Objective
Suicide is an important global public health issue and one of the leading causes of death among children and adolescents in this country. RDoC has the potential to drive the field of suicide research forward, where the field of negative valence systems refers to systems that respond to aversive environments, also known as threat information. The phenomenon of attentional vigilance occurs early in the processing of threat information, and attentional avoidance may be present late in the process. The vigilance-avoidance model suggests that individuals pay attention to those threatening cues automatically and unconsciously in the initial stages, but then the individual intentionally shifts attention away from the threatening cues so as not to experience negative emotions such as anxiety and fear. Differences in attentional patterns between adolescents at risk for suicide and those not at risk for suicide are primarily characterized by an early appearance of hypervigilance to threatening information and inconsistent results in the later stages of attention. Attentional avoidance refers to an automated avoidance process that does not involve volitional effort, and this neural processing capacity is not yet well developed in adolescents. Avoidance strategy is the process by which an individual employs all means to avoid experiencing negative emotions, and avoidance strategy is more responsive than attentional avoidance to the extent to which an individual actively chooses to avoid. The event-related potential (ERP) technique and ecological momentary assessment (EMA) were used to examine whether there are abnormalities in attention-related neurophysiological indices in adolescent patients with mood disorders who are at risk for suicide, when faced with predictable/unpredictable interpersonal threats, and the relationship with the use of avoidance strategies in real life.
Methods
Thirty adolescents with and without suicidal ideation were recruited from the adolescent psychiatric outpatient clinic of a psychiatric hospital in Tianjin. Demographic data were collected using scales, and a modified version of the Threat Processing Task combined with the Event Related Potentials technique was used to collect EEG components related to attentional alertness and attentional avoidance during the processing of threatening information, as well as the corresponding response time and correctness. An ecological transient assessment in the form of a telephone interview was used to collect information on patients' use of avoidance strategies when confronted with negative life events.
Results: We hypothesized that: (1) compared with the case-control group, the adolescent suicidal ideation group would have an increased amplitude of the anticipatory EEG component (stimulus-preceding negativity, SPN) and the early attention EEG component (Early Posterior Negativity, EPN) during picture viewing, and a decreased amplitude of the LPP component in the late emotional response phase of attention; (2) the adolescent suicidal ideation group would have a higher subjective perceived threat to the pictures, a lower rate of correctness in subsequent attention tasks, and a longer reaction time; (3) the adolescent suicidal ideation group would use avoidance-related strategies more often when facing negative life events; (4) avoidance strategies mediate the relationship between attentional vigilance and suicidal ideation in the adolescent suicidal ideation group.
 

vigilance-avoidance model;suicide；adolescent