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

自杀青少年的展望：识别一种新颖且可塑的认知风险因素

• 批准号: 10580100
• 负责人: Christine B. Cha
• 金额: $ 44.04万
• 依托单位: COLUMBIA UNIVERSITY TEACHERS COLLEGE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-03-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10580100
• 关键词: Address; Adolescence; Adolescent; Affect; Affective; Area; Cessation of life; Clinical; Cognition; Cognitive; Data; Development; Distress; Ecological momentary assessment; Etiology; Event; Feeling suicidal; Future; Goals; Growth; Hour; Intervention; Knowledge; Laboratories; Life; Link; Longitudinal Studies; Measures; Mental Depression; Pattern; Positioning Attribute; Public Health; Recording of previous events; Recurrence; Research; Risk Factors; Role; Sampling; Severities; Specific qualifier value; Specificity; Suicide; Suicide attempt; Teenagers; Testing; Thinking; Time; Work; Youth; clinical care; clinically significant; cognitive process; design; experience; improved; innovation; insight; negative affect; neglect; novel; preempt; prevent; psychologic; reducing suicide; response; spatiotemporal; standard care; suicidal; suicidal adolescent; suicidal behavior; suicidal individual; suicidal morbidity; suicidal risk; theories; therapy design

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.

项目概要 自杀意念是一种极其痛苦的经历，经常出现在青春期，随着时间的推移会反复出现， 并且很难治疗。它也是随后自杀未遂和死亡的最有力的危险因素之一。 减少青少年的自杀意念不仅可以预防向自杀行为的转变，而且 还可以减轻关键成长时期的痛苦。推进研究和发展存在一些障碍 该领域的临床护理。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自杀时对死亡的渴望有关。 事实上，自杀意念涉及死亡和继续生命之间的深思熟虑。三、最心理方面 沉淀物是通过生态有效性有限的单一时间点评估来捕获的。在 为了应对这些障碍，该研究的长期目标是制定现实世界的策略 减少青少年的自杀念头。拟议的 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诱因：前景特异性，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，较差的前景特异性将预测近期自杀意念的增加。我们将测试 青少年的预期特异性如何与随后的自杀意念相关，以及是否消极 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历（n = 160) 历时 14 天。具体目标是： (1) 比较近期勘探的实时经验 有自杀倾向和非自杀倾向的青少年； (2) 测试实时预测特异性是否预测后续， 自杀意念的近期变化； (3) 测试负面情绪与 前景特异性预测自杀意念的近期变化。该提案具有创新性，因为它： (a) 具有对近期自杀意念（即几分钟或几小时内）的罕见预测； (b) 目标a 生死攸关的审议历来被忽视的组成部分； (c) 使用最生态有效的描述 曾经对有自杀倾向的青少年进行过针对性的预测； (d) 提出了临床意义 比之前假设的更早时期的前景特异性； (e) 整合了以下研究： 具有情感功能的前景特异性。这个项目的发现将加深我们对 前景如何在有自杀倾向的青少年中实时进行，介绍潜在的心理 自杀意念的诱发因素，并拓宽我们对这些近期行为的情感背景的理解 预测发生。这些重要的知识收获将告诉我们是否、何时以及在什么情况下可以 在标准治疗设置之外对这种自杀意念的近端诱因进行干预。

项目成果

Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R): Reliability, Validity, and Inter-Informant Agreement in an Adolescent Sample.

• DOI: 10.1080/15374416.2021.1901229
• 发表时间: 2022-07
• 期刊: Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53
• 作者: Gratch I;Fernandes SN;Bell KA;Pollak OH;Fox KR;Tezanos K;Ebo T;Cha CB
• 通讯作者: Cha CB