JCCAP FDF/2017/Suicide

This is the landing page created at the First JCCAP Future Directions Forum to help organize information about publicly available data sets as well as some suggestions for best practices in designing and reporting research looking at these types of variables. There were four keynote addresses: Dr. Eric Youngstrom discussing future directions in assessment, Dr. Matthew Nock discussing suicidal and self injurious behavior, Dr. Mary Fristad discussing bipolar disorder, and Dr. Daniel Shaw discussing trajectories and treatment for conduct problems. Each of these was the focus for 2-3 smaller breakout discussion sessions led by content experts. There are a set of four pages that gather the ideas and resources related to these sessions.

Dr. Matthew Nock

Evidence based psychosocial treatments for self-injurious thoughts and behaviors in youths

Dr. Daniel Dickstein: Neuroscience

Reward/benefit is there is a HUGE need for neuroscience mechanism-oriented research on suicide

See Franklin meta-analysis showing lack of progress reducing suicide rate may be due to studying same 5 risk factors--none of which by neuroscience
See NIH/Nat'l Action Alliance for Suicide Prevention (NAASP)'s goals

Suicide research need is on breadth of approaches

Need for research on full spectrum of self-injurious thoughts and behavior: Suicidal ideation, suicide attempts, and non-suicidal self-injury (NSSI; which is distinct yet related)
Need for research on those regardless of diagnosis AND in context of specific diagnosis (ie bipolar with and without SI)

Neuroscience research is NOT just neuroimaging

Other brain assays: EEG, FNIRS, MEG, HPA-axis, Galvanic skin response/heart rate variability
Need to examine relationships between those brain assays and item-level, multi-informant symptom assessments and behavioral task assays (Nock's IIAT) and other--social medial, smart phone sensors-->to see if there are profiles of risk

Barriers to this research include considerations of safety risk

Pushback from IRBs re risk/lawsuits
Pushback from parents (don't ask suicide related questions due to fears about inducing SI etc)
Lack of clinically-trained staff or collaborators or clinical services to help participants' safety issues
Considering need to accept high-risks (i.e., want to keep people safe/do no harm VS not being able to understand suicide-related outcomes if we hospitalize everyone at risk)

POTENTIAL PUBLIC NEUROIMAGING DATABASES

(though symptomatology re suicide etc not fully available...yet)

1) Human Connectome Project

2) NITRC/1000 Functional Connectoms

3) NIMH RDoC requires data sharing including of original imaging data especially of many recent grants

4) NIDA ABCD project (just started longitudinal imaging of 10,000 kids)

Dr. Christianne Esposito-Smythers: Treatment

Dr. Christine Cha: Development forum

Dr. Cha outlined 5 points as best practice for both research and clinical use when identifying and treating suicidal ideation, suicide, and self harm. These five points are good to keep in mind when thinking about secondary analyses of the large datasets listed below, as well as when designing new studies.

Improve operationalizations

Beware of single-item measures (Millner et al, 2015, PLoS); be sensitive to the distinctions across self-injurious thoughts and behaviors (e.g., nonsuicidal self-injury, suicidal ideation, suicide attempt); and report in a transparent manner (e.g., specify whether thought/behavior, time frame, presence/absence of suicidal intent). Basic, critical steps.

Go beyond questionnaires

This pertains to the measurement of self-injurious thoughts and behaviors (e.g., via EMA), and correlates/risk factors (e.g., via other Units of Analyses).

Go beyond diagnostic risk factors

Most common risk factors assessed thus far include "bulky" and broad risk factors including psychiatric diagnoses (Franklin et al., 2016, Psych Bulletin). Explore findings at the symptom level, or via 'Elements'. In this sense the RDoC framework may be helpful (Glenn et al., in press, Clin Psych Science).

Account for diversity

The field of suicide research has room to improve sampling practice and sample reporting practices (Cha et al., 2017, SLTB). Beyond the bare minimum steps of including demographically representative samples and reporting these characteristics accordingly, the field is encouraged to more thoroughly examine the moderating role of sociodemographic factors (gender, race, ethnicity, sexual orientation, veteran status).

Practice greater developmental sensitivity

Similar to #4, assess age as a moderator to identify age-specific effects.

Resources and data sets

Public data sets

PUBLIC SYMPTOM-ORIENTED DATABASES FOR THIS RESEARCH (besides electronic health records)

1) National Longitudinal Study of Adolescent to Adult Health (Add Health)

Longitudinal nationally representative sample of US adolescents grades 7-12 during the 1994-95 school year.
Website: http://www.cpc.unc.edu/projects/addhealth
Inquires about suicidal ideation, suicide attempt, exposure to suicides

2) Youth Risk Behavior Survey (YRBS)

CDC’s national high school-based survey of risk behaviors--obesity, substance abuse, dietary habits, and unintentionally injurious and violent behaviors.
Website: https://www.cdc.gov/healthyyouth/data/yrbs/data.htm
Inquires about suicidal ideation, suicide attempt, non-suicidal self-injury

3) National Comorbidity Survey: Adolescent Supplement (NCS-A)

1st national survey of US 10,148 13-17 yo to assess DSM-IV mental disorders and suicidal behaviors using fully-structured diagnostic interviews
Website: https://www.hcp.med.harvard.edu/ncs/
Inquires about suicidal ideation, suicide plans, suicide attempt

Data sets available upon request from National Data Archive on American Child Abuse & Neglect

Free data available per request to NIMH and approval:

Suicide death rate data

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