Uncovering the Invisible Risks for Suicide: Nationally Representative Samples of Youth in Guyana

揭示自杀的隐形风险：圭亚那青少年的全国代表性样本

• 批准号: 10707231
• 负责人: Christina W. Hoven
• 金额: $ 66.81万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-20 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10707231
• 关键词: Accident and Emergency department; Accidents; Address; Adolescent; Adolescent and Young Adult; Adult; African; Age; Amerindian; Behavior; Black race; Case/Control Studies; Cause of Death; Cessation of life; Child; Clinical; Cohort Studies; Collaborations; Communities; Complex; Country; Databases; Development; East Indian; Economics; Ethnic Origin; Feeling suicidal; Fogarty International Center; Funding; Goals; Guyana; Health; Heterogeneity; Hindu; Human; Income; Individual; Infrastructure; Injury; International; Intervention; Investigation; Logistics; Longitudinal Studies; Longitudinal cohort; Measures; Modeling; Muslim population group; National Institute of Mental Health; Outcome; Pan American Health Organization; Personal Satisfaction; Persons; Positioning Attribute; Prevalence; Prevention; Prevention strategy; Probability; Public Health; Public Hospitals; Race; Random Allocation; Religion; Reporting; Research; Research Design; Resources; Rest; Risk; Risk Factors; Sampling; Self-Injurious Behavior; Site; Source; Suicide; Suicide attempt; Suicide prevention; Time; United States; World Health Organization; Youth; case control; cohort; cost; design; epidemiology study; experience; follow-up; ideation; improved; innovation; insight; longitudinal design; low and middle-income countries; protective factors; religious group; social; statistics; suicidal adolescent; suicidal behavior; suicidal morbidity; suicidal risk; suicide attempter; suicide rate

Rates of suicide among the young have been rising globally for decades. Despite research advances, suicide is now the second leading cause of death worldwide for those 15-29, clearly a global public health crisis. Importantly, improved prevention and intervention depend on development of innovative research approaches that overcome the challenges of existing research and that can lead to a broader and deeper understanding of the yet unidentified risk factors. We call these “invisible risks”. As LMICs represent 80% of the worldwide suicides, they are an important target for suicide prevention efforts. The risk factors for youth suicide in LMICs are especially poorly understood, in part due to the logistics of conducting epidemiologic research in LMICs, and in part because suicide research has its own well-known challenges, regardless of where it’s conducted. This proposed study of youth suicide, including its trajectories and risk factors, will take advantage of the special circumstances of Guyana, the country with the second highest rate of both adult and youth suicides in the world, and a Ministry of Health committed to suicide prevention and actively cooperating with our team to investigate adult suicide. Guyana has notable heterogeneity in ethnicity, race, religion and economic class, making it an important model country for suicide research. In addition, this proposed study will leverage the human, intellectual, and administrative infrastructure developed for our ongoing NIMH funded Guyana Well- Being Study. Taken together these factors make Guyana a well-suited site for the goals of this study, including examining factors that have often been ignored or misclassified, for example when youth present to the ERs with injury, accidents, or other clinical presentations, that may actually have an invisible suicide component. The goals of this study will be realized through three different youth cohorts: 1) A nationally representative Community Sample ages 10-24 (N=5000), will be thoroughly assessed to determine prevalence of a range of suicidal behaviors (ideation, attempt and completion) and the presence of risk factors, using a unique blend of quantitative and qualitative (vignettes) measures. This Cohort will also serve as comparisons/controls for the other two Cohorts. 2) The Clinical Attempters Sample will include all identified suicide attempters (estimated N=400), who will be assessed and compared to the Community and ER samples in a case-control design, to uncover factors influencing trajectories of suicidal behaviors. 3) Emergency Room Sample: To uncover an additional source of “invisible” risk factors, we will screen youth who present at the ER for ostensibly non-suicidal reasons (N=720) and assess them in the same way as the Community and Attempter samples. The assessment of each Cohort will be followed longitudinally in two subsequent waves. Taken together, these Cohorts, analyzed individually, longitudinally, and in case-control comparisons, will improve understanding of suicide trajectories and uncover the hitherto invisible risk factors for suicidal behaviors specific to developmental stages. Thus, this investigation should generate age and context targeted prevention strategies.

几十年来，全球年轻人的自杀率一直在上升。尽管研究取得了进展，