Mechanisms underlying the association of firearm availability and vulnerability to suicide

摘要 在过去的20年里，美国总体人口自杀率增加了35%以上。枪械 在同一时间段内，自杀率上升了15%，占美国自杀人数的大部分， 在所有与枪支有关的死亡中，有近三分之二的人死亡。枪支可获得性在一定程度上导致了自杀死亡 增加自杀行为后发生致命后果的可能性。枪支的可用性也可能是原因之一 通过对预期焦虑和认知控制的影响间接影响自杀死亡率，2 生物行为过程会增加自杀行为的易感性。我们的主要目标是 确定旨在防止枪击自杀的干预措施和方案的候选目标。要做到这一点 目标，我们将招募三个目标群体，其中一半将有自杀意念史：(A)手枪 经常携带枪支的持枪者；(B)不经常携带枪支的持枪者；以及(C)非持枪者 枪支拥有者。然后，我们将比较这些群体在各种自我报告、心理生理、行为 以及生态评价方法。我们将(目标1)揭示与以下相关的生物行为过程 使用NPU威胁惊吓范式和停止信号反应时间的枪支可用性和自杀风险 在不确定威胁条件下(如预期焦虑)确定行为反应差异的测试 以及抑制控制方面的差异。我们假设手枪持有者和有 自杀意念将与预见性焦虑增加和抑制性控制减少相关。我们会 (目标2)研究枪支持有、情绪反应和自杀风险之间的关系 使用视频社交情绪信息处理(V-SEIP)跟踪社交模棱两可的情况 评估在社交模棱两可的情况下消极情绪反应的差异。我们 假设想象自己拥有枪支的受试者会表现出更多的情绪 在社交模棱两可的情况下的反应能力。我们将(目标3)确定影响 使用生态瞬时评估(EMA)研究手枪持有者的情绪反应。我们 假设手枪持有者和有自杀意念史的受试者在 消极的情绪状态。我们进一步假设，消极情绪状态的变异性会在以下情况下增加 嫌犯持有枪支。拟议的项目将提供关于发展的新信息， 导致枪支自杀的个人和背景因素，并将确定潜在的干预措施 可以加强的目标，以减少与枪支供应相关的风险。这项研究还将 通知后续研究，这些研究将严格调查枪支与自杀的相关性。最后，我们的结果 可以为提高枪支伤害和死亡预防计划的有效性提供新的线索。

ABSTRACT The U.S. general population suicide rate has increased by more than 35% over the past 20 years. Firearm suicides have risen by 15% during this same timeframe, and account for the majority of U.S. suicides and nearly two-thirds of all firearm-related deaths. Firearm availability contributes to suicide mortality in part by increasing the probability of a fatal outcome following suicidal behavior. Firearm availability may also contribute to suicide mortality indirectly through its influence on anticipatory anxiety and cognitive control, two biobehavioral processes that can increase vulnerability to suicidal behaviors. Our primary objective is to identify candidate targets for interventions and programs intended to prevent firearm suicide. To achieve this objective, we will enroll three target groups, half of whom will have a history of suicide ideation: (a) handgun owners who regularly carry a firearm, (b) handgun owners who do not regularly carry a firearm, and (c) non- gun owners. We will then compare these groups on a variety of self-report, psychophysiological, behavioral, and ecological assessment methods. We will (Aim 1) reveal biobehavioral processes associated with firearm availability and suicide risk using the NPU-threat startle paradigm and the stop-signal reaction time test to identify differences in behavioral reactivity under conditions of uncertain threat (i.e., anticipatory anxiety) and differences in inhibitory control. We hypothesize that handgun owners and subjects with a history of suicide ideation will be associated with increased anticipatory anxiety and decreased inhibitory control. We will (Aim 2) examine associations among firearm possession, emotional reactivity, and suicide risk following socially ambiguous situations using the Video Social Emotional Information Processing (V-SEIP) task to assess differences in negative emotional reactivity during socially ambiguous situations. We hypothesize that subjects who imagine they are in possession of a firearm will show increased emotional reactivity during socially ambiguous situations. We will (Aim 3) identify contextual factors that influence emotional reactivity among handgun owners using ecological momentary assessment (EMA). We hypothesize that handgun owners and subjects with a history of suicide ideation will show more variability in negative mood state. We further hypothesize that variability in negative mood state will be increased when a subject is in possession of a firearm. The proposed project will provide novel information about developmental, individual, and contextual factors that contribute to firearm suicide, and will identify potential intervention targets that could be strengthened to reduce the risk associated with firearm availability. This research will also inform subsequent studies that will rigorously investigate the firearm-suicide correlation. Finally, our results could reveal new clues for improving the effectiveness of firearm injury and mortality prevention programs.