Multimodal Assessment of Social Disconnection as a Proximal Risk for Suicide Ideation in Late Life

社会脱节作为晚年自杀意念的近端风险的多模式评估

• 批准号: 10852290
• 负责人: Nicole M Cain
• 金额: $ 63.97万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10852290
• 关键词: Address; Affective; Age; Aging; Assisted Living Facilities; Back; Behavior assessment; Bereavement; Cessation of life; Cognitive; Conflict (Psychology); Development; Dimensions; Ecological momentary assessment; Elderly; Evaluation; Event; Exhibits; Expectancy; Feeling suicidal; Funding; Goals; Hour; Individual; Interview; Laboratories; Life; Link; Loneliness; Measures; Mediating; Mediator; Methods; National Institute of Mental Health; Outcome; Participant; Patient Self-Report; Persons; Population; Predisposition; Primary Care; Protocols documentation; Public Health; Reaction; Recommendation; Reporting; Research; Research Domain Criteria; Risk Assessment; Sampling; Services; Social Network; Social Processes; Suicide; Suicide prevention; Time; United States; Woman; Work; anxious; base; evidence base; experience; follow-up; human old age (65+); improved; innovation; insight; longitudinal design; medical specialties; men; multilevel analysis; multimodality; personalized medicine; recruit; response; social; social exclusion; suicidal behavior; suicidal morbidity; suicidal risk; suicide rate

Abstract/Project Summary Globally and in the United States, older adults exhibit the highest rates of suicide deaths. Research has shown that social disconnection and interpersonal negative life events (NLEs) are both significantly linked with suicide ideation, attempts, and deaths in late life, yet few studies have examined moderators of the relationship between social disconnection and suicide in late life or considered social disconnection as a mediator of the relationship between interpersonal NLEs and suicide outcomes, despite compelling evidence to do so. In addition, existing studies are mostly cross-sectional and provide little insight into how suicide risk unfolds over hours, days, weeks, and months in older adults. The overarching goal of this proposal is to leverage a multimodal assessment of behavioral and social mechanisms to improve our ability to identify specific predictors relating social disconnection to suicidal ideation in late life. We will examine how a crucial social- cognitive vulnerability, rejection sensitivity (RS), contributes to the link between social disconnection and suicidal ideation in late life. RS is the predisposition to subjectively perceive, anxiously expect, and intensely react to social rejection, and reflects the Research Domain Criteria (RDoC) of Social Processes: Affiliation and Attachment. Using an intensive longitudinal design, including three 21-day EMA bursts and follow-back interviews over a 1-year period, we will also examine social disconnection as a mediator of the relationship between interpersonal NLEs and suicidal ideation over different timescales. Participants will include a diagnostically diverse sample of 250 men and women ages 60 and older who report elevated suicidal ideation. Multimodal assessments at baseline will include interviews, self-reports, a laboratory-based social rejection paradigm, and a 21-day random and event-based ecological momentary assessment (EMA) protocol. Follow- up interviews will be conducted every 3 months for 1-year to fully assess rare, low base rate interpersonal NLEs (e.g., deaths illnesses, loss of relationships), and the 21-day EMA protocol will be repeated at 6-months and 12-months. The proposed project has three specific aims: 1) to examine within-person variability in social disconnection as a proximal predictor of momentary increases in suicidal ideation in late life; 2) to investigate RS as a static and time-varying moderator of the relationship between social disconnection and suicidal ideation in late life; and 3) to examine the mediating effect of social disconnection on the relationship between interpersonal NLEs and suicidal ideation in late life over the course of hours, days, weeks, and months. Results will aid in the development of evidence-based personalized treatment recommendations targeting key dimensions of social disconnection, social exclusion, interpersonal NLEs, and suicidal ideation in late life.

摘要/项目摘要 在全球和美国，老年人的自杀死亡率最高。研究表明 社交脱节和人际负面生活事件（NLE）都与自杀显着相关 晚年的构思、尝试和死亡，但很少有研究考察这种关系的调节因素 社交脱节与晚年自杀之间的关系，或将社交脱节视为自杀的中介因素 尽管有令人信服的证据表明人际 NLE 与自杀结果之间存在关系。在 此外，现有的研究大多是横断面的，对自杀风险如何在不同时期展开的了解甚少。 老年人的几小时、几天、几周和几个月。该提案的总体目标是利用 对行为和社会机制进行多模式评估，以提高我们识别特定行为的能力 将社会脱节与晚年自杀意念联系起来的预测因素。我们将研究一个重要的社会因素如何 认知脆弱性、拒绝敏感性（RS）有助于社会脱节和 晚年有自杀意念。 RS是主观感知、焦急期待和强烈期待的倾向。 对社会拒绝做出反应，并反映社会过程的研究领域标准（RDoC）：归属和 依恋。采用密集的纵向设计，包括三个 21 天 EMA 爆发和后续 在为期一年的访谈中，我们还将考察社交脱节作为关系的中介因素 不同时间尺度的人际 NLE 和自杀意念之间的关系。参与者将包括 250 名年龄在 60 岁及以上的男性和女性的诊断多样化样本报告自杀意念升高。 基线的多模式评估将包括访谈、自我报告、基于实验室的社会排斥 范例，以及 21 天随机和基于事件的生态瞬时评估 (EMA) 协议。跟随- up 访谈将在一年内每 3 个月进行一次，以充分评估罕见的、低基准率的人际关系 NLE（例如死亡、疾病、失去关系）和 21 天 EMA 方案将在 6 个月时重复 和12个月。拟议的项目有三个具体目标：1）检查社交方面的人内变异性 断线是晚年自杀意念短暂增加的近端预测因素； 2）调查 RS 作为社交脱节与自杀之间关系的静态和时变调节因素 晚年的思想； 3）检验社会脱节对两者关系的中介作用 人际关系 NLE 和晚年的自杀意念在数小时、数天、数周和数月的过程中。 结果将有助于制定针对关键关键因素的基于证据的个性化治疗建议 社会脱节、社会排斥、人际非生活状态和晚年自杀意念等方面。