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

项目总结 自杀是全球死亡的主要原因，在美国，自杀率的上升尤为严重 各州。因此，NIMH正在大力投资于预防，包括呼吁改善精准护理- 提供的干预基于对人员级脆弱性及其 与当地环境的互动。尽管压力是公认的既有和预期的风险因素 对于自杀意念(SI)，是所有人都经历的，它在两个群体中都不同--(例如，歧视、当地事件)和 人--(例如，争论、事故)在时间、频率和经验方面的水平。因此，有很大的需要 提高应激事件-SI关系细节的准确性，以及阐明人与人之间的关系 增加这种关联易感性的标记。主动性(特质样)和相性(状态)冲动性(IMP)和 情绪失调(ED)是公认的自杀风险的易感因素。只有小鬼和艾德是 没有足够的SI风险标记物，但每一个都可能在应激性生活事件的背景下增加SI的风险。他们的关节 影响也可能加强个人水平压力的变化与短暂性SI风险之间的关系； 然而，这一点还有待测试，因此人们对个人水平、时刻到时刻的SI预测知之甚少。这个 这项研究的首要目标是明确预示着即将到来的SI、信息的个人层面的情况 这有可能为有效的及时干预的发展提供信息，与精确一致 NIMH战略计划的关怀目标。本研究将：(1)评估即时应激的直接效应 事件的同时和预期的瞬时SI，(2)评估补药(特质样)和 实时应激事件与瞬时事件预期关系的阶段性(状态)IMP和ED SI，以及(3)探索在先前的压力反应中体验SI的倾向，作为潜在的调节因素 实时应激事件与短暂性SI之间的密切关系。高危人群样本 对于自杀(即，18岁的成年人，在过去6个月内持续终生SI和SI)将完成 基线会议和30天的生态瞬时评估，以评估紧张性和相性IMP和 ED、实时压力事件和瞬时SI。研究金培训计划的目标，该计划将在 圣母大学包括：(1)增强情感、个性和认知方面的知识 自杀风险的组成部分；(2)发展对自杀风险因素评估的高级知识； 增强对人内和人与人之间研究的高级统计分析的知识；(4)参与 专业发展活动和发展先进的研究技能；(5)提高道德知识 对高危人群的研究实践。

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.