Towards a reliable and valid assessment of preteen suicidal thoughts and behavior

项目摘要 青春期前是研究自杀意念发展的关键时期 行为（STB）。在此期间，青少年经历情绪调节的变化， 发展认知能力，包括对持久性的新认识 死亡，这反过来又影响STB的表达。然而，正如2021年NIMH所指出的那样， 赞助研究圆桌会议系列：风险，弹性，在青春期前的轨迹 自杀，对青春期前STB的研究一直受到阻碍，因为该领域未能集中在一个 准确、全面地评估该年龄组的STB。本申请旨在 开发和测试一种全面的方法来评估青春期前的STB，包括 儿童和父母/监护人自我报告，临床医生访谈，内隐联想测试，死亡 理解访谈和观察措施。为了解决这个问题，这 应用程序将检查评估方法的并发和预测有效性， 接受密集精神病服务（住院或部分住院）的青少年， 一系列的内在和外在症状，以及一系列的STB。我们将招募 布拉德利医院/布朗医学院和约翰霍普金斯医学院的360名青少年 医学，确保儿童样本多样化。除了改进对 青少年STB，我们还将：1）进行彻底的临床评估， 更好地为临床实践提供信息，以及2）检查假设的机制 来支持青少年前的STB，使用RDOC知情的方法。我们还将研究哪些共同- 出现的症状和机制显著提高了不良反应的预测有效性。 临床STB结果高于单独STB评估的结果。这种评估方法是 创新之处在于，这是第一项开发多模式、多信息提供者评估的研究 针对青少年前STB的方法，包括使用实时观察策略，以及 内隐联想测验这一点很重要，因为我们正在研究最高风险的 我们将能够描述与STB相关的机制， 青春期前的STB NIMH战略目标2.1.B“描述 2.2.A“确定精神疾病的早期风险和保护措施” 2.2.B“开发可靠和稳健的生物标志物， 评估工具来预测不同人群的疾病发作和病程”。

Project Summary The preteen years are a critical period in which to study the development of suicidal thoughts and behavior (STB). During this period, youth experience changes in emotion regulation and develop cognitive capacities that include an emerging understanding of the permanence of death, which in turn affect the expression of STB. However, as noted in the 2021 NIMH- Sponsored Research Round Table Series: Risk, Resilience, and Trajectories in Preteen Suicide, research on preteen STB has been hindered by the field’s failure to focus on an accurate, and thorough, assessment of STB in this age group.This application seeks to develop and test a comprehensive approach to the assessment of preteen STB that includes child and parent/guardian self-report, clinician interviews, an implicit association test, a death understanding interview, and observational measures. In order to address this question, this application will examine both concurrent and predictive validity of the assessment approach in preteens receiving intensive psychiatric services (inpatient or partial hospitalization) who have a range of internalizing and externalizing symptoms, as well as a range of STB. We will recruit 360 preteens at Bradley Hospital/Brown Medical School and the Johns Hopkins School of Medicine, ensuring a diverse sample of children. In addition to refining the assessment of preteen STB, we will also: 1) conduct a thorough clinical assessment of related symptomatology to better inform clinical practice, and 2) examine mechanisms hypothesized to underlie preteen STB, using an RDoC-informed approach. We will also examine which co- occurring symptoms and mechanisms significantly improve predictive validity for adverse clinical STB outcomes above that of the STB assessment alone. This assessment approach is innovative in that it is the first study to develop a multi-modal, multi-informant assessment approach for preteen STB including use of real-time observational strategies, as well as an implicit association test. This is significant because we are studying the most high-risk population of preteens with STB and we will be able to delineate mechanisms related to preteen STB. This work addresses: NIMH Strategic Objective 2.1.B “Characterize the emergence and progression of mental illnesses”, 2.2.A “Determining early risk and protective factors and related mechanisms”, and 2.2.B“Developing reliable and robust biomarkers and assessment tools to predict illness onset, and course, across diverse populations”.