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 自杀是全球死亡率的主要原因，在美国，自杀率的上升尤其陡峭。 States.因此，NIMH正在大力投资于预防，包括呼吁改善精准护理- 基于对个人层面脆弱性及其 与当地环境的互动。虽然压力，一个公认的并发和前瞻性的风险因素， 对于自杀意念（SI），所有人都经历过，它在两个组中不同-（例如，歧视、地方事件）和 人-（例如，争论，事故）的时间，频率和经验水平。因此，存在显著的需求， 以提高详细描述压力事件- SI关系的准确性，以及阐明人的水平 这些标志物增加了这种关联的脆弱性。紧张性（特质样）和阶段性（状态）冲动（IMP）， 情绪失调（艾德）是自杀风险的公认倾向。IMP和艾德单独给药 SI风险的标志物不足，但每一个都可能增加应激性生活事件背景下的SI风险。他们的联合 影响也可能加强人的水平的压力和瞬间SI的风险之间的关系的变化; 然而，这还有待检验，人们对人的水平、时刻到时刻的SI预测知之甚少。的 这项研究的首要目标是明确个人层面的条件，预示着即将到来的SI，信息 这有可能为制定有效的及时干预措施提供信息， 国家精神卫生战略计划的目标。本研究将：（1）评估即时压力的直接效应 事件的并发和前瞻性的瞬间SI，（2）评估的调节作用的紧张（特质样）， 时相（状态）IMP和艾德对实时应激事件和瞬时应激事件之间的前瞻性关系的影响 SI，（3）探索在应对先前压力时体验SI的倾向，作为潜在的调节剂。 实时压力事件和瞬时SI之间的密切关系。高危人群样本 对于自杀（即，年龄≥18岁且在过去6个月内持续存在SI的成年人）将完成 基线阶段和30天的生态瞬时评估期，以评价强直性和阶段性IMP，以及 艾德、实时压力事件和瞬时SI。研究金培训计划的目标， 圣母大学，包括：（1）提高知识的情感，个性，和认知 自杀风险的组成部分;（2）发展自杀风险因素评估的先进知识;（3） 提高对人员内和人员间研究的高级统计分析的认识;（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 高风险人群的研究实践。