Do discrimination and adversity drive the inflammatory basis of suicidal ideation in Black and Latinx young adults?

项目总结/摘要 近年来，年轻的黑人和拉丁裔个体中自杀意念的流行率一直在上升。 种族/民族歧视和不良儿童事件（ACE）4，5被认为可以解释这种健康状况 差距全身性炎症是身体应激反应系统过度激活的产物， 被假设为在自杀意念发展中发挥独特的预测作用6，7，8。经历 种族/民族歧视和ACE可导致全身炎症9，10，11-可能导致自杀 在经历ACE和歧视的年轻种族/少数民族中，想法越来越普遍 以不成比例的速度。相反，安全的依恋关系与减少 在全身炎症12和自杀意念的风险较低13。这项奖学金研究的主要目的是 是测试生物和关系机制解释种族/民族之间的自杀意念 少数民族年轻人，特别是审查ACE和种族/民族歧视作为风险因素， 以及介导作用与全身炎症的保护作用关系密切。 长期暴露于种族/民族歧视和ACE可导致下丘脑- 垂体-肾上腺（HPA）轴，导致促炎细胞因子的耗竭释放和全身性 炎症10，14，15.生物学模型将全身炎症确定为自杀意念的潜在介导者 在自杀行为的个体中给予促炎细胞因子水平升高6，8，9进一步，研究 已经表明ACE和种族/民族歧视可以改变促炎细胞因子水平和信号10，15 然而，没有研究试图调查全身炎症作为自杀意念的介导因素， 成年期，也没有提出的风险或保护因素在这一途径。本提案解决了这些差距 通过（a）检查ACE与种族/民族歧视与自杀念头之间的联系是否 由全身炎症介导，和（B）检查作为调节剂的附着安全性。这项建议 利用整合多个分析水平的生物心理社会模型（即，免疫生物学，行为学， 关系）。它反映了国家少数民族健康和健康差异研究所的使命， 确定差异的机制和保护因素，以便本研究旨在阐明如何 ACE和种族/民族歧视可能引起全身性炎症， 年轻人的自杀意念，强调安全依恋的保护作用 关系，以揭示不同国家紧迫的健康差距的基本机制， 人口。最后，该奖项将有助于培养一名年轻的研究人员， 与少数民族/种族群体的年轻人的负面结果相关， 脚手架走向独立的研究生涯和机会，先进的研究技能的广度 跨学科的知识深度。

PROJECT SUMMARY/ABSTRACT In recent years, the prevalence of suicidal ideation among young Black and Latinx individuals has been on the rise1,2,3 with racial/ethnic discrimination and adverse childhood events (ACEs)4,5 thought to explain this health disparity. Systemic inflammation—a product of over-activation of the body’s stress response system—has been hypothesized to play a unique predictive role in suicidal ideation development6,7,8. Experiencing racial/ethnic discrimination and ACEs can lead to systemic inflammation9,10,11—possibly accounting for suicidal ideation’s growing prevalence among young racial/ethnic minorities who experience ACEs and discrimination at disproportionate rates. Conversely, secure attachment relationships have been associated with a reduction in systemic inflammation12 and a lower risk for suicidal ideation13. The broad aim of this fellowship research is to test biological and relational mechanisms explaining suicidal ideation among racial/ethnic minority young adults, specifically examining ACEs and racial/ethnic discrimination as risk factors as well as the mediating role of systemic inflammation and the protective effects of close relationships. Chronic exposure to racial/ethnic discrimination and ACEs can lead to dysregulation of the hypothalamic- pituitary-adrenal (HPA) axis, leading to an exhausted release of proinflammatory cytokines and systemic inflammation10,14,15. Biological models identify systemic inflammation as a potential mediator of suicidal ideation given elevated levels of proinflammatory cytokines in individuals with suicidal behaviors6,8,9 Further, studies have shown ACEs and racial/ethnic discrimination can alter proinflammatory cytokine levels and signaling10,15 However, no study has attempted to investigate systemic inflammation as a mediator of suicidal ideation in adulthood nor the proposed risk or protective factors within this pathway. This proposal addresses these gaps by (a) examining whether the links between ACEs and racial/ethnic discrimination with suicidal ideation are mediated by systemic inflammation and (b) examining attachment security as a moderator. This proposal utilizes a biopsychosocial model integrating multiple levels of analysis (i.e., immunobiological, behavioral, relational). It reflects the mission of the National Institute of Minority Health and Health Disparities (NIMHD) to identify mechanisms and protective factors of disparities such that this study aims to elucidate how systemic inflammation might arise from ACEs and racial/ethnic discrimination and increase risk for suicidal ideation in young adults with emphasis on the protective effects of secure attachment relationships to uncover fundamental mechanisms of a pressing health disparity in diverse populations. Finally, this award will aid in training a young researcher seeking to understand the mechanisms associated with negative outcomes in young adults from ethnic/racial minority groups by providing necessary scaffolding toward an independent research career and opportunities for advanced research skills breadth depth of knowledge across disciplines.