Longitudinal examination of emotional reactivity and reactive aggression linking threat exposure with childhood self-injurious thoughts and behaviors

将威胁暴露与儿童自伤思想和行为联系起来的情绪反应和反应性攻击的纵向检查

• 批准号: 10734437
• 负责人: Adam Bryant Miller
• 金额: $ 84.07万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 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 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10734437
• 关键词: 7 year old; Adolescence; Adolescent; Adolescent Risk Behavior; Adult; Age; Aggressive behavior; Behavior; Caregivers; Catchment Area; Cessation of life; Child; Childhood; Clinical; Communities; Data; Development; Emotional; Enrollment; Event; Exposure to; Feeling suicidal; Female; Future; Goals; Grain; Home; Intervention; Interview; Link; Longevity; Measurement; Mediation; Mental disorders; Methods; Modeling; National Institute of Mental Health; Nursery Schools; Parents; Pathway interactions; Physiological; Prevention; Process; Psychopathology; Questionnaires; Race; Recording of previous events; Recurrence; Research; Risk; Risk Behaviors; Risk Factors; Sampling; School-Age Population; Self-Injurious Behavior; Sex Differences; Sinus; Suicide; Suicide attempt; Testing; Thinking; Time; Translation Process; Work; Youth; aged; behavior measurement; behavior prediction; biological sex; critical period; diaries; experience; follow up assessment; middle childhood; multimodality; non-suicidal self injury; peer; preadolescence; prevent; prospective; psychologic; racial difference; racial diversity; research study; respiratory; response; sex; social; stressor; suicidal morbidity; suicidal risk; suicide rate; theories

PROJECT SUMMARY/ABSTRACT Despite misconceptions that young children do not experience self-injurious thoughts and behaviors (STBs), data from samples of youth that include children under age 9 suggest rates of suicidal ideation between 11%–19%, non-suicidal self-injury at 6.2%–21%, and suicide attempts between 2.4%–3.5%. Although rare, rates of suicide death in young children are increasing. However, the development of STBs in young children is vastly understudied. Our team’s research demonstrates a robust link between threat exposure history and risk for STBs in youth. Moreover, data support that threat experiences increase risk for STBs possibly through heightened emotional reactivity and reactive aggression. Much of the work examining the impact of threat exposure on the development of STBs focuses on adolescent youth, long after many children have experienced threat and after STBs have developed for some youth. The purpose of the current study is to test key components of our conceptual model positing that a history of exposure to threat initiates develop- mental pathways toward earlier risk for STBs in young children through its influence on emotional reactivity and reactive aggression. Moreover, youth may be at greatest risk for STBs in the days after future threat and non-threat negative events occur, highlighting the need to understand potential short-term risk (i.e., over days) for STBs among young children. Aim 1 of this proposal will investigate the extent to which more severe and multiple threat exposures contribute to earlier emergence of STBs in young children ages 5–9. Aim 2 will examine emotional reactivity and reactive aggression as predictors of STBs, including short-term (days) and longer-term (months) predictors, and as mechanisms through which threat may influence STBs. Aim 3 will examine the extent to which future threat and non-threat negative events amplify short- and long-term risk for STBs among young children with emotional reactivity and reactive aggression. We will conduct exploratory analyses testing our full model positing that threat influences STBs through heightened emotional reactivity and reactive aggression, particularly when future threat or non-threat events occur. We will also explore sex and race differences in STBs in young children. We will enroll 300 5- to 7-year-olds with a history of a range of threat exposure and their caregiver in a racially diverse catchment area and follow youth longitudinally for 2 years (until ages 7–9). Youth and caregivers will complete an in-home baseline assessment composed of multiple methods, including clinical interviews; questionnaires; and observational, physiological (i.e., respiratory sinus arrythmia), and behavioral measures within developmentally relevant negative emotional contexts (e.g., social-evaluative stressor). Caregivers and youth will complete three 1-week periods of daily diary assessments spaced 1 month apart to assess short-term STB risk. Remote follow-up assessments will occur every 6 months to examine long-term STB risk. This project will have a high impact on the field by examining early pathways to STB risk and identifying intervention points to offset negative trajectories.

项目概要/摘要 尽管人们错误地认为幼儿不会经历自残的想法和行为（STB）， 来自包括 9 岁以下儿童在内的青少年样本的数据表明，自杀意念发生率 11%–19%，非自杀性自残占 6.2%–21%，自杀企图在 2.4%–3.5% 之间。虽然很少见， 幼儿自杀死亡率正在上升。然而，幼儿 STB 的发展 尚未得到充分研究。我们团队的研究表明，威胁暴露历史与 青少年中 STB 的风险。此外，数据表明威胁经历可能会增加机顶盒的风险 通过增强的情绪反应和反应性攻击。大部分工作都在检验其影响 对机顶盒发展的威胁暴露主要集中在青少年身上，而此时许多儿童已经 经历过威胁并且在某些青少年发展出 STB 后。当前研究的目的是 测试我们概念模型的关键组成部分，假设暴露于威胁的历史会引发发展- 通过对情绪反应的影响，幼儿早期罹患 STB 风险的心理途径 和反应性攻击。此外，在未来的威胁和威胁发生后的几天里，青少年可能面临最大的机顶盒风险。 非威胁性负面事件的发生，凸显了了解潜在短期风险（即过度 天）用于幼儿中的机顶盒。该提案的目标 1 将调查更严重的程度 多重威胁暴露会导致 5-9 岁幼儿较早出现 STB。目标2将 检查情绪反应和反应性攻击作为 STB 的预测因子，包括短期（天）和 长期（数月）预测因素，以及威胁可能影响机顶盒的机制。目标3将 检查未来威胁和非威胁负面事件放大短期和长期风险的程度 幼儿中的 STB 具有情绪反应性和反应性攻击行为。我们将进行探索性的 分析测试我们的完整模型，假设威胁通过增强的情绪反应影响机顶盒 和反应性攻击，特别是当未来发生威胁或非威胁事件时。我们还将探索性 以及幼儿 STB 的种族差异。我们将招收 300 名具有一定范围历史的 5 至 7 岁儿童 的威胁暴露及其照顾者在种族多元化的集水区，并纵向跟踪青少年 2 岁（直到 7-9 岁）。青少年和护理人员将完成家庭基线评估，包括 多种方法，包括临床访谈；问卷调查；以及观察、生理（即 呼吸性窦性心律失常），以及与发育相关的负面情绪内的行为测量 环境（例如，社会评价压力源）。护理人员和青少年将完成三个为期 1 周的日常活动 间隔 1 个月进行日记评估，以评估短期 STB 风险。远程后续评估将 每 6 个月进行一次，以检查长期 STB 风险。该项目将在该领域产生重大影响 检查STB风险的早期途径并确定干预点以抵消负面轨迹。