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: 10595394
• 负责人: Christina W. Hoven
• 金额: $ 71.11万
• 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/10595394
• 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 Analysis; 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; Lead; 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; Religion; Religion and Spirituality; 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; base; case control; cohort; cost; design; epidemiology study; experience; follow-up; ideation; improved; innovation; insight; longitudinal design; low and middle-income countries; protective factors; racial and ethnic; religious group; social; statistics; suicidal adolescent; suicidal behavior; suicidal morbidity; suicidal risk; suicide attempter; suicide rate; young adult

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，年轻人的自杀率在全球范围内一直在上升。尽管有研究进展， 现在，自杀是全球第二大死亡原因，显然是全球公共卫生危机。 重要的是，改进的预防和干预取决于创新研究方法的发展 这克服了现有研究的挑战，这可能会导致对 尚未确定的风险因素。我们称这些“无形风险”。由于LMIC代表世界自杀的80％， 它们是预防自杀工作的重要目标。 LMIC中青年自杀的危险因素是 特别是理解的，部分原因是在LMIC中进行流行病学研究的后勤工作以及 部分是因为自杀研究都有自己的众所周知的挑战，无论其进行何方。 对青年自杀的拟议研究，包括其轨迹和危险因素，将利用 圭亚那的特殊情况，圭亚那是成人和青年自杀率第二高的国家 世界和卫生部致力于预防自杀，并与我们的团队积极合作 调查成人自杀。圭亚那在种族，种族，宗教和经济阶层中具有明显的异质性， 使其成为自杀研究的重要模型国家。此外，这项拟议的研究将利用 人类，智力和行政基础设施为我们正在进行的NIMH资助的圭亚那建立了 正在学习。综合这些因素使圭亚那成为这项研究目标的合适网站，包括 检查经常被忽略或毫无分类的因素，例如，年轻人与ERS一起出席 伤害，事故或其他临床表现实际上可能具有无形的自杀成分。 这项研究的目标将通过三个不同的青年队列实现：1）全国代表 将对10-24岁（n = 5000）的社区样本进行彻底评估，以确定一系列范围的患病率 自杀行为（构想，尝试和完成）以及存在风险因素的存在，使用独特的融合 定量和定性（小插图）措施。该队列还将作为对比较/对照 其他两个队列。 2）临床预示员样本将包括所有已识别的自杀式尸体（估计） n = 400），将在病例对照设计中与社区和ER样本进行评估并进行比较 发现因素会影响自杀行为的轨迹。 3）急诊室样本：发现 “无形”风险因素的其他来源，我们将筛选出在急诊室的年轻人表面上的非婚姻 原因（n = 720），并以与社区和预示样本相同的方式进行评估。评估 每个队列将在随后的两个波浪中纵向遵循。两者一起分析了这些同类 单独，纵向和情况对照比较，将提高对自杀轨迹的理解 并发现了针对发展阶段的自杀行为的隐藏的隐形风险因素。那，这个 调查应产生针对性的预防策略。