Interpersonal Stress, Social Media, and Risk for Adolescent Suicidal Thoughts and Behaviors

项目摘要 在过去的15年里，青少年的自杀率上升了约60%。最近，有问题 社交媒体的使用与自杀想法和行为(STB)的出现有关，这可能反映了 更大的人际压力暴露。了解人际压力的类型、时间和严重程度 暴露是理解STB风险的关键，这需要仔细地描述其 数字生活通过对社交媒体中实时互动的深入询问来实现。与压力相一致 世代框架，经历精神障碍的青少年具有增加的特征 人际关系压力的发生，这可能包括负面的社交媒体暴露。因此，这 该项目将确定可能增加负面社交媒体发生的社会神经敏感性 暴露并检查受负面社交媒体暴露影响的生理过程 时间到了。我们的研究将包括14-17岁的青少年(N=300)，这将是对高危青少年的过度抽样 自杀(n=200)，定义为过去3个月内的性传播疾病和/或过去一年的自杀未遂。此外，我们还将 招募有精神障碍但无STB终生病史的青少年(n=100)，提供 识别表征风险的生物标记和暂时细化的社交媒体暴露的机会 而不是确定更广泛地与精神障碍相关的风险因素。 全面的临床评估将在基线上完成，此外，我们还将探讨过去一年的情况 用户生成的内容，用于评估负面暴露的动态变化，以表征核心人际关系 跨社交媒体平台的进程，包括：(A)在线受害(例如，骚扰、仇恨言论)，(B) 减少社会资本(例如，减少社交网络规模)，以及(C)减少社会支持(例如，减少 参与、消息传递的互惠)。我们还将收集基线fMRI神经反应，以表征社会 处理和评估慢性HPA轴活动。在2个月、4个月和6个月的随访评估、面谈中， 将重新评估社交媒体数据、HPA Axis活动和自我报告。首要目标是检查 生物过程和社交媒体曝光之间的关系，特别是在以下方面 阐明自杀风险。首先，我们将测试社会神经网络的改变是否会增加对 负面的社交媒体曝光。其次，我们将测试负面的社交媒体曝光是否会带来负面影响 影响HPA轴活动。最后，我们将测试负面的社交媒体曝光，社交神经改变， HPA轴活动及其相互作用导致自杀事件的出现(例如，实际的、中断的或 未遂；有方法、意图或计划的主动自杀念头；急诊科就诊或精神科医生 STB的住院治疗)。通过这种全面的方法，我们将解决一项重要的公共卫生倡议 通过确定哪些人容易受到负面社交媒体曝光的影响，并提供可操作的标记 以减少年轻人不必要的生命损失。

Project Summary Over the past 15 years, suicide rates among adolescents have increased ~60%. Recently, problematic social media use has been linked to the emergence of suicidal thoughts and behaviors (STB), perhaps reflecting greater interpersonal stress exposure. Understanding the type, timing, and severity of interpersonal stress exposure is critical to understand STB risk, which requires carefully characterizing exposures present in their digital lives through a deep interrogation of real-time interactions within social media. In line with the Stress Generation Framework, adolescents experiencing psychiatric disorders possess characteristics that increase the occurrence of interpersonal stress, which may include negative social media exposures. Accordingly, this project will identify social neural susceptibilities that may increase the occurrence of negative social media exposures and examine physiological processes that are impacted by negative social media exposures over time. Our study will include adolescents ages 14-17 (N=300), which will be oversampled for youth at high risk for suicide (n=200), defined as STB in the past 3 months and/or a past-year suicide attempt. Additionally, we will recruit adolescents with psychiatric disorders but without a lifetime history of STB (n=100), providing an opportunity to identify biological markers and temporally refined social media exposures that characterize risk for STB as opposed to identifying risk factors that associate with psychiatric disorders more broadly. Comprehensive clinical assessments will be completed at baseline, and additionally, we will probe past-year user-generated content to assess dynamic changes in negative exposures to characterize core interpersonal processes across social media platforms, including: (a) online victimization (e.g., harassment, hate speech), (b) reduced social capital (e.g., reduced social network size), and (c) reduced social support (e.g., reduced engagement, reciprocity of messaging). We also will collect baseline fMRI neural responses characterizing social processes and assess chronic HPA axis activity. At the 2-, 4-, and 6-month follow-up assessments, interviews, social media data, HPA axis activity, and self-reports will be re-assessed. The overarching goals is to examine the relationship between biological processes and social media exposures, particularly with regards to elucidating suicide risk. First, we will test whether social neural network alterations increase susceptibility to negative social media exposures. Second, we will test whether negative social media exposures negatively impact HPA axis activity. Last, we will test whether negative social media exposures, social neural alterations, HPA axis activity, and their interactions lead to the emergence of suicide events (i.e., actual, interrupted, or aborted attempts; active suicidal ideation with method, intent, or plan; emergency department visits or psychiatric hospitalizations for STB). Through this comprehensive approach, we will address a critical public health initiative by identifying those who are susceptible to negative social media exposures, and providing actionable markers to reduce the needless loss of life among young people.