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Principal Investigator: Erin Anne Kaufman
Organization: UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
Fiscal Year: 2024
Award: $199,481
Funding agency: National Institute of Mental Health
PROJECT SUMMARY/ABSTRACT
Suicide is a global public health concern that marks an extreme along a spectrum of self-inflicted injury (SII)
and is the leading cause of death among adolescents. Although we have evidence-based interventions for
youth SII, mechanisms of change are underexplored, and suicide rates have not appreciably declined.
Efficacious treatments like Dialectical Behavior Therapy (DBT) are intensive, expensive, and require extensive
therapist training, making it inaccessible for many adolescents in need. We also lack vital data on whether and
how adolescents apply and retain therapeutic skills in daily life. There are too few researchers interested in and
trained to develop mechanistic innovations in this area. The candidate will complete training in the neural
underpinnings of skill acquisition (fMRI, Training Aim 1), measurement in everyday life (Ecological momentary
assessment; EMA, Training Aim 2), and factors (life stress) that may impede skill acquisition (Training Aim 3).
This training is embedded within a research study that uses a rigorous multi-method approach to: compare
intra- vs. interpersonal skills targeting emotion dysregulation (Aim 1); assess the potency of intervention effects
in daily life (Aim 2); and examine persistence/decay effects of skill use in daily life following initial skill exposure
and a “booster” call (Aim 3). We will also examine bi-directional effects of life-stress and underlying
mechanisms of risk and change. Adolescents with a history of repeated SII (N = 100) will attend 4 study visits
with a parent. At Visit 1, participants will complete baseline assessments of psychiatric diagnoses, SII, and life
stress. Fifty-six of the 100 youth will be randomly assigned to complete fMRI paradigms to tap neural
processes underlying perspective taking and empathy, and approach/avoidance (Training Aim 1). Adolescents
will then complete a 2-week EMA (EMA1, Training Aim 2) to measure daily affect, perceived stressors, SII, and
suicidal thoughts. At Visit 2, dyads will be randomly assigned to learn and practice GIVE (interpersonal skills
training) or opposite-to-emotion action (OA; intrapersonal skill). We will assess behavioral, affective, and
physiological regulatory processes during two conflict discussions: (1) pre- skills training, and (2) post-training,
while dyads use their assigned skill. A second EMA period (EMA2) will assess skill use along with all variables
from EMA1. Dyads will return for Visit 3 to repeat fMRI assessment before crossing over to learn the alternate
skill ⎯ followed by another 2-week EMA (EMA3). Visit 4 is completed 6 months post-EMA3, where we will
reassess SII, symptom severity, and life stressors. The candidate has existing expertise in adolescent SII,
DBT, and cardiac psychophysiological measures of emotion regulation. The mentorship team will support her
in growing her skill set to include fMRI task design, data acquisition, and analysis, EMA methods and analysis,
and life stress assessment. By achieving the aims of this proposal, the candidate will develop a unique
program of research that can inevitably lead to more effective and targeted interventions for SII in youth.
Terms: <12-20 years old><Accessory Sinuses><Active Follow-up><Adolescence><Adolescent><Adolescent Youth><Affect><Affective><Area><Behavior><Behavior assessment><Behavioral><Biosocial><Brain><Brain Nervous System><Cardiac><Cardiovascular><Cardiovascular Body System><Cardiovascular Organ System><Cardiovascular system><Causality><Cause of Death><Characteristics><Conflict><Conflict (Psychology)><Crossing Over><DNA crossover><Data><Dialectical behavior therapy><Ecological momentary assessment><Educational process of instructing><Emotions><Empathy><Encephalon><Etiology><Evidence based intervention><Feeling suicidal><Functional MRI><Functional Magnetic Resonance Imaging><Genetic Crossing Over><Heart Vascular><History><Injury><Intervention><Intervention Strategies><Interview><Investigators><Laboratories><Lead><Learning><Left><Life><Life Stress><Maintenance><Measurement><Measures><Medial><Mentorship><Methods><Nasal Sinuses><Nasal cavity/Paranasal><Nasal cavity/Paranasal sinuses><Outcome><Outcome Measure><Paranasal Sinuses><Parents><Participant><Pb element><Persons><Physiologic><Physiologic Psychology><Physiological><Physiological Psychology><Population><Prefrontal Cortex><Process><Protocol><Protocols documentation><Psychiatric Diagnosis><Psychopathology><Psychophysiological><Psychophysiology><Public Health><Questionnaires><Randomized><Recording of previous events><Reporting><Research><Research Personnel><Researchers><Risk><Sampling><Self Assessment><Severities><Sinus><Stress><Suicidal thoughts><Suicide><Symptoms><Teaching><Testing><Therapeutic><Time><Training><Training Programs><Translating><Visit><Vulnerable Populations><Withdrawal><Work><Youth><Youth 10-21><abnormal psychology><active followup><adolescence (12-20)><behavioral assessment><causation><circulatory system><crossover recombination><data acquisition><data acquisitions><design><designing><disease causation><efficacious therapy><efficacious treatment><emotion dysregulation><emotion regulation><emotional dysregulation><emotional regulation><experience><fMRI><fatal attempt><fatal suicide><follow up><follow-up><followed up><followup><genomic crossover><heavy metal Pb><heavy metal lead><high risk><histories><improved><injuries><innovate><innovation><innovative><intent to die><inter-homolog crossover><interest><intervention effect><interventional strategy><juvenile><juvenile human><measurable outcome><meiotic crossover><multi-modality><multimodality><neural><non-sister chromatid exchange><nonsister chromatid exchange><outcome measurement><parent><perspective taking><physiopsychology><primary care giver><primary caregiver><programs><psycho-physiological><randomisation><randomization><randomly assigned><research study><respiratory><response><skill acquisition><skill development><skills><skills training><social><stressor><suicidal ideation><suicidal risk><suicidal thinking><suicide ideation><suicide rate><suicide risk><suicides><thoughts about suicide><understanding others' perspectives><uptake><vulnerable group><vulnerable individual><vulnerable people>