Disorders - suicide or self-harm behaviours
Till, B., Tran, U. S., Voracek,
M., Niederkrotenthaler, T.
BackgroundSuicide prevention organisations frequently
use websites to educate the public, but evaluations of these websites are lacking.AimsTo examine the effects of educative websites and the
moderating effect of participant vulnerability.MethodA total of 161 adults were randomised to either view an educative website on suicide
prevention or an unrelated website in a single-blinded randomised controlled trial (trial registration with the American Economic Association's
registry: RCT-ID: 000924). The primary outcome was suicidal ideation; secondary outcomes were mood, suicide-prevention-related knowledge and
attitudes towards suicide/seeking professional help. Data were collected using questionnaires before (T1), immediately after exposure
(T2), and 1 week after exposure (T3) and analysed using linear mixed models.ResultsNo significant intervention effect
was identified for the entire intervention group with regard to suicidal ideation, but a significant and sustained increase in suicide-prevention-
related knowledge (T3v. T1, P<0.001, d = 1.12, 95% CI 0.96 to 1.28) and a non-sustained worsening of mood (P<0.001,
T2v. T1, d = -0.59, -0.75 to -0.43) were observed. Participants with increased vulnerability experienced a partially sustained
reduction of suicidal ideation (T3v. T1, P<0.001, d = -0.34, -0.50 to -0.19).ConclusionsEducative professional suicide
prevention websites appeared to increase suicide-prevention-related knowledge, and among vulnerable individuals website exposure may be associated
with a reduction of suicidal ideation.\rCopyright © The Royal College of Psychiatrists 2017.
British Journal of
Psychiatry, 18 : 18
- Year: 2017
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation
Asarnow, J. R., Hughes, J. L., Babeva, K. N., Sugar, C.
A.
Objective: Suicide is a leading cause of death.
New data indicate alarming increases in suicide death rates, yet no treatments with replicated efficacy or effectiveness exist for youths with self-
harm presentations, a high-risk group for both fatal and nonfatal suicide attempts. We addressed this gap by evaluating Safe Alternatives for Teens
and Youths (SAFETY), a cognitive-behavioral, dialectical behavior therapy-informed family treatment designed to promote safety. Method: Randomized
controlled trial for adolescents (12-18 years of age) with recent (past 3 months) suicide attempts or other self-harm. Youth were randomized either
to SAFETY or to treatment as usual enhanced by parent education and support accessing community treatment (E-TAU). Outcomes were evaluated at
baseline, 3 months, or end of treatment period, and were followed up through 6 to 12 months. The primary outcome was youth-reported incident suicide
attempts through the 3-month follow-up. Results: Survival analyses indicated a significantly higher probability of survival without a suicide attempt
by the 3-month follow-up point among SAFETY youths (cumulative estimated probability of survival without suicide attempt = 1.00, standard error = 0),
compared to E-TAU youths (cumulative estimated probability of survival without suicide attempt = 0.67, standard error = 0.14; z = 2.45, p = .02,
number needed to treat = 3) and for the overall survival curves (Wilcoxon chi21 = 5.81, p = .02). Sensitivity analyses using parent report when youth
report was unavailable and conservative assumptions regarding missing data yielded similar results for 3-month outcomes. Conclusion: Results support
the efficacy of SAFETY for preventing suicide attempts in adolescents presenting with recent self-harm. This is the second randomized trial to
demonstrate that treatment including cognitive-behavioral and family components can provide some protection from suicide attempt risk in these high-
risk youths. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of the American Academy of Child & Adolescent Psychiatry, 56(6) : 506-
514
- Year: 2017
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Tan, J. X., Fajardo, M. L. R.
Background: Antisocial behaviour and conduct disorders are the most common
behavioural and mental health problems in children and young people globally. An efficacious intervention is needed to manage these antisocial
behaviours that have costly consequences. Multisystemic Therapy (MST), an intensive home-based intervention for youths with psychosocial and
behavioural problems, is recommended under National Institute for Health and Clinical Excellence guidelines for conduct disorder. However, reviews on
the efficacy of MST are mixed.\rAim: To review randomised controlled trials (RCTs) reporting efficacy of MST among youths presenting with antisocial
behaviour and emotional disorder respectively.\rMethod: A systematic map term to subject heading search was conducted in PsycINFO, Embase, and Ovid
Medline databases for articles up to November 2015. RCTs comparing MST vs.treatment as usual (TAU) in youths presenting with antisocial behaviour and
emotional disorder were included.\rResults: 12 RCTs (n = 1425) reported efficacy of MST vs. TAU in youths presenting with antisocial behaviour and
emotional disorder. Clinically significant treatment effects of MST showed a reduction of antisocial behaviour which includes delinquency. MST, vs.
psychiatric hospitalisation, was associated with a reduction of suicidal attempts in youths presenting with psychiatric emergencies. 4 studies showed
that MST was less costly than TAU in the short term, with further analysis required for long-term cost-effectiveness.\rConclusion: MST is an
efficacious intervention for severe antisocial behaviours in reduction of delinquency and should be included in clinical practices. MST was shown to
have a positive effect on emotional disorder but further research is needed to evaluate the efficacy of MST with emotional disorder. Further analysis
is required to assess the services utilized for long-term cost effectiveness.
London Journal of Primary Care, 9(6) : 95-
103
- Year: 2017
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Multisystemic
therapy
Midgley,
N., OKeeffe, S., French, L., Kennedy, E.
While
the evidence base for psychodynamic therapy with adults is now quite substantial, there is still a lack of research evaluating the effectiveness of
psychodynamic therapies with children and young people. Those studies that have been carried out are also not widely known in the field. To help
address the second point, in 2011, we carried out a review of the evidence base for psychodynamic psychotherapy for children and adolescents, which
identified 35 studies which together provided some preliminary evidence for this treatment for a range of childhood disorders. The present study is
an updated review, focusing on research published between March 2011 and November 2016. During this period, 23 additional studies were published, of
which 5 were reports on randomised controlled trials, 3 were quasi-experimental controlled studies and 15 were observational studies. Although most
studies covered children with mixed diagnoses, there were a number of studies examining specific diagnostic groups, including children with
depression, anxiety and disruptive disorders. whilst the quality of studies was mixed, some were well-designed and reported, and overall indicated
promising findings. Nevertheless, further high-quality research is needed in order to better understand the effectiveness of psychodynamic
psychotherapy across a range of different disorders, and to ensure that services can provide a range of evidence-based treatments for children and
young people. Copyright © 2017 Association of Child Psychotherapists.
Journal of
Child Psychotherapy, 43(3) : 307-329
- Year: 2017
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Psychodynamic/Psychoanalysis
Roberts, C. M., Kane, R. T., Rooney, R. M., Pintabona, Y., Baughman, N., Hassan, S., Cross, D., Zubrick, S. R., Silburn, S. R.
The efficacy of an enhanced version of the Aussie
Optimism Program (AOP) was investigated in a cluster randomized controlled trial. Grade 6 students aged 10-11 years of age (N = 2288) from 63
government primary schools in Perth, Western Australia, participated in the pre, post, and follow-up study. Schools were randomly assigned to one of
three conditions: Aussie Optimism with teacher training, Aussie Optimism with teacher training plus coaching, or a usual care condition that received
the regular Western Australian Health Education Curriculum. Students in the Aussie Optimism conditions received 20, 1-h lessons relating to social
and interpersonal skills and optimistic thinking skills over the last 2 years of primary school. Parents in the active conditions received a parent
information booklet each year, plus a self-directed program in Grade 7. Students and parents completed the Extended Strengths and Difficulties
Questionnaire. Students who scored in the clinical range on the Emotional Symptoms Scale were given The Diagnostic Interview for Children and
Adolescents IV, to assess suicidal ideation and behavior, and depressive and anxiety disorders.
Frontiers in
Psychology, 8 : 1392
- Year: 2017
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Santamarina, P., Blanco, I. M., Picado, M., Font, E., Moreno, E., Martinez, E., Linan, A. M., Romero, S.
Objectives: Self-harm in adolescents is a major clinical problem and is strongly associated with suicide. DBT was originally
developed for adults with suicidal behavior to improve skills and regulate intense emotions. Evidence has shown that DBT is associated with a
substantial reduction in self-harm in that population. Currently, DBT has been adapted for youth with suicidal behavior, and there is little evidence
in support of its efficacy. However, to date, none of these RCTs has compared DBT with another group therapy. We examined whether DBT is more
effective than a combined individual and group supportive therapy (ST) to reduce self-harm in adolescents. Methods: Thirty-five participants (ages
12-18 years) with recent and repetitive self-harming behavior were selected from a psychiatry outpatient clinic. Patients were randomly assigned to
receive either treatment: DBT (n = 18) or ST (n = 17). Both treatments included 16 weekly group sessions with adolescents and families separately,
and biweekly individual sessions. Group DBT was carried out following the manualized intervention protocol developed by Rathus and Miller. The ST was
not manualized and consisted of an eclectic psychotherapy approach, which included psychoeducational and supportive therapy. Assessments of self-
harming behavior (number of self-reported selfharm episodes), suicidal ideation (Suicidal Ideation Questionnaire), and Clinical Global Impression
(CGI) for suicide were made at baseline and at the end of the trial period. Analyses were conducted using ANCOVA adjusted for baseline measures.
Results: The groups did not differ from one another at baseline with respect to sociodemographic and clinical variables. DBT was superior to ST in
reducing self-harm and CGI. Analyses indicated large effect sizes for self-harm [0.89 (95% CI 0.7-1.71); P = 0.034] and CGI [0.75 (95% CI 0-1.49); P
= 0.049] among adolescents receiving DBT. Although there were no between-group differences in suicidal ideation, we found that it improved after
receiving both treatments. Conclusions: This is the first RCT to demonstrate the efficacy of DBT treatment for adolescents with suicidal behavior by
comparing it to another group treatment. These findings suggest that DBT is a promising treatment for suicidal behavior in this population.
Journal of the American Academy of Child and Adolescent
Psychiatry, 56 (10) : S226-S227
- Year: 2017
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Dialectical behavioural therapy
(DBT), Supportive
therapy
Tighe, J., Shand, F., Ridani,
R., Mackinnon, A., De-La-Mata, N., Christensen, H.
OBJECTIVES: Rates of youth suicide in
Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage
is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to
individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal
ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia.\rSETTING: Remote and very remote communities
in the Kimberley region of North Western Australia.\rPARTICIPANTS: Indigenous Australians aged 18-35 years.\rINTERVENTIONS: 61 participants were
recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and
then received the app for the following 6 weeks.\rPRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the Depressive Symptom Inventory-
Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient
Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11).\rRESULTS: Although
preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were
not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and
statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist
participants improved after 6 weeks of app use.\rCONCLUSIONS: Apps for suicide prevention reduce distress and depression but do not show significant
reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities
is via appropriately designed self-help apps.\rTrial registration number: actrn12613000104752.
BMJ
Open, 7(1) : e013518
- Year: 2017
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Won, S. J., Choi, Y. S.
This study was attempted in order to offer basic data, which are useful for
understanding and guiding middle school students' behavior in the school field, to teachers and counselors by closely examining which influence the
application of aromatherapy intervention targeting middle school students has upon academic stress, academic self-efficacy, suicidal ideation, and
salivary cortisol. As this is a study in the randomized control group pre-post test design that applied with making aroma essential oil in the form
of aroma stick so that continuous management can be easy, it proved the effective intervention method available for being used in alleviating
academic stress and enhancing academic self-efficacy in middle school students by objectively verifying an effect of aroma essential oil. Also, a
useful method was suggested that even the middle school students as the stressful youths can easily use with having an interest in own health
promotion. The intervention of aromatherapy using aroma essential oil has significance in corresponding to a flow of stress and health management in
modern times of pointing to a natural healing method focusing on a concept of wellbeing, and in offering a scientific basic of a complementary and
alternative therapy. Copyright © 2017, Scientific Publishers of India. All rights reserved.
Biomedical Research (India), 28(16) : 7005-7011
- Year: 2017
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Zou,
Y., Li, H., Shi, C., Lin, Y., Zhou, H., Zhang, J.
The present study aimed to explore the effects of psychological pain theory-based cognitive therapy (PPTBCT) on suicide among
depressed patients, compared with a control group who received usual psychological care (UPC). The sample consisted of 32 depressed patients and 32
healthy control subjects. All participants completed the Beck Scale for Suicide Ideation (BSI), Beck Depression Inventory, Three-Dimensional
Psychological Pain Scale (TDPPS), and Problem Solving Inventory(PSI), and Automatic Thoughts Questionnaire (ATQ). All measures differed significantly
between depressed patients and healthy controls. Then clinical participants were assigned randomly to the PPTBCT (n=19) and control (n=13) groups.
During the 8-week intervention, scores related to depression, suicidal ideation, psychological pain, and automatic thoughts were decreased in both
groups at the post-intervention and 4-week follow-up time points, compared with pre-intervention scores. BSI scores remained low at follow up and did
not differ significantly from post-intervention scores in the PPTBCT group, but were significantly higher at follow up than at post-intervention in
the control group. PPTBCT may effectively reduce suicide risk in patients with major depressive disorder, although the effects of its application
need to be confirmed.
Psychiatry Research, 249 : 23-
29
- Year: 2017
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Bryan, C. J., Mintz, J., Clemans, T. A., Leeson, B., Burch, T., Williams, S.
R., Maney, E., Rudd, M.
Objective: To evaluate the
effectiveness of crisis response planning for the prevention of suicide attempts. Method: Randomized clinical trial of active duty Army Soldiers (N =
97) at Fort Carson, Colorado, presenting for an emergency behavioral health appointment. Participants were randomly assigned to receive a contract
for safety, a standard crisis response plan, or an enhanced crisis response plan. Incidence of suicide attempts during follow-up was assessed with
the Suicide Attempt Self-Injury Interview. Inclusion criteria were the presence of suicidal ideation during the past week and/or a lifetime history
of suicide attempt. Exclusion criteria were the presence of a medical condition that precluded informed consent (e.g., active psychosis, mania).
Survival curve analyses were used to determine efficacy on time to first suicide attempt. Longitudinal mixed effects models were used to determine
efficacy on severity of suicide ideation and follow-up mental health care utilization. Results: From baseline to the 6-month follow-up, 3
participants receiving a crisis response plan (estimated proportion: 5%) and 5 participants receiving a contract for safety (estimated proportion:
19%) attempted suicide (log-rank chi2(1) = 4.85, p = 0.028; hazard ratio = 0.24, 95% CI = 0.06-0.96), suggesting a 76% reduction in suicide attempts.
Crisis response planning was associated with significantly faster decline in suicide ideation (F(3,195) = 18.64, p < 0.001) and fewer inpatient
hospitalization days (F(1,82) = 7.41, p < 0.001). There were no differences between the enhanced and standard crisis response plan conditions.
Conclusion: Crisis response planning was more effective than a contract for safety in preventing suicide attempts, resolving suicide ideation, and
reducing inpatient hospitalization among high-risk active duty Soldiers. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Affective Disorders, 212 : 64-72
- Year: 2017
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions
Esposito-Smythers, C., Hadley, W., Curby, T. W., Brown, L. K.
Adolescents with mental health conditions represent a high-risk group for substance use, deliberate
self-harm (DSH), and risky sexual behavior. Mental health treatment does not uniformly decrease these risks. Effective prevention efforts are needed
to offset the developmental trajectory from mental health problems to these behaviors. This study tested an adjunctive cognitive-behavioral family-
based alcohol, DSH, and HIV prevention program (ASH-P) for adolescents in mental healthcare. A two group randomized design was used to compare ASH-P
to an assessment only control (AO-C). Participants included 81 adolescents and a parent. Assessments were completed at pre-intervention as well as 1,
6, and 12-months post-enrollment, and included measures of family-based mechanisms and high-risk behaviors. ASH-P relative to AO-C was associated
with greater improvements in most family process variables (perceptions of communication and parental disapproval of alcohol use and sexual behavior)
as well as less DSH and greater refusal of sex to avoid a sexually transmitted infection. It also had a moderate (but non-significant) effect on odds
of binge drinking. No differences were found in suicidal ideation, alcohol use, or sexual intercourse. ASH-P showed initial promise in preventing
multiple high-risk behaviors. Further testing of prevention protocols that target multiple high-risk behaviors in clinical samples is warranted.
\rCopyright © 2016 Elsevier Ltd. All rights reserved.
Behaviour Research &
Therapy, 89 : 49-56
- Year: 2017
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Cox, G., Hetrick, S.
We reviewed the evidence for the effectiveness of indicated individual
psychosocial interventions for the treatment of self-harm, suicidal ideation and suicide attempts in children and young people, with a particular
emphasis on the emerging use of electronic methods to deliver psychological interventions. In total, 16 randomised controlled trials (RCTs) were
identified, none of which included children under the age of 12 years. Cognitive-behavioural therapy is the most commonly implemented approach in
RCTs until now, although problem-solving therapy, interpersonal psychotherapy, social support and distal support methods by provision of a green card
and regular receipt of postcards have also been investigated. Young people have been recruited into RCTs within schools, outpatient clinics,
emergency departments and inpatient facilities. Face-to-face delivery of therapy has dominated the intervention trials thus far; however, the use of
the internet, social media and mobile devices to deliver interventions to young people and other family members allows for a more novel approach to
suicide prevention in youth going forward.\rCopyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted
under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Evidence-Based Mental Health, 20(2) : 35-
40
- Year: 2017
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)