Cognitive and Contextual Factors in Suicide Ideation Persistence in Adolescents

青少年自杀意念持续性的认知和背景因素。自杀事件仍在继续 是一个主要的公共卫生问题，特别是在自杀排在第二位的年轻人中， 死因了据报道，近20%的高中生最近有自杀意念， 这些人报告持续意念超过一年。如果与持续和缓解相关的因素 自杀意念可以被识别，然后资源可以被引导到那些最有风险的人， 自杀率。抑郁，绝望和精神病诊断已被研究为风险因素， 50多年来，这些研究对了解自杀风险既不充分，也不有效。重要的是要 评估自杀意念的认知和背景因素，这是研究不足，特别是对农村 青年可能与自杀意念有关的认知因素包括失败、诱捕、坚毅和自我效能。 可能影响自杀意念的背景因素包括社会经济地位、获得 致命手段、社会支助、粮食和住房安全以及获得保健的机会。拟议的研究目标 通过对225名非临床的农村青少年进行为期12个月的纵向研究， 年龄在14到18岁之间，有自杀意念史。目前的研究提出， 认知和背景因素将区分青少年与无自杀意念的历史， 基线样本预期失败和诱捕的认知因素会与 持续自杀意念、自我效能和坚毅与随访时自杀意念缓解相关。 最后，预计环境因素将与持续存在有关（社会经济地位低和获得致命手段）。 vs.在随访时缓解（社会支持、食物和住房保障、获得医疗保健）自杀意念。 9 - 11年级的青少年将被招募来完成一项自我报告和行为的研究方案。 在基线时在他们的家庭学校测量（n = 700）;有自杀意念史的青少年（est. n = 225）将 在基线后6个月和12个月招募参与随访评估。教师报告225 并会收集有自杀意念的青少年。二项式线性回归将用于 检查哪些因素区分基线时有和没有自杀意念史的青少年。测试 关于与自杀意念持续性相关的认知和背景因素的假设， 汇款，将对变更组进行评分（跨时间点的持续和汇款构思）。重复 将通过时间相互作用对测试组进行方差分析，以确定青少年是否具有 与青少年相比，持续性思维在认知和背景因素方面显示出差异性变化， 缓解思维能力这些发现将为青年自杀研究提供信息，这将对上游产生重大影响。 通过识别增加、保护和缓和风险的新因素进行预防和早期干预。

Cognitive and Contextual Factors in Suicide Ideation Persistence in Adolescents. Deaths from suicide continue to be a major public health concern, particularly among youth for whom suicide ranks as the second leading cause of death. Recent suicide ideation is reported by almost 20% of high school students, and the majority of those report persistent ideation of more than one year. If the factors that associate with persistent and remitting suicide ideation can be identified, then resources can be directed to those most at risk, with a likely impact on rates of suicide. Depression, hopelessness, and psychiatric diagnoses have been studied as risk factors for over 50 years, yet they are neither sufficient, nor effective, for understanding suicide risk. It is important to evaluate cognitive and contextual factors for suicide ideation, which are understudied, particularly for rural youth. Cognitive factors that may relate to suicide ideation are defeat, entrapment, grit, and self-efficacy. Contextual factors with potential to make an impact on suicide ideation are socio-economic status, access to lethal means, social support, food and housing security, and access to health care. The proposed study aims to fill these knowledge gaps through a 12-month longitudinal study of 225 non-clinical, rural adolescents between the ages of 14 and 18 who report a history of suicide ideation. The current study proposes that cognitive and contextual factors will differentiate adolescents with and without suicide ideation history in the baseline sample. It is further expected that the cognitive factors defeat and entrapment will associate with persisting suicide ideation, and self-efficacy and grit will associate with remitting suicide ideation at follow-ups. Lastly, it is expected that contextual factors will associate with persisting (low SES and access to lethal means) vs. remitting (social support, food and housing security, access to health care) suicide ideation at follow-ups. Adolescents in 9th-11th grades will be recruited to complete a research protocol of self-report and behavioral measures at their home schools at baseline (n=700); adolescents with suicide ideation history (est. n=225) will be recruited into follow-up assessments at 6- and 12-months post baseline. Teacher reports for the 225 adolescents with suicide ideation history will also be collected. Binominal linear regression will be used to examine which factors differentiate adolescents with and without suicide ideation history at baseline. To test hypotheses about cognitive and contextual factors associating with suicide ideation persistence and remittance, change groups will be scored (persistent and remitting ideation across time points). Repeated measures ANOVA will be conducted to test group by time interactions to determine if adolescents with persistent ideation show differential change in cognitive and contextual factors compared to adolescents with remitting ideation. The findings will inform youth suicide research, which will significantly impact upstream prevention and early intervention by identifying new factors that increase, protect, and moderate risk.