Prospection in suicidal teens: Identifying a novel and malleable cognitive risk factor

项目总结 自杀念头是一种非常痛苦的经历，通常出现在青春期，随着时间的推移反复出现， 而且很难治疗。这也是随后自杀未遂和死亡的最大风险因素之一。 减少青少年的自杀念头不仅可能先发制人地转变为自杀行为，而且 也缓解了关键增长时期的痛苦。推进研究和发展有几个障碍 这方面的临床护理。首先，对近期自杀意念的预测研究有限。 第二，以前研究过的自杀意念的心理诱因与自杀时的死亡欲望有关。 事实上，自杀意念涉及到在死亡和继续生活之间的权衡。第三，心理上最强的 使用单一时间点评估捕获了沉淀物，这种评估具有有限的生态有效性。在……里面 为了应对这些障碍，这一研究领域的长期目标是制定现实世界的战略，以 减少青少年的自杀念头。建议的R15更新的直接目标是检查 在有自杀倾向的青少年中，自杀念头的候选心理诱因：前瞻性、特异性或 青少年想象未来事件的细节程度和时空定位。中环 假说是，较差的预测特异性将预测近期自杀意念的增加。我们将测试 青少年的预见专一性如何与随后的自杀意念相关，以及是否为负性 情感加剧了这种联系。利用生态瞬时评估(EMA)，拟议的更新将 揭示最近有自杀倾向和非自杀倾向的青少年对未来思考的日常经历(n= 160)跨14天。具体目标是：(1)比较最近几年的实时预测经验 有自杀倾向和非自杀倾向的青少年；(2)检验实时预测特异性是否能预测随后， 自杀意念的近期变化；以及(3)检验负性情感与自杀意念之间的交互作用 预见性专一性预测自杀意念的近期变化。这项建议具有创新性，因为它： (A)罕见地预测近期有自杀念头(即在几分钟或几小时内)；(B)目标a 历史上被忽视的生死讨论的组成部分；(C)使用最生态有效的描述 对有自杀倾向的青少年的预测特异性；(D)提出了 在生命中比先前假设的更早的时间点上的预测特异性；和(E)整合对 具有情感功能的预见性专一性。这个项目的发现将提高我们对 展望如何在有自杀倾向的青少年中实时运作，引入潜在的心理 自杀意念的诱因，并拓宽我们对这些近期的情感背景的理解 预测就会发生。这些重要的知识收获将告诉我们是否、何时以及在哪些情况下可以 在标准治疗环境之外对自杀意念的近端诱因进行干预。

PROJECT SUMMARY Suicidal ideation is an immensely distressing experience that often emerges in adolescence, recurs over time, and is difficult to treat. It is also one of the most potent risk factors for subsequent suicide attempt and death. Reducing suicidal ideation among adolescents may not only preempt the transition to suicidal behaviors but also alleviate distress during a time of critical growth. There are several barriers to advancing research and clinical care in this area. First, there have been limited studies of the prediction of near-term suicidal ideation. Second, previously studied psychological precipitants of suicidal ideation pertain to a desire for death when in fact suicidal ideation involves a deliberation between death and continued life. Third, most psychological precipitants have been captured using single time-point assessments that have limited ecological validity. In response to these barriers, a long-term goal of this line of research is to produce real-world strategies to mitigate suicidal thinking among adolescents. The immediate goal of this proposed R15 renewal is to examine in suicidal adolescents a candidate psychological precipitant of suicidal ideation: prospection specificity, or the degree of detail and spatiotemporal localization with which adolescents imagine future events. The central hypothesis is that poor prospection specificity will predict near-term increases in suicidal ideation. We will test how adolescents’ prospection specificity is associated with subsequent suicidal ideation and whether negative affect exacerbates this association. Using ecological momentary assessment (EMA), the proposed renewal will uncover the everyday experiences of future thinking among recently suicidal and nonsuicidal adolescents (n = 160) across 14 days. Specific Aims are to: (1) compare real-time experiences of prospection between recently suicidal and nonsuicidal adolescents; (2) test whether real-time prospection specificity predicts subsequent, near-term changes in suicidal ideation; and (3) test whether the interaction between negative affect and prospection specificity predicts near-term changes in suicidal ideation. This proposal is innovative because it: (a) features the rare prediction of near-term suicidal ideation (i.e., within minutes or hours); (b) targets a historically neglected component of life-and-death deliberations; (c) uses the most ecologically valid depiction of prospection specificity ever administered to suicidal adolescents; (d) posits the clinical significance of prospection specificity at an earlier point in life than previously assumed; and (e) integrates the study of prospection specificity with affective functioning. Findings from this project will improve our understanding of how prospection operates in real-time among suicidal adolescents, introduce a potential psychological precipitant of suicidal ideation, and broaden our understanding of affective contexts in which these near-term predictions occur. These significant knowledge gains will inform whether, when, and in which contexts we can intervene on this proximal precipitant of suicidal ideation outside of standard treatment settings.