Prospection in suicidal teens: Identifying a novel and malleable cognitive risk factor

项目摘要 自杀意念是一种非常痛苦的经历，通常出现在青春期，随着时间的推移反复出现， 并且很难治疗。它也是随后自杀企图和死亡的最强有力的风险因素之一。 减少青少年的自杀意念不仅可以预防向自杀行为的转变， 也能在关键增长时期减轻痛苦。推进研究有几个障碍， 临床护理在这方面。首先，对近期自杀意念预测的研究有限。 其次，先前研究的自杀意念的心理诱因与死亡的欲望有关， 事实上，自杀意念涉及死亡和继续生活之间的考虑。第三，最心理 使用单一时间点评估捕获沉淀物，其生态有效性有限。在 为了应对这些障碍，这一系列研究的长期目标是制定现实世界的战略， 减少青少年的自杀念头。本次R15更新的直接目标是检查 在有自杀倾向的青少年中，自杀意念的候选心理沉淀物：前瞻特异性，或 青少年想象未来事件的细节程度和时空定位。中央 假设是，不良前瞻特异性将预测自杀意念的近期增加。我们将测试 青少年的前瞻特异性如何与随后的自杀意念相关， 影响加剧了这种关联。使用生态瞬时评估（EMA），拟议的更新将 揭示最近自杀和非自杀青少年的未来思维的日常经验（n = 10）。 160)在14天内。具体目的是：（1）比较近期和近期的实时勘探经验， 自杀和非自杀青少年;（2）测试实时前瞻特异性是否预测随后， 自杀意念的近期变化;以及（3）测试负面情绪与 前瞻特异性预测自杀意念的近期变化。这一建议具有创新性，因为它： (a)特征是罕见的近期自杀意念预测（即，（B）目标a 历史上被忽视的生死审议的组成部分;（c）使用最生态有效的描述 的前瞻性特异性曾经给予自杀的青少年;（d）假定的临床意义 前瞻性的特异性，在较早的一点，在生活中比以前假设的;和（e）整合的研究， 情感功能的前瞻特异性。该项目的结果将提高我们对 前瞻如何在自杀青少年中实时运作，引入一种潜在的心理学 自杀意念的沉淀物，并扩大我们对情感背景的理解，在这些情感背景中， 预测发生。这些重要的知识增益将告知我们是否，何时以及在何种情况下可以 在标准治疗设置之外对自杀意念的近端诱发因素进行干预。

PROJECT SUMMARY Suicidal ideation is an immensely distressing experience that often emerges in adolescence, recurs over time, and is difficult to treat. It is also one of the most potent risk factors for subsequent suicide attempt and death. Reducing suicidal ideation among adolescents may not only preempt the transition to suicidal behaviors but also alleviate distress during a time of critical growth. There are several barriers to advancing research and clinical care in this area. First, there have been limited studies of the prediction of near-term suicidal ideation. Second, previously studied psychological precipitants of suicidal ideation pertain to a desire for death when in fact suicidal ideation involves a deliberation between death and continued life. Third, most psychological precipitants have been captured using single time-point assessments that have limited ecological validity. In response to these barriers, a long-term goal of this line of research is to produce real-world strategies to mitigate suicidal thinking among adolescents. The immediate goal of this proposed R15 renewal is to examine in suicidal adolescents a candidate psychological precipitant of suicidal ideation: prospection specificity, or the degree of detail and spatiotemporal localization with which adolescents imagine future events. The central hypothesis is that poor prospection specificity will predict near-term increases in suicidal ideation. We will test how adolescents’ prospection specificity is associated with subsequent suicidal ideation and whether negative affect exacerbates this association. Using ecological momentary assessment (EMA), the proposed renewal will uncover the everyday experiences of future thinking among recently suicidal and nonsuicidal adolescents (n = 160) across 14 days. Specific Aims are to: (1) compare real-time experiences of prospection between recently suicidal and nonsuicidal adolescents; (2) test whether real-time prospection specificity predicts subsequent, near-term changes in suicidal ideation; and (3) test whether the interaction between negative affect and prospection specificity predicts near-term changes in suicidal ideation. This proposal is innovative because it: (a) features the rare prediction of near-term suicidal ideation (i.e., within minutes or hours); (b) targets a historically neglected component of life-and-death deliberations; (c) uses the most ecologically valid depiction of prospection specificity ever administered to suicidal adolescents; (d) posits the clinical significance of prospection specificity at an earlier point in life than previously assumed; and (e) integrates the study of prospection specificity with affective functioning. Findings from this project will improve our understanding of how prospection operates in real-time among suicidal adolescents, introduce a potential psychological precipitant of suicidal ideation, and broaden our understanding of affective contexts in which these near-term predictions occur. These significant knowledge gains will inform whether, when, and in which contexts we can intervene on this proximal precipitant of suicidal ideation outside of standard treatment settings.