Neural Mechanisms Underlying Self-Critical Rumination and Self-Reassurance and Suicidal Thoughts and Behavior in Youth

自杀是10-34岁青少年的第二大死因。与NIMH的优先顺序保持一致 自杀预防研究议程，这个K23职业发展奖旨在推动已知的 关于自我批判性沉思的大脑/行为机制─被定义为持续的负面自我 评估─和自我保证─提供对自我的同情。这个K23的S中心假说是 背外侧和背内侧前额叶皮质、背侧前扣带回和岛叶的环路改变 潜在的自我反省和自我肯定与更多的自杀念头和 青少年的行为(STB)。我们的中心方法论是审视自我批判的沉思和自我 使用任务依赖和任务独立的功能磁共振成像(FMRI)和 在STB范围内招募的90名12~15岁女孩的生态瞬时评估(EMA)。这个年龄 群体代表着这些自我参照过程和这个时代的年轻人的关键发展时期- 在过去的十年里，该组织的自杀率急剧上升。我们只关注女孩是因为 与男性相比，女性的自我批评更普遍，但我们计划调查潜在的性行为- 未来研究中的差异。本次K23 S的研究目标是：(一)检验活体自我与 批判性反省、自信心和STB；(Ii)确定自我反省背后的神经机制 和自我保证；(3)将扫描仪的结果与青少年现实世界中评估的性传播障碍相结合 环境。这位K23的S的职业发展目标是获得(I)任务型的实践指导 和独立于任务的功能磁共振成像，用于评估电路功能；(Ii)EMA，用于更好地进行自我批评的真实世界评估 反省和自我保证；(3)成像和环境影响评估数据的统计方法；(4)专业人员 开发和协作技能。这个K23意义重大，因为识别出特定的神经机制 自我批评、自我保证和STB之间的相互作用有助于确定 青少年患STB的风险更大，并有助于开发新的机械信息 干预措施。这项研究与拟议培训目标的完成相结合，将有效地推动 建立一个独立的研究计划的候选人，专注于识别生物行为 制定预防青少年自杀风险的机制和干预措施。这款K23是创新的，因为 这将是第一个确定自我批评沉思和自我反省的具体神经机制的项目。 在青少年中的保证侧重于：(I)确定特定结构的神经机制；(Ii)反式- 选择STB范围内的青少年的诊断样本；(Iii)成像和EMA技术的整合。 建议的导师(Dickstein、Armey、Jones和Brick博士)和顾问(Price和Maratos博士) 有丰富的经验来支持拟议的培训目标。精神病学与人文系 布朗大学的行为是拟议中的培训和研究的突出环境。

Suicide is the second leading cause of death among 10-34 year-olds. Aligning with the NIMH's Prioritized Agenda for Suicide Prevention Research, this K23 career development award seeks to advance what is known about the brain/behavior mechanisms underlying self-critical rumination ─ defined as persistent negative-self- evaluation ─ and self-reassurance ─ providing compassion to self. This K23's central hypothesis is that circuit alterations in the dorsolateral and dorsomedial prefrontal cortex, dorsal anterior cingulate, and insula underlying self-critical rumination and self-reassurance is associated with increased suicidal thoughts and behavior (STB) in adolescents. Our central methodology is to examine self-critical rumination and self- reassurance using task-dependent and task-independent functional magnetic resonance imaging (fMRI) and ecological momentary assessment (EMA) in 90 12-15 year-old girls recruited on the range of STB. This age group represents a critical developmental period for these self-referential processes and youth in this age- group experienced a sharp increase in suicide rates over the last decade. Our focus on only girls is due to greater prevalence of self-criticism among females compared to males, but we plan to examine potential sex- differences in future studies. This K23's research goals are to: (i) test the associations between in vivo self- critical rumination, self-reassurance, and STB; (ii) identify neural mechanisms underlying self-critical rumination and self-reassurance; (iii) integrate the findings from the scanner with STB assessed in adolescents' real world environment. This K23's career development goals are to gain hands-on mentorship with (i) task-dependent and task-independent fMRI to assess circuit function; (ii) EMA for better real-world assessment of self-critical rumination and self-reassurance; (iii) statistical approaches for imaging and EMA data; (iv) professional development and collaboration skills. This K23 is significant, because identifying specific neural mechanisms underlying the interplay between self-critical rumination, self-reassurance, and STB can help ascertain which teens are at a greater risk for STB and contribute to development of novel, mechanistically-informed interventions. This study, combined with the completion of proposed training goals, will effectively propel the candidate towards establishing an independent program of research focused on identifying bio-behavioral mechanisms and developing preventative interventions for youth suicide risk. This K23 is innovative because this will be the first project to identify specific neural mechanisms of self-critical rumination and self- reassurance in adolescents focusing on: (i) identifying construct-specific neural mechanisms; (ii) a trans- diagnostic sample of teenagers selected on the range of STB; (iii) integration of imaging and EMA techniques. The proposed mentors (Drs. Dickstein, Armey, Jones, and Brick) and consultants (Drs. Price and Maratos) have extensive experience to support the proposed training goals. The Department of Psychiatry and Human Behavior at Brown University is an outstanding environment for the proposed training and research.