeling; Feeling suicidal; Hour; Intervention; Knowledge; Lead; Life; Link; Mediating; Outcome; Parents; Pathway interactions; Patient Self-Report; Process; Psychiatric therapeutic procedure; Psychosocial Assessment and Care; Reporting; Research; Risk; Risk Factors; Sampling; Site; Sleep Disorders; Sleep disturbances; Social Processes; Suicide; Suicide attempt; System; Technology; Testing; Thinking; Time; Work; Wrist; Youth; actigraphy; adolescent suicide; base; design; emotion regulation; high risk; informant; negative emotional state; peer; peer victimization; real time monitoring; recruit; social; stressor; suicidal adolescent; suicidal behavior; suicidal morbidity; suicidal risk; temporal measurement; trait; wearable sensor technology

PROJECT SUMMARY Suicide is the 2nd leading cause of death among adolescents, and, alarmingly, rates have continued to increase over the past decade. With the current dearth of empirically supported psychosocial interventions for adolescent suicidal behavior, there is a great need to identify processes underlying risk for this outcome. Interpersonal negative life events (NLEs) have been linked to short-term risk for suicidal behavior (i.e., suicide attempts and deaths). However, how or why these interpersonal NLEs confer risk is currently unclear. Understanding the moderators and mechanisms of the link between interpersonal NLEs and suicidal behavior is crucial in order to identify when adolescents are most at risk and to develop interventions that can target these mechanisms and reduce suicidal behavior during these periods of risk. Interpersonal NLEs may lead to suicidal behavior through their impact negative emotional states (e.g., agitation) and social connectedness, and further magnified by rejection sensitivity, emotion regulation difficulties, and sleep disturbance. Although past studies have found these constructs to be linked with suicidal behavior, this research is limited in three key ways: (1) Most prior studies have examined long time periods (months and years), which lack the temporal resolution to examine these mechanisms on the time scale in which they unfold (hours and days). We will intensively (over hours and days) examine how interpersonal NLEs relate to suicidal behavior. (2) Little is known about the impact of the social system, such as the family unit, and what key collaterals (e.g., parents) are observing in the short-term leading up to their adolescent’s suicidal behavior. By including parental reports, this study will reveal parents’ awareness of their adolescents’ suicide risk and potentially identify how parents can help them during these high-risk times. (3) Most past work has been insufficiently powered to examine links with suicidal behavior (instead focusing on suicidal thoughts). We propose to examine how and why interpersonal NLEs confer risk for suicidal behavior using smartphone-based ecological momentary assessment (EMA) and wearable sensors (i.e., wrist actigraphy) among 600 adolescents and their parents recruited from three diverse sites (Brown, Old Dominion, Rutgers) during the month after discharge from acute psychiatric care. We will address three aims: Aim 1. Examine how interpersonal (particularly familial and peer) NLEs increase risk for suicidal behavior through increased negative emotion and decreased social connectedness. Aim 2. Examine how rejection sensitivity moderates the link from interpersonal NLEs to negative emotionality/decreased social connectedness. Aim 3. Examine how sleep disturbance and emotion regulation difficulties moderate links from increased negative emotions and decreased social connectedness to suicidal behavior. This work will significantly advance understanding of proximal risk for suicidal behavior in youth and how the field assesses and treats suicidal adolescents.

项目概要 自杀是青少年死亡的第二大原因，令人担忧的是，自杀率持续上升 过去十年增加。由于目前缺乏经验支持的心理社会干预措施 青少年的自杀行为，非常需要确定导致这一结果的潜在风险的过程。 人际负面生活事件（NLE）与自杀行为（即自杀）的短期风险有关。 尝试和死亡）。然而，目前尚不清楚这些人际关系 NLE 如何或为何会带来风险。 了解人际 NLE 与自杀行为之间联系的调节因素和机制 对于确定青少年何时面临最大风险并制定针对青少年的干预措施至关重要 这些机制可以减少这些风险时期的自杀行为。人际 NLE 可能会导致 自杀行为通过其影响负面情绪状态（例如激动）和社会联系， 拒绝敏感性、情绪调节困难和睡眠障碍进一步放大了这种情况。虽然 过去的研究发现这些结构与自杀行为有关，本研究仅限于三个方面 关键方法：（1）大多数先前的研究都考察了较长的时间段（月和年），缺乏时间 决议在它们展开的时间尺度（小时和天）上检查这些机制。我们将 深入（经过数小时和数天）研究人际 NLE 与自杀行为的关系。 (2) 很少是 了解社会制度的影响，例如家庭单位，以及哪些关键抵押品（例如父母） 正在短期内观察导致青少年自杀行为的原因。通过纳入家长报告， 这项研究将揭示父母对其青少年自杀风险的认识，并可能确定父母如何 可以在这些高风险时期为他们提供帮助。 (3)过去的大部分工作没有足够的力量来检验 与自杀行为的联系（而不是关注自杀想法）。我们建议研究如何以及为何 人际 NLE 使用基于智能手机的生态瞬间赋予自杀行为风险 对 600 名青少年及其父母进行评估 (EMA) 和可穿戴传感器（即腕部活动记录仪） 在急性发作出院后的一个月内，从三个不同的地点（布朗大学、旧道明尼恩大学、罗格斯大学）招募 精神科护理。我们将实现三个目标： 目标 1. 检查人际交往（特别是家庭和同伴） NLE 通过增加负面情绪和减少社交来增加自杀行为的风险 连通性。目标 2. 检查拒绝敏感性如何调节人际 NLE 与人际 NLE 之间的联系 负面情绪/社交联系减少。目标 3. 检查睡眠障碍和情绪如何 调节困难缓和了负面情绪增加和社会联系减少与 自杀行为。这项工作将显着促进对自杀行为近期风险的理解 青年以及该领域如何评估和治疗有自杀倾向的青少年。