The Developmental Psychopathology of Suicidal Ideations and Cognitions in Childhood

童年自杀意念和认知的发展精神病理学

• 批准号: 10593936
• 负责人: Deanna Barch
• 金额: $ 62.47万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10593936
• 关键词: 11 year old; 7 year old; Accounting; Adolescence; Adolescent; African American; Age; Award; Behavior assessment; Behavioral; Bipolar Disorder; Brain; Case Study; Cause of Death; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Child; Child Rearing; Childhood; Climacteric; Cognition; Corpus striatum structure; Data; Death Rate; Depressed mood; Development; Early Intervention; Early identification; Event; Event-Related Potentials; Evolution; Exhibits; Family; Family history of; Feedback; Feeling; Feeling hopeless; Feeling suicidal; Frequencies; Funding; Guilt; Hospitals; Impulsivity; Injury; Investigation; Life; Literature; Longitudinal Studies; Maps; Measures; Mediating; Mediator; Mental Depression; Methods; Modeling; National Institute of Mental Health; Nursery Schools; Pain Threshold; Parents; Preschool Child; Prevalence; Prevention; Psychopathology; Psychosocial Factor; Publishing; Recording of previous events; Reporting; Research Domain Criteria; Rewards; Risk; Risk Factors; Sampling; School-Age Population; Self-Injurious Behavior; Severities; Shame; Stimulus; Suicide; Suicide attempt; Testing; Thinking; Time; Visit; aged; boys; bullying; design; early adolescence; early childhood; early onset; emotion dysregulation; experience; follow-up; girls; indexing; longitudinal course; middle childhood; neural; neural correlate; non-suicidal self injury; peer; peer victimization; prepuberty; prospective; protective factors; psychologic; psychosocial; response; risk sharing; social; suicidal; suicidal behavior; suicidal morbidity; suicide rate

Abstract: A marked increase in suicidal thoughts and behaviors (STB) among pre-pubertal children over the last decade has been reported by the CDC. Death by suicide in children ages 10-14 more than doubled between 2007 and 2014 with rates of non-lethal self-inflicted injuries doubling during the same period. Despite these dramatic rises in STB rates, there has been little investigation of the prevalence, timing of onset, or correlates and causes of STB or non-suicidal self-injury (NSSI) in pre-pubertal children. In a longitudinal study of preschool depression, we reported that preschool-onset STB shows stability across childhood. Outside of case reports, there are no other published data on STB or NSSI in early childhood. Our findings, taken together with the CDC data, support the critical need for studies of STB and NSSI that start in early childhood to identify the predictors of STB and NSSI in middle childhood and adolescence. In a sample of 3-7 year olds screened for a treatment study of depression we again found alarmingly high rates of NSSI (21.3%) and STB (19.4%) at baseline. Supplemental NIMH funding was awarded to investigate the characteristics and neural and behavioral correlates of STB and NSSI in this depressed sample, and to add age matched healthy controls. We found both common and unique risk factors for STB and NSSI in young children, consistent with the extant adolescent literature. Building on these findings, we propose to follow this well characterized sample into school age and early adolescence to test developmental models of these phenomena. We will investigate the longitudinal course, mediators and moderators, and neural correlates of early onset STB and NSSI. We will conduct behavioral and ERP assessments at two time points, 18-months apart in our sample of N=314 who have data from the preschool period. We will also sample the frequency, intensity, and proximal precipitants of STB/NSSI using weekly mini-assessments (WMA). Building on preliminary findings, we will use ERPs to test hypotheses about RDoC constructs that map to the risk factors that may contribute to STB and NSSI, including responses to negative and positive feedback to reward, errors, and peer rejection. We will test specific hypotheses about both shared risk factors for NSSI and STB (greater depression, peer rejection, adverse life events, and harsh parenting, as well as stronger ERP responses to loss and peer rejection, and blunted ERP responses to wins and social acceptance) as well as risk factors that may be more selective for NSSI (greater shame, irritability, self-criticism and higher pain tolerance) versus STB (reduced belongingness, greater hopelessness and a family history of suicide). Given the young age of the ascertained sample at baseline, we also have the opportunity to investigate differences in risk as a function of developmental stage. The proposed study provides an unprecedented opportunity to follow the largest ever sample of young children with STB and NSSI to investigate developmental trajectories into school age and early adolescence, potentially identifying early developmental targets for earlier intervention.

摘要：青春期前儿童的自杀念头和行为（STB）显着增加 据CDC报道，近十年来，10-14岁儿童自杀死亡人数增加一倍以上 在2007年至2014年期间，非致命性自我伤害的发生率在同一时期翻了一番。尽管 尽管STB发病率急剧上升，但很少有关于患病率、发病时间或 青春期前儿童STB或非自杀性自伤（NSSI）的相关因素和原因。在纵向研究中 学龄前抑郁症，我们报告说，学龄前发病的STB显示稳定的整个童年。之外 病例报告，没有其他关于儿童早期STB或NSSI的已发表数据。我们的发现， 与疾病预防控制中心的数据一起，支持从幼儿期开始对STB和NSSI进行研究的迫切需要 确定儿童中期和青春期STB和NSSI的预测因素。在3-7奥尔兹的样本中， 在一项抑郁症治疗研究中，我们再次发现了令人震惊的高比率的NSSI（21.3%）和STB。 (19.4%）。NIMH的补充资金被授予调查的特点和神经 和行为相关的STB和NSSI在这个抑郁的样本，并添加年龄匹配的健康 对照我们发现了幼儿STB和NSSI的常见和独特风险因素，与 现存的青少年文学基于这些发现，我们建议遵循这一良好表征的样本 进入学龄期和青春期早期，以测试这些现象的发展模型。我们将调查 早发性STB和NSSI的纵向过程、介质和调节剂以及神经相关因素。我们将 在两个时间点进行行为和ERP评估，在我们的样本N=314人中间隔18个月， 有学前阶段的数据。我们还将采样的频率，强度，和邻近的沉淀物， STB/NSSI使用每周小型评估（WMA）。在初步研究结果的基础上，我们将使用ERP测试 关于RDoC的假设构建了可能导致STB和NSSI的风险因素的映射，包括 对奖励、错误和同伴拒绝的消极和积极反馈的反应。我们将测试具体的 关于NSSI和STB的共同风险因素的假设（更大的抑郁症，同伴拒绝，不良生活 事件，严厉的父母，以及更强的ERP反应损失和同伴拒绝，和钝化ERP 对胜利的反应和社会接受度）以及可能对NSSI更具选择性的风险因素（更大 羞耻、易怒、自我批评和更高的疼痛耐受性）与STB（更低的羞耻感、更高的疼痛耐受性）相比， 绝望和自杀家族史）。鉴于确定样本在基线时的年轻年龄，我们 也有机会调查风险的差异作为发展阶段的功能。拟议 这项研究提供了一个前所未有的机会，可以跟踪有史以来最大的STB幼儿样本， NSSI将调查学龄和青春期早期的发展轨迹， 早期干预的早期发展目标。

项目成果

Neural signatures of data-driven psychopathology dimensions at the transition to adolescence.

• DOI: 10.1192/j.eurpsy.2021.2262
• 发表时间: 2022-01-24
• 期刊: European psychiatry : the journal of the Association of European Psychiatrists
• 作者: Modabbernia A;Michelini G;Reichenberg A;Kotov R;Barch D;Frangou S
• 通讯作者: Frangou S