Stress Responses as Prospective Predictors of Girls' Suicidality and Self-Injury

压力反应作为女孩自杀和自残的前瞻性预测因子

• 批准号: 8197059
• 负责人: MATTHEW K NOCK
• 金额: $ 62.38万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-12-01 至 2014-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8197059
• 关键词: Address; Adolescence; Adolescent; Affective; Arousal; Attention; Behavior; Behavioral; Biological; Biological Assay; Biological Factors; Biological Markers; Cardiovascular system; Characteristics; Cognitive; Data; Depressed mood; Development; Evidence based treatment; Family; Feeling suicidal; Female Adolescents; Gestures; Goals; Individual; Inpatients; Intervention; Interview; Investigation; Knowledge; Lead; Life; Literature; Longitudinal Studies; Measures; Mediation; Mediator of activation protein; Mental Depression; Mental disorders; Methods; Modeling; National Institute of Mental Health; Neurosecretory Systems; Outcome; Outpatients; Parents; Participant; Pattern; Performance; Physiological; Prevalence; Preventive Intervention; Problem Solving; Process; Psychopathology; Questionnaires; Recording of previous events; Regulation; Reporting; Research; Risk; Risk Factors; Sampling; Self Mutilation; Self-Injurious Behavior; Social Problems; Source; Strategic Planning; Stress; Structure; Suicide; Suicide attempt; Suicide prevention; Symptoms; System; Testing; Text; Theoretical model; United States National Institutes of Health; Variant; Work; base; behavior test; biological adaptation to stress; boys; critical developmental period; depressive symptoms; evidence base; experience; follow-up; girls; in vivo; informant; innovation; non-suicidal self injury; predictive modeling; prospective; psychologic; public health relevance; response; social; social stress; stressor; suicidal; suicidal behavior; theories

DESCRIPTION (provided by applicant): Especially among girls, the adolescent transition is associated with dramatic increases in the prevalence of suicidal ideation, and several forms of self-injury, including non-suicidal self-injury (NSSI; i.e., self-mutilation), suicidal gestures, threats, and attempts. This study proposes, and will test a theoretical model suggesting that biological and cognitive responses to social stressors explain the association between psychopathology (i.e., depression) and self-injury (i.e., mediation) and that specific interactions between stress responses (i.e., moderation) will help identify which girls with psychopathology are most likely to engage in self-injury longitudinally. Specific combinations of cognitive and biological stress responses are proposed to uniquely identify risks for different types of self-injury/suicidality (i.e., NSSI vs. suicidal ideation). Moreover, this study will examine trajectories of, and associations among self-injury constructs, addressing several limitations of past work. The aims of this research thus address several of the goals outlined in PA # 07-079, Research on the Reduction and Prevention of Suicidality as well as many of the goals articulated the NIMH Strategic Plan (NIMH, 2008) and the NAMHC Workgroup report on Transformative Neurodevelopmental Research (NAMHC, 2008). This study will use an innovative, lab-based methodological paradigm to examine cognitive (i.e., attributions, social problem solving) and biological (i.e., neuroendocrine, cardiovascular) responses to an in vivo social stressor. Participants will include 250 female adolescents from both outpatient and inpatient clinically-referred samples. Data will be collected from multiple informants (adolescents, parents) and multiple sources (observational methods, structured interviews, questionnaires, biological assays). It is expected that observed stress responses in the lab will interact with the experience of actual social stress measured during follow-up to predict self-injury trajectories over an 18 month interval. In other words, this study will address long-standing, but under-explored questions regarding why and how psychological symptoms, and/or the experience of stress, are associated with self-injurious behaviors. PUBLIC HEALTH RELEVANCE: Although much research has indicated that adolescents with a history of psychopathology are at increased risk for self-injury (e.g., self-mutilation; suicide attempts), little is known about why or how psychological symptoms lead to self-injury. Thus, there are few directions for evidence-based prevention/intervention. This research will examine specific psychological and biological responses to social stress that may increase the risk for girls' self- injury, and help to elucidate the development of self-injurious behaviors by exploring the course of these behaviors across a sensitive and critical developmental period.

描述（由申请人提供）：特别是在女孩中，青春期的转变与自杀意念和几种形式的自伤（包括非自杀性自伤（NSSI;即，自残）、自杀姿态、威胁和企图。这项研究提出并将测试一个理论模型，该模型表明对社会压力源的生物和认知反应解释了精神病理学（即，抑郁症）和自伤（即，调解）和应激反应之间的特定相互作用（即，适度）将有助于确定哪些女孩与精神病理学是最有可能从事纵向自我伤害。提出了认知和生物应激反应的特定组合，以唯一地识别不同类型的自伤/自杀倾向的风险（即，NSSI与自杀意念）。此外，本研究将研究自我伤害结构的轨迹和关联，解决过去工作的几个局限性。因此，本研究的目的涉及PA # 07-079中概述的几个目标，减少和预防自杀的研究以及NIMH战略计划（NIMH，2008）和NAMHC工作组关于变革性神经发育研究的报告（NAMHC，2008）中阐述的许多目标。本研究将使用一种创新的、基于实验室的方法论范式来研究认知（即，归因，社会问题解决）和生物学（即，神经内分泌、心血管）对体内社会应激源的反应。参与者将包括来自门诊和住院临床参考样本的250名女性青少年。将从多个信息提供者（青少年、父母）和多个来源（观察方法、结构化访谈、问卷调查、生物测定）收集数据。预计实验室中观察到的压力反应将与随访期间测量的实际社会压力体验相互作用，以预测18个月间隔内的自伤轨迹。换句话说，这项研究将解决长期存在的，但未充分探索的问题，即为什么以及如何心理症状和/或压力的体验与自我伤害行为相关。 公共卫生相关性： 虽然许多研究表明，有精神病理学史的青少年自我伤害的风险增加（例如，自残;自杀企图），但人们对心理症状为什么或如何导致自残知之甚少。因此，循证预防/干预的方向很少。本研究旨在探讨社会应激对女孩自我伤害风险的影响，并通过探讨女孩自我伤害行为在敏感和关键发育期的发展过程，阐明女孩自我伤害行为的发展过程。