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

项目摘要/摘要 这项国家研究服务奖将为PI提供必要的培训和资源，以帮助她 目标成为一名独立的调查员，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，我们预测个人何时处于参与的高风险的能力 在STB仍然很穷。在提供自杀预防和干预的信息时，识别急性风险时期至关重要 努力。研究表明，消极的人际关系经历(例如，童年创伤、被拒绝) 与机顶盒关联。然而，这些体验往往是无法控制的，而且往往是可衡量的 通过自我报告进行回顾；确定潜在的可修改机制，解释这些负面影响 人际关系经历可能导致急性STB风险至关重要。增加自我批评是一个可能的选择 机制(例如，父母拒绝通过提高自我批评导致STB)。然而，自我批评往往是 在广泛的特质水平上衡量；经历严重的负面人际体验是可能的 可能会促使国家自我批评和相关的自我意识情绪立即增加，而这 然后将个人置于STB的迫在眉睫的风险中。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的情绪反应是否急剧增加来应对(1)基于实验室的 人际压力源，和(2)日常生活中的人际压力源预测STB的迫在眉睫的风险(测量两者 在实验室和在瞬间的基础上)。这一创新项目的数据收集将建立在正在进行的 研究(R01MH124832)：我们的目标是从一家自杀高危住院医院招募85名参与者。在……里面 在实验室中，我们将使用经过良好测试的范式(即，Cyberball)操纵社会排斥，并测量 受试者的状态自我批评和自我意识情感(羞耻、内疚)，以及终生的STB。参与者 还将完成为期4周的生态瞬时评估(EMA)。该项目将由一名 个性化培训计划，促进关键技能和知识的获得，打动申请者 朝着她的职业目标前进。这包括(1)EMA方法的高级授课和体验式培训， (2)急性自杀风险预测模型；(3)高危临床样本的风险评估与管理；(4) 高级统计工具，用于分析密集的纵向数据，以及(5)资质和手稿 准备工作。申请者将与她的赞助人Armey博士(EMA和自杀方面的专家)和她的 共同赞助人：Schatten博士(环境管理和风险管理专家)、Nugent博士(风险社会背景专家 和Brick博士(密集纵向数据统计工具专家)。这位杰出的 指导团队，结合巴特勒医院提供的基础设施和资源 布朗大学阿尔伯特医学院，代表着完成申请者 培养目标，促进她的专业发展，增加她作为自杀研究人员的自主性。

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.