Longitudinal examination of emotional reactivity and reactive aggression linking threat exposure with childhood self-injurious thoughts and behaviors

项目总结/摘要 尽管有误解认为幼儿不会经历自我伤害的想法和行为（STBs）， 包括9岁以下儿童在内的青少年样本数据表明， 11%-19%，非自杀性自伤6.2%-21%，自杀企图2.4%-3.5%。虽然罕见， 幼儿自杀死亡率正在上升。然而，在幼儿中的STBs的发展 被大大低估了我们团队的研究表明，威胁暴露历史与 青少年中的STBs风险。此外，数据支持威胁体验可能会增加STB的风险 通过情绪反应和攻击性反应大部分的工作都在研究 暴露于性传播疾病发展的威胁主要集中在青少年身上， 经历过威胁，并在性病已发展为一些青年。本研究的目的是 测试我们的概念模型的关键组成部分，假设暴露于威胁的历史开始发展- 通过对情绪反应的影响，探讨幼儿早期感染性病的心理途径 和反应性攻击此外，青年人在未来的威胁之后的日子里可能面临最大的性传播疾病风险， 非威胁性负面事件的发生，突出了理解潜在短期风险的需要（即，超过 在幼儿中传播性传播疾病。本提案的目标1将调查更严重的 和多重威胁暴露有助于5-9岁幼儿更早出现性传播疾病。目标2将 检查情绪反应和反应性攻击作为STB的预测因子，包括短期（天）和 长期（月）预测，并作为机制，通过威胁可能会影响性病。目标3将 检查未来威胁和非威胁负面事件放大短期和长期风险的程度， 有情绪反应和反应性攻击的幼儿中的性传播感染。我们将进行探索性的 分析测试我们的完整模型，假设威胁通过提高情绪反应来影响STB 和反应性攻击，特别是当未来的威胁或非威胁事件发生时。我们还将探讨性 和种族差异在幼儿中的性传播疾病。我们将招募300名5到7岁的儿童， 的威胁暴露和他们的照顾者在种族多样化的集水区，并跟踪青年纵向 2年（直到7-9岁）。青少年和照顾者将完成一项家庭基线评估， 多种方法，包括临床访谈;问卷调查;和观察，生理（即， 呼吸道窦性心律失常），以及发育相关的负性情绪中的行为测量 上下文（例如，社会评价压力源）。照顾者和青少年将完成三个为期一周的每日 间隔1个月的日记评估，以评估短期STB风险。远程后续评估将 每6个月进行一次，以检查长期STB风险。该项目将对该领域产生重大影响， 检查STB风险的早期途径，并确定干预点以抵消负面轨迹。

PROJECT SUMMARY/ABSTRACT Despite misconceptions that young children do not experience self-injurious thoughts and behaviors (STBs), data from samples of youth that include children under age 9 suggest rates of suicidal ideation between 11%–19%, non-suicidal self-injury at 6.2%–21%, and suicide attempts between 2.4%–3.5%. Although rare, rates of suicide death in young children are increasing. However, the development of STBs in young children is vastly understudied. Our team’s research demonstrates a robust link between threat exposure history and risk for STBs in youth. Moreover, data support that threat experiences increase risk for STBs possibly through heightened emotional reactivity and reactive aggression. Much of the work examining the impact of threat exposure on the development of STBs focuses on adolescent youth, long after many children have experienced threat and after STBs have developed for some youth. The purpose of the current study is to test key components of our conceptual model positing that a history of exposure to threat initiates develop- mental pathways toward earlier risk for STBs in young children through its influence on emotional reactivity and reactive aggression. Moreover, youth may be at greatest risk for STBs in the days after future threat and non-threat negative events occur, highlighting the need to understand potential short-term risk (i.e., over days) for STBs among young children. Aim 1 of this proposal will investigate the extent to which more severe and multiple threat exposures contribute to earlier emergence of STBs in young children ages 5–9. Aim 2 will examine emotional reactivity and reactive aggression as predictors of STBs, including short-term (days) and longer-term (months) predictors, and as mechanisms through which threat may influence STBs. Aim 3 will examine the extent to which future threat and non-threat negative events amplify short- and long-term risk for STBs among young children with emotional reactivity and reactive aggression. We will conduct exploratory analyses testing our full model positing that threat influences STBs through heightened emotional reactivity and reactive aggression, particularly when future threat or non-threat events occur. We will also explore sex and race differences in STBs in young children. We will enroll 300 5- to 7-year-olds with a history of a range of threat exposure and their caregiver in a racially diverse catchment area and follow youth longitudinally for 2 years (until ages 7–9). Youth and caregivers will complete an in-home baseline assessment composed of multiple methods, including clinical interviews; questionnaires; and observational, physiological (i.e., respiratory sinus arrythmia), and behavioral measures within developmentally relevant negative emotional contexts (e.g., social-evaluative stressor). Caregivers and youth will complete three 1-week periods of daily diary assessments spaced 1 month apart to assess short-term STB risk. Remote follow-up assessments will occur every 6 months to examine long-term STB risk. This project will have a high impact on the field by examining early pathways to STB risk and identifying intervention points to offset negative trajectories.