Mechanisms of nonsuicidal self-injury facilitating transitions to suicidal behavior

项目摘要 自杀死亡仍然是一个主要的公共卫生问题，特别是在青年和年轻人中， 自杀是他们的第二大死因尽管对自杀的研究越来越多， 关于促进自杀想法发展的近端行为和心理社会机制， 和/或转变为自杀行为非自杀性自伤（NSSI）是指故意破坏身体的行为。 组织没有自杀意图，通常切割或烧伤皮肤，并已被确定为一个特别的 自杀的危险因素。研究发现，高达19%的大学生报告说，在他们的工作期间， 他们的大学生活，使许多人处于自杀的高风险之中。我们对时间的了解非常少 NSSI和自杀意念/行为的过程，或者关于NSSI为什么以及如何赋予自杀风险。的 拟议的研究旨在通过一项为期18个月的自我伤害纵向研究来填补这些知识空白 大学生本研究以自杀动机-意志整合理论为指导， 提出，行为严重性的NSSI，缺乏有效性的NSSI在实现应对功能， 和对NSSI的自我认同是导致自杀意念发展的机制。 然而，对痛苦的习惯和对死亡的无畏，对自我伤害的注意力偏见， 冲动地参与NSSI是从NSSI到自杀行为转变的中介机制。学院 报告当前NSSI的学生将被招募完成行为反应时间任务和自我报告 基线、基线后6个月、12个月和18个月时在实验室环境中测量研究变量。 潜在增长模型将用于研究拟议的NSSI机制如何介导的变化， 随着时间的推移，自杀意念和企图。研究结果将为自杀研究领域提供必要的信息 预防，并有可能通过确定特定的机制来显著影响临床实践 以及可以转化为评估和干预策略的自杀风险标志。

Project Summary Deaths from suicide continue to be a major public health concern, particularly among youth and young adults, for whom suicide ranks as the second leading cause of death. Despite growing research on suicide, knowledge about the proximal behavioral and psychosocial mechanisms that facilitate the development of suicidal thinking and/or the transition to suicidal behavior. Nonsuicidal self-injury (NSSI) is the intentional destruction of body tissue without suicidal intent, typically cutting or burning the skin, and has been identified as a particularly robust risk factor for suicide. Studies find that up to 19% of college students report engaging in NSSI during their college years, placing many at elevated risk for suicide. Remarkably little is known about the temporal course of NSSI and suicide ideation/ behavior, or about why and how NSSI confers its risk for suicide. The proposed study aims to fill these knowledge gaps through an 18-month longitudinal study of self-injuring college students. Using the integrative motivational- volitional theory of suicide as a guide, the current study proposes that the behavioral severity of NSSI, lack of effectiveness of the NSSI in achieving coping functions, and self-identification with NSSI are mechanisms contributing to the development of suicidal ideation. Whereas, habituation to pain and fearlessness about death, attentional bias towards self-injury, and impulsively engaging in NSSI are mechanisms mediating the transition from NSSI to suicide behavior. College students reporting current NSSI will be recruited to complete behavioral-reaction time tasks and self-report measures of the study variables within a laboratory setting at baseline, 6-, 12-, and 18-months post baseline. Latent growth modeling will be used to examine how the proposed NSSI mechanisms mediate changes in suicidal ideation and attempts over time. The results will provide essential information to the field of suicide prevention, and have the potential to significantly impact clinical practice by identifying specific mechanisms and markers of suicide risk that can be translated into assessment and intervention strategies.