Multimodal Dynamics of Parent-child Interactions and Suicide Risk

自杀仍然是一个日益严重的公共卫生问题。事实上，自那以来，自杀率上升了33% 1999年。这一担忧在青少年中尤其明显，因为在这个国家，自杀率 在过去的10年里，这个年龄段的人增加了两倍。阐明自杀行为的潜在风险过程 因此，人口仍然是一个紧迫的优先事项。越来越多的理论和经验关注已经投入 对于急性自杀风险的概念化，认为这是一段兴奋的时期。亲子之间的压力 关系动力学对于了解青少年自杀的近期风险可能具有特别重要的意义 行为。然而，过去所有研究亲子关系压力和自杀行为的研究都使用了 自我报告方法和/或追溯召回。尽管采用这些方法的研究提供了 关于生活压力和心理健康结果之间关系的重要知识，它们并不是 旨在刻画这些压力源随着时间的推移而展开的人际动态，这可能是 尤其与短期自杀风险有关。自动计算方法的最新进展 听觉和视觉行为的感知有望解决澄清觉醒指数的需要 亲子动态与青少年自杀风险相关。一种评估家庭压力的新方法 过程是通过对唤醒之间的同步性或行为匹配的自动评估 青少年和他们的父母。在健康的亲子二人组中，父母和青少年对每一种 其他人的行为和情感暗示。然而，在高压力或冲突期间，行为匹配可能是一种 高风险交互模式的标志，因为它可能指示高唤醒维持或 升级。当前的R21提案着眼于唤醒和社交过程的RDoC结构，旨在 利用自动感知听觉和视觉行为的最新发展来表征 住院精神病患者中亲子冲突任务动态变化的同步性 青少年(n=100)及其父母。目前的研究旨在评估听觉和视觉 唤醒同步性的行为标记物分别与预期的自杀意念有关。 出院后几个月。我们还致力于收集亲子唤醒的听觉和视觉行为标记物 通过计算建模来同步，以创建针对预期自杀的多模式预测模型 因此，在对自杀风险进行分类时，从单模式分析发展到多模式分析。这 R21旨在作为迈向自动化评估亲子唤醒同步性的第一步 临床背景，为临床决策和干预提供信息。这一建议既有科学性，也有 临床意义，因为这是第一个使用计算机自动化声学和视觉的研究 二元水平的自杀风险标记物，并有可能直接告知青少年自杀风险 评估和干预。

Suicide continues to be a growing public health concern. Indeed, suicide rates have increased 33% since 1999. This concern has been particularly pronounced in the case of adolescents, as the suicide rates in this age group have tripled over the last 10 years. Clarifying potential processes of risk for suicidal behavior in this population therefore remains a pressing priority. Increasing theoretical and empirical focus has been devoted to the conceptualization of acute suicidal risk as being a period of elevated arousal. Stress within parent-child relationship dynamics may hold particular importance for understanding adolescents' proximal risk for suicidal behavior. However, all past studies examining parent-child relationship stress and suicidal behavior have used self-report methodologies and/or retrospective recall. Although studies employing these methodologies provide important knowledge about the association between life stress and mental health outcomes, they are not designed to characterize the interpersonal dynamics of these stressors as they unfold over time, which may be particularly relevant to short-term suicide risk. Recent advances in computational approaches to automatic sensing of acoustic and visual behaviors hold promise to address the need for clarifying indices of arousal in parent-child dynamics associated with adolescent suicide risk. A novel method to assess familial stress processes is through the automated assessment of synchrony, or the behavioral matching, of arousal between adolescents and their parents. In healthy parent-child dyads, parents and adolescents are responsive to each other's behavioral and emotional cues. However, during high stress or conflict, behavioral matching may be a marker of a high-risk interaction pattern inasmuch as it may be indicative of high arousal maintenance or escalation. Focusing on the RDoC constructs of arousal and social processes, the current R21 proposal aims to leverage recent developments in automated sensing of acoustic and visual behavior to characterize synchrony within the dynamics of a parent-child conflict task in a sample of psychiatrically hospitalized adolescents (n = 100) and their parents. The current study aims to evaluate whether acoustic and visual behavioral markers of arousal synchrony, respectively, are associated with prospective suicidal ideation three months post-discharge. We also aim to pool acoustic and visual behavioral markers of parent-child arousal synchrony through computational modeling to create a multimodal prediction model for prospective suicidal ideation, thereby to advance beyond unimodal analysis to multimodal analysis in classifying suicide risk. This R21 is intended as an initial step toward automating the assessment of parent-child arousal synchrony within clinical contexts to inform clinical decision-making and interventions. This proposal has both scientific and clinical significance because it is the first study to employ computational automation of acoustic and visual markers of suicide risk at the dyadic level and has the potential directly to inform adolescent suicide risk assessment and intervention.