Examining the Interplay of Negative Social Experiences and Self-Criticism on Suicide Risk in the Lab and Daily Life

项目总结/摘要 这个国家研究服务奖将为PI提供必要的培训和资源，以促进她的研究。 目标是成为一名独立的研究者，专注于自杀的预测，预防和治疗 思想和行为（STB）。自杀是一个主要的公共卫生问题，自杀率稳步上升;尽管 几十年的研究集中在预测上，我们预测个人何时处于高风险参与的能力， STB仍然很差。确定急性风险期对于告知自杀预防和干预至关重要 努力研究表明，消极的人际关系经历（例如，童年创伤，排斥） 与STB有关。然而，这些经验往往是无法控制的，往往是可以衡量的 通过自我报告进行回顾;确定解释这种负面影响的潜在可改变机制 人际交往经历可能导致急性STB风险至关重要。自我批评的增加是一个候选人 机构（例如，父母的拒绝通过提高自我批评导致STB）。然而，自我批评往往 在广泛的特质水平上测量;有可能经历严重的负面人际关系体验 可能会立即引起自我批评和相关的自我意识情绪的增加，这可能会引起自我批评和相关的自我意识情绪的增加， 就会使一个人面临严重的STB风险本研究将解决文献中的这些空白 通过探索自我批评和自我意识情绪反应的急剧增加是否对（1）基于实验室的 人际压力源，（2）日常生活中的人际压力源预测STB的即将发生的风险（测量两者 在实验室中和在瞬间的基础上）。这一创新项目的数据收集将建立在一个持续的 研究（R 01 MH 124832）;我们的目标是从一家自杀高风险的住院医院招募85名参与者。在 在实验室里，我们将用一个经过充分测试的范例来操纵社会排斥（即，Cyberball），并测量 参与者的状态自我批评和自我意识的影响（羞耻，内疚），以及终身STB。参与者 此外，还将完成为期4周的生态瞬时评估（EMA）。该项目将与一个 个性化的培训计划，以促进关键技能和知识的获取，以推动申请人 实现她的职业目标。这包括在（1）EMA方法， (2)急性自杀风险预测模型，（3）高风险临床样本的风险评估和管理，（4） 先进的统计工具，用于分析密集的纵向数据，以及（5）手稿和手稿 准备.申请人将与她的申办者Armey博士（EMA和自杀专家）密切合作， 共同发起人Schatten博士（EMA和风险管理专家）、Nugent博士（风险社会背景专家 和儿童创伤），以及布里克博士（密集纵向数据统计工具专家）。这位杰出 导师团队，结合巴特勒医院提供的基础设施和资源， 布朗大学阿尔珀特医学院，代表了理想的环境，以实现申请人的 培训目标，促进她的专业发展，并增加她作为自杀研究者的自主权。

Project Summary/Abstract This National Research Service Award will provide essential training and resources for the PI to facilitate her goal of becoming an independent investigator, focused on the prediction, prevention, and treatment of suicidal thoughts and behaviors (STB). Suicide is a major public health concern, with rates steadily rising; despite decades of research focused on prediction, our ability to predict when individuals are at high-risk of engaging in STB remains poor. Identifying periods of acute risk is critical in informing suicide prevention and intervention efforts. Research suggests that negative interpersonal experiences (e.g., childhood trauma, rejection) are associated with STB. However, these experiences are often uncontrollable, and tend to be measured retrospectively via self-report; identifying potential modifiable mechanisms that explain how such negative interpersonal experiences may lead to acute STB risk is vital. Increases in self-criticism is one candidate mechanism (e.g., parental rejection leads to STB via elevated self-criticism). However, self-criticism is often measured at the broad trait level; it is possible that undergoing an acute negative interpersonal experience may prompt immediate increases in state self-criticism and associated self-conscious emotions, and that this then places an individual at imminent risk for STB. The present study will address these gaps in the literature by exploring whether acute increases in self-criticism and self-conscious emotional reactions to (1) a lab-based interpersonal stressor, and (2) interpersonal stressors in daily life predict imminent risk for STB (measured both in the lab and on a momentary basis). Data collection for this innovative project will build upon an ongoing study (R01MH124832); we aim to recruit 85 participants from an inpatient hospital at high risk for suicide. In the lab, we will manipulate social exclusion with a well-tested paradigm (i.e., Cyberball), and measure participants’ state self-criticism and self-conscious affect (shame, guilt), as well as lifetime STB. Participants will also complete 4 weeks of ecological momentary assessment (EMA). This project will be conducted with an individualized training program to facilitate the acquisition of key skills and knowledge to move the applicant towards her career goals. This includes advanced didactic and experiential training in (1) EMA methodology, (2) acute suicide risk prediction models, (3) risk assessment and management in a high-risk clinical sample, (4) advanced statistical tools for analyzing intensive longitudinal data, and (5) grantsmanship and manuscript preparation. The applicant will work closely with her Sponsor, Dr. Armey (expert in EMA and suicide), and her Co-Sponsors Dr. Schatten (expert in EMA and risk management), Dr. Nugent (expert in social contexts of risk and childhood trauma), and Dr. Brick (expert in statistical tools for intensive longitudinal data). This outstanding mentorship team, in combination with the infrastructure and resources available through Butler Hospital and Alpert Medical School of Brown University, represents the ideal environment to accomplish the applicant’s training goals, foster her professional development, and increase her autonomy as a suicide researcher.