Cognitive and Contextual Factors in Suicide Ideation Persistence in Adolescents

青少年自杀意念持续性的认知和情境因素研究自杀死亡人数仍在增加 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 死因是。据报道，近20%的高中生最近有自杀念头，大多数 这些人报告说，他们的想法持续了一年以上。如果与持久和持久相关的因素 自杀念头可以被识别，然后资源可以被引导到那些最有风险的人，可能会对 自杀率。抑郁、绝望和精神疾病的诊断已被研究为罹患 50多年来，它们既不足以理解自杀风险，也不能有效地理解自杀风险。重要的是要 评估自杀意念的认知和背景因素，这些因素研究不足，特别是在农村 青春年华。可能与自杀意念有关的认知因素是失败、诱捕、坚韧和自我效能。 有可能对自杀意念产生影响的背景因素是社会经济地位、获得 致命手段、社会支持、食品和住房保障以及获得卫生保健的机会。建议的研究目的是 通过对225名非临床农村青少年进行为期12个月的纵向研究来填补这些知识空白 年龄在14岁到18岁之间，他们报告有自杀意念史。目前的研究提出， 认知和背景因素将区分有和没有自杀意念史的青少年 基线样本。进一步预计，失败和诱捕的认知因素将与 坚持自杀意念，以及自我效能感和毅力将与后续缓解自杀意念有关。 最后，预计背景因素将与持久化有关(低SES和使用致命手段) 对缓解(社会支持，食物和住房保障，获得医疗保健)自杀意念的后续研究。 9-11年级的青少年将被招募完成一项关于自我报告和行为的研究方案 基线(n=700)的家庭学校测量；有自杀意念史的青少年(Est.N=225)将 在基线后6个月和12个月招募参加后续评估。225名教师的报告 有自杀意念史的青少年也将被收集。二项线性回归将用于 检查哪些因素在基线时区分有和没有自杀意念史的青少年。为了测试 认知和语境因素与自杀意念持续性和自杀性相关的假说 汇款、零钱组将被计分(跨时间点的持续和反复的想法)。重复 将进行测量方差分析，以测试按时间分组的互动，以确定青少年是否有 与青少年相比，持续性思维在认知和背景因素上表现出不同的变化 发散思维。这些发现将为青少年自杀研究提供信息，这将对上游产生重大影响 通过确定增加、保护和适度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.