Stress experiences as markers of person-level vulnerability and temporal risk for near-term suicidal ideation

压力体验是个人脆弱性和近期自杀意念暂时风险的标志

• 批准号: 10825847
• 负责人: Anne Knorr
• 金额: $ 4.77万
• 依托单位: UNIVERSITY OF NOTRE DAME
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-28 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10825847
• 关键词: Accidents; Accounting; Adult; Age; Aging; Cessation of life; Cognitive; Development; Discrimination; Ecological momentary assessment; Emotional; Environment; Ethics; Etiology; Event; Feeling suicidal; Fellowship; Frequencies; Future; Goals; Impulsivity; Individual; Individual Differences; Intervention; Investments; Joints; Knowledge; Maps; Measures; National Institute of Mental Health; Pathway interactions; Personality; Persons; Phase; Predisposition; Prevention; Reaction; Reporting; Research; Risk; Risk Factors; Risk Reduction; Sampling; Specific qualifier value; Statistical Data Interpretation; Strategic Planning; Stress; Stressful Event; Suicide; Testing; Time; Training; United States; Universities; acute stress; emotion dysregulation; experience; high risk; high risk population; improved; longitudinal design; men; mortality; next generation; personalized care; prevent; prospective; recruit; response; skills; suicidal behavior; suicidal risk; suicide rate; trait

PROJECT SUMMARY Suicide is a leading cause of global mortality and rising suicide rates have been particularly steep in the United States. Accordingly, NIMH is investing heavily in prevention, including calls for improved precision care— interventions delivered based on specific, granular understanding of person-level vulnerabilities and their interaction with local environments. Although stress, a well-established concurrent and prospective risk factor for suicidal ideation (SI), is experienced by all, it varies at both group- (e.g., discrimination, local events) and person- (e.g., arguments, accidents) levels in timing, frequency, and experience. Thus, there is a significant need to improve the accuracy in detailing the stressful events – SI relationship, as well as elucidate person-level markers that increase vulnerability to this association. Tonic (trait-like) and phasic (state) impulsivity (IMP) and emotion dysregulation (ED) are well-established predispositions for suicide risk. IMP and ED alone are insufficient markers of SI risk, yet each may increase risk for SI in the context of stressful life events. Their joint effects may also potentiate the relationship between changes in person-level stress and risk for momentary SI; however, this has yet to be tested, leaving little known about person-level, moment-to-moment SI prediction. The overarching objective of this research is to specify person-level conditions that portend imminent SI, information that has the potential to inform the development of effective just-in-time interventions, consistent with precision care objectives of the NIMH Strategic Plan. This research will: (1) evaluate the direct effect of real-time stressful events on concurrent and prospective momentary SI, (2) evaluate the moderating effects of tonic (trait-like) and phasic (state) IMP and ED on the prospective relationship between real-time stressful events and momentary SI, and (3) explore the propensity to experience SI in response to prior stress as a potential moderator of the proximal relationship between real-time stressful events and momentary SI. A sample of individuals at high risk for suicide (i.e., adults age ≥18 with persistent lifetime SI and SI during the past 6-months) will complete a baseline session and 30-day period of ecological momentary assessment to evaluate tonic and phasic IMP and ED, real-time stressful events, and momentary SI. Goals of the fellowship training plan, which will take place at the University of Notre Dame, include: (1) enhance knowledge of emotional, personality, and cognitive components of suicide risk; (2) develop advanced knowledge of the assessment of suicide risk factors; (3) enhance knowledge of advanced statistical analyses for within- and between-persons research; (4) engage in professional development activities and develop advanced research skills; (5) enhance knowledge of ethical research practices with high-risk populations.

项目摘要 自杀是全球死亡率和自杀率上升的主要原因，在曼联 国家。根据NIMH的预防投资，包括改善精度护理的呼吁 - 根据对人级漏洞及其的特定颗粒状理解提供的干预措施 与本地环境的互动。虽然压力是一个完善的并发和预期的风险因素 对于自杀的想法（SI），所有人都经历了这两个群体（例如，歧视，本地事件）和 人（例如，论点，事故）的时间，频率和经验。那是很大的需求 提高详细说明压力事件的准确性 - SI关系，并阐明人级 增加对这种关联的脆弱性的标记。补品（特质）和阶段（状态）冲动性（IMP）和 情绪失调（ED）是自杀风险的完善倾向。小动物和埃德是 SI风险的标记不足，但在压力大的生活事件中，每个人都可能会增加SI的风险。他们的关节 影响也可能潜在人级压力变化与瞬时SI风险之间的关系； 但是，这尚未进行测试，对人级，时刻的SI预测鲜为人知。这 这项研究的总体目的是指定预示迫在眉睫的SI的人级条件 这有可能告知开发有效的即时干预措施，这与精度一致 NIMH战略计划的护理对象。这项研究将：（1）评估实时压力的直接影响 关于并发和前瞻性SI的事件，（2）评估补品（特质样）和 关于实时压力事件与瞬间之间的前瞻性关系的阶段（状态）和 SI和（3）探索承诺以响应先前的压力作为潜在的主持人的承诺 实时压力事件与瞬时SI之间的近端关系。一个高风险的个体样本 对于自杀（即，在过去6个月中持续的寿命≥18岁的成年人≥18岁）将完成 基线会议和30天的生态瞬时评估，以评估补品和阶段性IMP和 Ed，实时压力事件和暂时的SI。奖学金培训计划的目标，该计划将在 圣母大学，包括：（1）增强情感，个性和认知知识 自杀风险的组成部分； （2）发展自杀危险因素评估的先进知识； （3） 增强对素内研究和之间研究的先进统计分析知识； （4）参与 专业发展活动并发展高级研究技能； （5）增强道德知识 具有高风险人群的研究实践。