Child Trauma, Neural Systems Underlying Emotion Regulation, and Adolescent Suicide

 描述(申请人提供)：每年约有4000名15-24岁的青少年和年轻人自杀。此外，更多的年轻人试图进行非致命性自杀(据估计，每完成一次自杀，就有100-200次自杀企图)，通常在此之前有严重的自杀意念(SI)。在以前的研究中已经确定了许多自杀的危险因素。虐待儿童，特别是儿童性虐待和身体虐待，与青春期的SI密切相关。尽管这种联系是一致的，但令人惊讶的是，我们对可能有助于解释为什么一些受虐待的人继续考虑自杀而另一些人不考虑的机制知之甚少。情绪反应增强和调节受损与SI风险增加有关。新的研究表明，虐待儿童会影响情绪反应和调节。因此，一种潜在的机制可能是通过参与情绪调节的神经系统。这项建议的主要目的是检查虐待儿童对涉及情绪调节和相关SI的神经系统的影响。具体地说，这项提案将审查儿童的影响 当参与者看到负面(与中性)刺激时，对杏仁核激活(反应性)的虐待。同样，当参与者被要求下调他们的情绪反应(调节)(假设1)时，这一建议将检查试验期间腹侧内侧前额叶皮质(VmPFC)的激活。接下来，这项研究将检验杏仁核反应性和vmPFC激活以及SI之间的关系(假设2)。最后，这项研究将检验这些神经系统作为儿童逆境和SI之间联系的潜在中介(假设3)。参与者将从一笔更大的初级R01补助金中抽出，并使用多种方法回答研究问题。这些措施包括神经成像、自我和父母报告、临床访谈和心理生理学测量。样本量将包括100名青少年、50名有虐待儿童史的青少年和50名匹配的对照组。探索性分析将检验这些神经系统是否是SI所特有的，或者也可能与其他形式的自我伤害有关，包括非自杀性自我伤害和自杀企图。本研究的结果将有助于青少年情绪调节的发展模型，也将为提高青少年对SI风险的识别提供信息。作为该奖项的一部分，培训包括发展认知神经科学(包括神经成像)、发展精神病理学和对发展数据的高级统计方法。

 DESCRIPTION (provided by applicant): Approximately 4,000 adolescents and young adults, ages 15-24, commit suicide each year. Moreover, an even greater number of youth make non-lethal suicide attempts (estimated at 100-200 suicide attempts for each completed suicide), often preceded by severe suicidal ideation (SI). Many risk factors for suicide have been identified in previous research. Child maltreatment, particularly child sexual and physical abuse, is robustly associated with SI in adolescence. Despite the consistency of this association, we know surprisingly little about mechanisms that may help explain why some maltreated individuals go on to contemplate suicide while others do not. Increased emotional reactivity and impaired regulation are associated with increased risk of SI. Emerging research suggests that child maltreatment influences emotional reactivity and regulation. Thus, one potential mechanism may be through neural systems involved in emotion regulation. The primary aim of this proposal is to examine the effects of child maltreatment on the neural systems involved in emotion regulation and associated SI. Specifically, this proposal will examine the effects of child maltreatment on amygdala activation (reactivity) when participants view negative (vs neutral) stimuli. Similarly, this proposal will examine ventral medial prefrontal cortex (vmPFC) activation during trials when participants are asked to down-regulate their emotional response (regulation) (Hypothesis 1). Next, this study will examine the associations between amygdala reactivity and vmPFC activation and SI (Hypothesis 2). Finally, this study will examine these neural systems as potential mediators of the association between child adversity and SI (Hypothesis 3). Participants will be drawn from a larger, primary R01 grant and employs multiple methods to answer study questions. These include neuroimaging, self- and parent-report, clinical interview, and psychophysiological measures. The sample size will include 100 youth, 50 with a history of child maltreatment and 50 matched controls. Exploratory analyses will examine whether or not these neural systems are specific to SI, or may also be associated with other forms of self-injury, including nonsuicidal self-injury and suicide attempts. The results of this study will contribute to developmental models of adolescent emotion regulation, and also will yield information to improve the identification of SI risk among youth. Training as part of this award includes developmental cognitive neuroscience (including neuroimaging), developmental psychopathology, and advanced statistical approaches to developmental data.