Understanding Bystanders for Self-Directed Violence Prevention: A Prospective National Study Highlighting Marginalized Youth and Young Adults

自我导向的暴力（SDV），定义为一个人故意做的任何可能造成伤害的事情。 自我，包括死亡（即，自杀未遂、自杀意念、非自杀性自伤），是一项重要的公共卫生 问题.越来越多的SDV预防计划培训成年人和同龄人（称为“看门人培训”）， 做一个更积极的旁观者--当他们看到有人可能有自残的危险时，试着去帮助他们。等 项目已经证明了对自杀的知识和态度的积极变化， 在真实的世界环境中改变行为的成功。有限的影响可能是由于缺乏纵向 研究SDV旁观者行为如何展开，以及什么态度和障碍影响旁观者的行为。 该研究小组最近对1,031名青年和年轻人进行了一项全国性调查， 目前的建议显示，83.1%的人在其一生中暴露于SDV。虽然这表明 虽然有机会对旁观者进行干预，但研究还记录了这些干预对心理健康的影响， 暴露于SDV（即，“旁观者”）。事实上，一生中接触自杀行为与过去的 月创伤症状，自杀意念，并在青少年的自我伤害的想法。同时，令人惊讶的是， 关于这些旁观者如何受到他们提供的帮助的影响的信息有限。在人际 在暴力领域，研究表明，旁观者对他们的干预的感觉受到 他们的行为被对方接受的方式。鉴于对SDV在年轻人中传染的研究， 因此，将这项研究扩展到SDV旁观者是至关重要的。此外，暴露于SDV可能会放大 性和性别少数群体（SGM）人群所经历的现有心理健康差异。青春有 SGM身份经历自杀行为和相关风险因素，包括抑郁症， 毒品使用和由于歧视和结构性不平等而造成的同伴受害。负 上述SDV暴露的影响可能会放大这些差异。新的和创新的方法是 显然需要帮助缩小SGM和其他少数群体之间在SDV风险和暴露方面的差距 人口。为了解决这些差距，我们建议对13-22岁的青年进行全国性纵向研究。 参与者将通过社交媒体招募，以促进全国范围内的SGM青年的过度抽样。 具体的目标是由研究小组的先前工作，以前的研究有关人际暴力 旁观者行为，并由SDV的增强社会认知模型（ESC-SDV）指导。我们特别 将：1）招募并调查5，000名青少年和年轻人的队列，以确定通过 ESC-SDV的哪些态度和背景成分预测：a）行动机会，B）行动意图，以及 c）SDV的实际旁观者行为; 2）间隔12个月再对这些青少年进行两次调查，以确定 旁观者行为对旁观者本身的影响; 3）检查这些趋势如何不同， 青年的重要群体。

Self-directed violence (SDV), defined as anything a person does intentionally that can cause injury to one's self, including death (i.e., suicide attempt, suicide ideation, non-suicidal self-injury), is a significant public health issue. A growing number of SDV prevention programs train adults and peers (termed “gatekeeper training”) to be more active bystanders– to try to help when they see someone who may be at risk for self-injury. Such programs have demonstrated positive changes in knowledge and attitudes about suicide, but have had less success in changing behaviors in real world settings. Limited impact may be due to the absence of longitudinal research on how SDV bystander actions unfold and what attitudes and barriers influence bystanders' behavior. A recent national survey of 1,031 youth and young adults conducted by this research team to inform the current proposal revealed that 83.1% have been exposed to SDV in their lifetimes. While this suggests great opportunity for interventions focused on bystanders, studies also document the mental health impact of those exposed to SDV (i.e., “bystanders”). Indeed, lifetime exposure to suicidal behavior is associated with past month trauma symptoms, suicide ideation, and thoughts of self-harm among youth. Also, we have surprisingly limited information about how these bystanders are impacted by the help they provide. In the interpersonal violence field, research suggests that the feelings of bystanders about their intervention are influenced by the way their actions were received by the other person. Given research on the contagion of SDV among young people, extending this research to SDV bystanders is critical. Further, exposure to SDV may be amplifying existing mental health disparities experienced by sexual and gender minority (SGM) populations. Youth with SGM identities experience elevated rates of suicidal behavior and associated risk factors including depression, substance use, and peer victimization because of discrimination and structural inequalities. The negative impacts of SDV exposure noted above may amplify these disparities. New and innovative approaches are clearly needed to help narrow these gaps in SDV risk and exposures among SGM and other minority populations. To address these gaps, we propose to conduct a national longitudinal study of youth, ages 13-22. Participants will be recruited via social media to facilitate a national reach and oversampling of SGM youth. Specific Aims are informed by the research team's prior work, previous research about interpersonal violence bystander behavior, and guided by the Enhanced Social Cognitive Model for SDV (ESC-SDV). Specifically, we will: 1) Recruit and survey a cohort of 5,000 adolescents and young adults to identify the pathways through which attitudinal and contextual components of the ESC-SDV predict: a) opportunity to act, b) intent to act, and c) actual bystander behavior for SDV; 2) Survey these youth two more times, 12 months apart, to identify the impact of bystander behavior on the bystanders themselves; and 3) Examine how these trends are different for important subgroups of youth.