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.

项目摘要 自杀是青少年的第二大死亡原因，令人震惊的是 在过去的十年中增加。随着当前经验支持的心理心理干预措施的死亡 青春期的自杀行为，非常需要确定这种结果的风险。 人际负面生活事件（NLE）与自杀行为的短期风险有关（即自杀 尝试和死亡）。但是，目前尚不清楚这些人际NLE会议风险的原因或原因。 了解人际关系和自杀行为之间联系的主持人和机制 至关重要的是要确定青少年何时有最大的风险并制定可以针对的干预措施 这些机制并减少了这些风险时期的自杀行为。人际关系可能会导致 通过影响负面情绪状态（例如煽动）和社会联系，自杀行为， 并通过拒绝敏感性，情绪调节困难和睡眠障碍进一步放大。虽然 过去的研究发现这些结构与自杀行为有关，这项研究在三个中受到限制 关键方法：（1）大多数先前的研究都检查了长期（几个月和几年），而缺乏临时性 解决这些机制在它们展开的时间尺度上（小时和天）。我们将 密集（超过几个小时和几天）检查人际NLE与自杀行为的关系。 （2）几乎是 知道社会体系的影响，例如家庭单位，以及哪些关键抵押品（例如，父母） 在短期内观察到青少年的自杀行为。通过包括父母的报告， 这项研究将揭示父母对青少年自杀风险的认识，并有可能确定父母如何 可以在这些高风险时期帮助他们。 （3）过去的大多数工作都无法进行考试 与自杀行为联系起来（而不是自杀思想）。我们建议研究如何以及为什么 人际NLE会议会议使用基于智能手机的生态瞬间的自杀行为风险 600名青少年的评估（EMA）和可穿戴传感器（即腕部表观摄影）及其父母 从急性出院后的一个月，从三个潜水员站点（棕色，旧自治领，罗格斯）招募 精神病护理。我们将解决三个目标：目标1。检查人际关系（部分家庭和同伴）如何 NLE通过增加负面情绪并改善社会的自杀行为的风险 连接。目标2。检查拒绝敏感性如何调节从人际关系的链接到 负面情绪/社会联系减少。目标3。检查睡眠障碍和情感如何 监管困难的中等联系，从增加的负面情绪和增加的社会联系与 自杀行为。这项工作将大大提高对自杀行为近端风险的理解 青年以及现场评估和如何治疗自杀青少年。