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，特别是在年轻人和年轻人中， 对他们来说，自杀是第二大死因。尽管关于自杀的研究越来越多，但知识 关于促进自杀念头发展的最近的行为和心理社会机制 和/或过渡到自杀行为。非自杀性自残(NSSI)是对身体的故意破坏 无自杀意图的组织，通常是割伤或烧伤皮肤，已被确认为一种特殊的 自杀的强大危险因素。研究发现，高达19%的大学生报告在 他们的大学生活，使许多人面临更高的自杀风险。令人惊讶的是，人们对时间的了解很少 NSSI和自杀意念/行为的过程，或NSSI为什么和如何赋予其自杀风险。这个 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NSSI的行为严重性，NSSI在实现应对功能方面缺乏有效性， 对NSSI的自我认同是促进自杀意念发展的机制。 然而，对痛苦的习惯性和对死亡的无畏，对自我伤害的注意偏差，以及 冲动参与NSSI是从NSSI向自杀行为转变的中介机制。专科学校 报告当前NSSI的学生将被招募来完成行为反应时任务和自我报告 在基线、基线后6个月、12个月和18个月的实验室环境中测量研究变量。 潜在增长模型将被用来检验拟议的NSSI机制如何调节 随着时间的推移，自杀的念头和企图。研究结果将为自杀领域提供必要的信息。 预防，并有可能通过确定特定的机制显著影响临床实践 以及可转化为评估和干预策略的自杀风险标记。

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.