Causal Mechanisms Underlying Social Pain and Suicidal Behaviors: Examining the Role of Altered Decision-making and Psychophysiological Reactivity

项目摘要/摘要 此F32奖学金项目和培训计划的目标是为候选人独立准备 进行创新研究，以提高我们对自杀风险的认识，预防自杀 高危人群行为(SB)。尽管几十年来的自杀风险研究，我们预测和 预防自杀是不够的，24自杀率继续上升。37在18-35岁的年轻人中， 自杀是第二大死因。37这项拟议的研究对理解和减少 青壮年高危发育期自杀。社会痛苦和社会排斥是 理论上和经验上与自杀意念和SB有关，但社会机制 痛苦导致某人在很大程度上是未经考验的。中心假设是对社会痛苦的不适应反应 (由感觉到的长期社会排斥引起)导致决策受损(价值赤字 比较)和钝化的生理反应(钝化的交感觉醒和钝化的 副交感神经戒断)，这与某人有关。为了验证这一假设，虚拟现实(VR) 模拟，有效和安全的实验室代理SB，39，50将与高度敏感的组合使用 认知和生理唤醒的客观测量。这些机制将在 125名年轻人(年龄18-35岁)最近有自杀意念和/或SB的诊断样本。这 多方法研究是一种人内交叉设计，其中社会排斥的顺序 操作(排除与中性对照)在参与者中随机进行。参与者完成 具有生理评估的决策任务和VR自杀场景，以及访谈和 自杀风险和社会排斥的自我报告测量在前、后和4个月的随访期。本研究 有两个具体的目标：1)确定认知和生理机制联系社会痛苦和 VR SB场景中的参与度；2)确定实验室派生的认知和 未来现实世界SB的生理机制和潜在的调节因素(例如，拒绝 这些联系的敏感性、拒绝感)。我的研究将提供2个原因的证据 对某人可改变的机制：决策和生理唤醒受损。这对以下各项至关重要 改进我们对某人的评估、预测和待遇。这是迈向我的 隔离现实世界中的关键机制和开发有效干预措施的长期目标(例如， 注意力或认知偏差修正，84，85实时生物反馈86)关键目标机制 减少某人的时间点。根据建议的培训和研究计划，应聘者将 具备生理、认知和虚拟现实方法方面的专业知识，以及实用、临床和统计学方面的专业知识 在高危人群中开展自杀风险尖端研究所需的技能。

Project Summary/Abstract The goal of this F32 fellowship project and training plan is to prepare the candidate to independently conduct innovative research aimed at improving our understanding of suicide risk and preventing suicidal behaviors (SB) in high-risk populations. Despite decades of suicide risk research, our ability to predict and prevent suicide is inadequate,24 and suicide rates continue to rise.37 Among young adults ages 18-35, suicide is the 2nd leading cause of death.37 The proposed research is critical to understanding and reducing suicide during the high-risk developmental period of young adulthood. Social pain and social exclusion are theoretically and empirically associated with suicide ideation and SB, but the mechanisms by which social pain leads to SB are largely untested. The central hypothesis is that a maladaptive response to social pain (elicited by perceived chronic social exclusion) leads to impaired decision-making (deficits in value comparisons) and blunted physiological reactivity (blunted sympathetic arousal and blunted parasympathetic withdrawal), which is associated with SB. To test this hypothesis, virtual reality (VR) simulation, a valid and safe laboratory proxy for SB, 39,50 will be used in combination with highly sensitive objective measures of cognition and physiological arousal. These mechanisms will be examined in a transdiagnostic sample of 125 young adults (ages 18-35) with recent suicide ideation and/or SB. This multi-method study is a within-person crossover design, in which the sequence of the social exclusion manipulation (exclusion vs. neutral control) is randomized across participants. Participants complete decision-making tasks and VR suicide scenarios with physiological assessment, as well as interview and self-report measures of suicide risk and social exclusion at pre-, post-, and 4-month follow-up. This study has two specific aims: 1) Identify cognitive and physiological mechanisms linking social pain and engagement in VR SB scenarios; 2) Determine the predictive value of laboratory-derived cognitive and physiological mechanisms for future real-world SB and the potential moderators (e.g., rejection sensitivity, perceptions of rejection) of these associations. My study will provide causal evidence for 2 modifiable mechanisms for SB: impaired decision-making and physiological arousal. This is critical to improving our assessment, prediction, and treatment of SB. This is the fundamental step towards my long-term goal of isolating key mechanisms in the real-world and developing effective interventions (e.g., attentional or cognitive bias modification,84,85 real-time biofeedback86) targeting mechanisms at critical time points to reduce SB. With the proposed training and research plan, the candidate will develop expertise in physiological, cognitive, and VR methodology, as well as the practical, clinical, and statistical skills necessary to conduct cutting-edge research on suicide risk with high-risk populations.