Passive Assessment of Behavioral Warning Signs for Suicide Risk in Adolescents: An Idiographic Approach

青少年自杀风险行为警告信号的被动评估：一种具体方法

• 批准号: 10762701
• 负责人: Taylor A Burke
• 金额: $ 5.4万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10762701
• 关键词: Acute; Admission activity; Adolescent; American; Behavior assessment; Behavioral; Cause of Death; Cellular Phone; Complement; Data Sources; Detection; Distal; Environment; Event; Failure; Feeling suicidal; Foundations; Future; General Hospitals; Goals; Hospitalization; Hospitals; Individual; Influentials; Inpatients; Intervention; Interview; Knowledge; Massachusetts; Measurement; Measures; Mentorship; Methodology; Methods; Modeling; Movement; National Institute of Mental Health; Participant; Pathway Analysis; Patient Self-Report; Pattern; Persons; Physical activity; Positioning Attribute; Process; Reinforcing Factor; Research; Research Design; Resources; Risk; Risk Assessment; Risk Behaviors; Risk Factors; Science; Sleep; Structure; Suicide; Suicide attempt; Suicide prevention; Surveys; Symptoms; System; Technology; Teenagers; Text; Time; Training; Youth; actigraphy; adolescent suicide; career; data modeling; density; digital; digital delivery; digital health; dynamic system; follow-up; high-risk adolescents; improved; indexing; innovation; insight; medical schools; mobile sensing; neglect; network models; personalized intervention; programs; psychologic; recruit; reducing suicide; sensor; social engagement; social media; suicidal adolescent; suicidal behavior; suicidal individual; suicidal risk; suicide rate; theories; therapy development; unsupervised learning; wearable device

PROJECT SUMMARY/ABSTRACT Suicide is the second leading cause of death among adolescents and the rates have doubled since 2000. The rise in suicide rates is due in part to a failure to identify short-term risk factors for suicidal thoughts and behaviors. Additionally, most existing research relies primarily on group-level methodological approaches to suicide risk assessment; intraindividual suicide risk processes are largely neglected. Because of the lack of knowledge on short-term and individual-level suicide risk, it remains unclear when and how to intervene with the individual adolescents who need it most. Three particularly promising observable, state-sensitive, temporally delimited, and modifiable proximal indicators of suicide risk among adolescents are social engagement, sleep, and physical activity. Although acute changes in these behavioral processes are often denoted as imminent “behavioral warning signs” of suicide, most existing research has examined these behavioral factors only as distal predictors and correlates of suicide risk. Importantly, their contribution to short- term risk using individual-level approaches (i.e., fully idiographic, “n-of-1” methods) remains unknown. The Candidate’s proposed K23’s overarching goal is to employ mobile sensing and actigraphy to assess whether objectively and passively measured acute behavioral changes from typical patterns of social engagement, sleep, and physical activity indicate proximal risk for increases in suicidal ideation using idiographic n-of-1 models in high-risk adolescents. It further aims to characterize the intraindividual network structure of these behavioral factors and suicidal ideation to enhance suicide risk assessment and guide intervention. Adolescents (N=100) admitted to an inpatient or partial hospital program due to acute suicide risk will be recruited. For a period of 3 months, wearable actigraphs will be used to assess adolescents’ sleep and physical activity and mobile sensing will be used to assess adolescents’ digital social engagement and patterns of movement to approximate additional indices of physical activity. Once-daily mobile surveys will be used to assess suicidal ideation. The proposed training plan complements the Candidate’s research plan and will facilitate training in: conducting translational digital health research in high-risk adolescents, passive mobile sensing, passive adolescent sleep and physical activity assessment via actigraphy, and advanced computational approaches to person-specific intensive data modeling. A team of leading scholars will provide expert mentorship to facilitate the Candidate’s training goals within the highly resourced environment of Massachusetts General Hospital and Harvard Medical School. The proposed study will promote the Candidate’s long-term career goal to employ low-burden and scalable methods of assessment to develop personalized risk models that will improve the proximal prediction of suicide risk and inform intervention for youth. Through the execution of this research and training plan, the Candidate will be positioned to become a leader in the field of adolescent suicide.

项目概要/摘要 自杀是青少年死亡的第二大原因，自 2000 年以来自杀率翻了一番。 自杀率上升的部分原因是未能识别自杀念头的短期风险因素 行为。此外，大多数现有研究主要依赖于群体层面的方法论方法 自杀风险评估；个体内部的自杀风险过程在很大程度上被忽视了。因为缺乏 尽管人们对短期和个人层面的自杀风险缺乏了解，但仍不清楚何时以及如何进行干预 最需要它的青少年个体。三个特别有前途的可观察的、状态敏感的、 青少年自杀风险的暂时界定和可修改的近端指标是社会性的 参与、睡眠和体力活动。尽管这些行为过程的急剧变化通常是 被称为即将发生的自杀“行为警告信号”，大多数现有研究都检查了这些 行为因素仅作为自杀风险的远端预测因素和相关因素。重要的是，他们对短期的贡献 使用个人层面的方法（即完全具体的“n-of-1”方法）的术语风险仍然未知。这 候选人提出的 K23 的总体目标是利用移动传感和体动记录仪来评估是否 客观、被动地测量典型社会参与模式的急性行为变化， 使用具体的n-of-1，睡眠和体力活动表明自杀意念增加的近端风险 高危青少年的模型。它进一步旨在表征这些个体内部的网络结构 行为因素和自杀意念，以加强自杀风险评估并指导干预。 因急性自杀风险而入住住院或部分医院计划的青少年 (N=100) 将被 被招募了。在为期 3 个月的时间内，可穿戴式活动记录仪将用于评估青少年的睡眠和睡眠状况。 身体活动和移动传感将用于评估青少年的数字社交参与和模式 运动以近似身体活动的其他指数。每日一次的移动调查将用于 评估自杀意念。拟议的培训计划补充了候选人的研究计划，并将 促进以下方面的培训：在高危青少年中进行转化数字健康研究、被动移动 通过体动记录仪进行传感、被动青少年睡眠和身体活动评估以及先进的 针对特定人员的密集数据建模的计算方法。顶尖学者团队将提供 专家指导，以促进候选人在资源丰富的环境中实现培训目标 马萨诸塞州总医院和哈佛医学院。拟议的研究将促进 候选人的长期职业目标是采用低负担和可扩展的评估方法来发展 个性化风险模型将改善自杀风险的近期预测并为干预提供信息 青年。通过执行本研究和培训计划，候选人将成为一名 青少年自杀领域的领导者。