Testing a Dyadic Model of Proximal Suicide Risk in Young Adult Romantic Couples

测试年轻浪漫情侣近期自杀风险的二元模型

• 批准号: 10582261
• 负责人: STEPHANIE D STEPP
• 金额: $ 75.29万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-15 至 2027-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10582261
• 关键词: Address; Affect; Age; Arousal; Assessment tool; Behavior; Borderline Personality Disorder; Cause of Death; Code; Communication; Conflict (Psychology); Couples; Development; Distal; Ecological momentary assessment; Emotional; Ensure; Etiology; Event; Evidence based treatment; Feeling suicidal; Future; Goals; Hour; Hypersensitivity; Impairment; Individual; Intake; Intervention; Laboratories; Life; Maintenance; Measures; Methods; Modeling; National Institute of Mental Health; Outcome; Participant; Patient Self-Report; Pattern; Persons; Physiological; Physiology; Process; Protocols documentation; Psychophysiology; Public Health; Research; Risk Factors; Risk Reduction; Sampling; Severities; Sinus Arrhythmia; Speech; Strategic Planning; Suicide; Testing; Time; Vulnerable Populations; Work; biopsychosocial; disorder risk; evidence base; experience; follow up assessment; high risk; improved; indexing; member; multimodality; negative affect; non-verbal; novel; proband; psychosocial; recruit; reducing suicide; resilience; respiratory; response; severe mental illness; suicidal individual; suicidal risk; suicide model; theories; verbal; young adult

PROJECT SUMMARY/ABSTRACT Suicide is a leading cause of death in young adults, especially among those with borderline personality disorder (BPD), of whom up to 10% of whom die by suicide. BPD is hallmarked by relationship threat sensitivity (e.g., hyperreactivity to perceived rejection) which predicts conflict in romantic relationships, and often immediately precedes suicide-related events (SREs; suicide ideation, suicide-related communication, preparatory behaviors, attempts). While most theories of suicide explicitly underscore the importance of relationship factors however, suicide research has focused almost exclusively on the suicidal individual and failed to consider the dyadic context in which the suicidal individual exists. Thus, the overarching goal of this project is to identify dyadic interpersonal mechanisms within romantic relationships of high-suicide-risk young adults that exacerbate and maintain suicide risk. We will test a dyadic model of suicide risk whereby multimodal indices of emotional reactivity and problematic communication during dyadic conflict function to increase and maintain risk for SREs over time. To achieve this goal, we will recruit 168 romantic couples (ages 18-35) in which at least one member has had recent SREs and is thus at high risk for suicide. We will stratify the sample to ensure a full range of relationship threat sensitivity and BPD severity, and these distal risk factors will be examined as predictors and moderators of all hypothesized effects. Participants will complete a baseline laboratory assessment including a laboratory-based dyadic conflict discussion task and a 14-day ecological momentary assessment (EMA) protocol with continuous ambulatory psychophysiology and brief samples of audio recordings. Additionally, dyads will complete three follow-up assessments of SREs and psychosocial functioning at 4-, 8- and 12-months post- baseline. Our specific aims are to: 1) Examine interdependent associations between emotional reactivity and problematic communication in romantic dyads with suicide risk; 2) Investigate whether within-individual and dyadic patterns of emotional reactivity and problematic communication predict proximal increases (over hours, days) in SREs; and 3) Assess whether emotional reactivity and problematic communication following SREs functions to reinforce future SREs and predict worsening trajectories of suicide risk and psychosocial functioning. Findings from this study will lead to improved assessment tools, identify novel couples-based intervention targets, and inform the development of evidence-based strategies to reduce suicide risk and psychosocial impairment in vulnerable individuals.

项目摘要/摘要 自杀是年轻人的主要死亡原因，尤其是在边缘人格障碍的人中 （BPD），其中多达10％的自杀死亡。 BPD受到关系威胁敏感性的标志性（例如， 对感知拒绝的过度反应性），这可以预测浪漫关系中的冲突，通常会立即 在自杀相关事件之前（SRES；自杀念头，自杀相关的沟通，预备行为， 尝试）。尽管大多数自​​杀理论明确强调了关系因素的重要性 自杀研究几乎完全集中在自杀人士上，未能考虑二元 自杀个体存在的上下文。因此，该项目的总体目标是确定二元 高自杀风险的年轻人的浪漫关系中的人际交往机制加剧和 保持自杀风险。我们将测试一种自杀风险的二元模型，通过该模型，情绪多模式指标 二元冲突功能期间的反应性和有问题的沟通以增加和维持SRE的风险 随着时间的推移。为了实现这一目标，我们将招募168对浪漫情侣（18-35岁），其中至少一名成员 最近有SRES，因此有自杀的高风险。我们将对样品进行分层，以确保 关系威胁敏感性和BPD的严重程度，这些远端风险因素将被检查为预测因素和 所有假设效应的主持人。参与者将完成基线实验室评估，包括 基于实验室的二元冲突讨论任务和14天的生态瞬时评估（EMA）协议 持续的卧床心理生理学和音频录音的简短样本。此外，二元组会 在4个，8个月和12个月后完成三项SRES和心理社会功能的后续评估。 基线。我们的具体目的是：1）检查情绪反应性与 自杀风险的浪漫二元组中有问题的交流； 2）调查个人内部和 情绪反应性和有问题的交流的二元模式预测近端增加（数小时， 日子）在SRES中； 3）评估SRES之后的情绪反应性和有问题的沟通 加强未来SRE的功能并预测自杀风险和社会心理功能的恶化轨迹。 这项研究的发现将导致改进的评估工具，确定基于新的夫妇的干预措施 目标，并告知制定基于证据的策略，以减少自杀风险和社会心理 弱势个人的损害。