Suicide is a leading cause of death among youth and a high research priority. There are three major barriers to advancing research and clinical care in this area. First, suicide risk in youth (vs. adults) is disproportionately understudied. Second, the field has produced a narrow range of known risk factors, largely made up of diagnostic and sociodemographic characteristics. Third, very few discrete risk factors have been shown to be modifiable targets of intervention. In response to these barriers, a long-term goal is to disrupt the trajectory toward suicide by intervening on new, malleable mechanisms underlying suicide risk. The immediate goal of the proposed research is to examine suicidal ideation among adolescents and its association with a novel and malleable cognitive process: prospection, or the ability to imagine detailed, personal, future-oriented events. Prospection is often measured in cognitive science by collecting audio recordings of future event descriptions which are later parsed into details and coded. Prospection is rarely examined using basic science measures among clinical populations, and the current study represents the first effort to do so among suicidal adolescents (15-19 years). The central hypothesis is that prospection deficits perpetuate and predict suicidal ideation over time, and that prospection and related cognitive deficits (e.g., episodic memory) can be modified and improved. The proposed longitudinal study will recruit 180 suicidal and nonsuicidal adolescents from the community. All adolescents will complete a laboratory visit during which prospection is measured before and after a brief specificity induction. They will also complete a measure assessing episodic memory, and a control task assessing their general narrative style. Adolescents will then indicate their degree of suicidal ideation one- and six-months after their baseline visit.
Specific Aims of the study are to: (1) Examine the association between prospection and recent history of suicidal ideation among adolescents; (2) Determine whether prospection predicts adolescents? future suicidal ideation; (3) Test the malleability of prospection among suicidal and nonsuicidal adolescents; and (4) Explore the role of episodic memory alongside prospection among suicidal adolescents, and its malleability. The approach is innovative, in the applicant?s opinion, because it introduces prospection as a viable Research Domain Criteria (RDoC) construct, extends prior literature linking prospection deficits with suicidal ideation in adults, and for the first time tests the malleability of prospection and episodic memory in suicidal individuals. The proposed research is significant, because it is expected to improve our understanding of how and why adolescents experience suicidal ideation (Aims 1-2), and would for the first time test the effect of specificity inductions on prospection and episodic memory in any suicidal population (Aims 3- 4). Ultimately, this project highlights a promising intersection between clinical and cognitive science to inform etiological understanding and future treatment development.
PROJECT NARRATIVE The proposed research aims to identify novel, malleable cognitive risk factors for suicidal ideation among adolescents. It is relevant to public health because the discovery of modifiable risk factors for suicide-related outcomes earlier in life can inform the prevention of suicide, a leading cause of death and significant public health burden. By applying innovations from cognitive and neuroscience to the study of clinical populations, the proposed research is also highly aligned with NIMH?s mission to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure.