Disorders - Suicide or self-harm behaviours
Ahmadi, N., Pynoos, R., Leuchter, A., Kopelowicz, A.
Objective: This study aimed to investigate the effect of
brief reminder-focused positive psychiatry and suicide prevention (RFPP-S) on suicidal ideation, posttraumatic stress disorder (PTSD) symptoms, and
clinical outcomes among youths with PTSD treated in psychiatric emergency rooms. Method(s): This study included youths with PTSD and suicidality who
received either RFPP-S (N550) or treatment as usual (N5150). The Columbia Suicide Severity Rating Scale (C-SSRS), Clinician-Administered PTSD Scale
for children and adolescents, University of California, Los Angeles Trauma Reminder Inventory, Patient Health Questionnaire-9, Positive Emotion,
Engagement, Relationships, Meaning, and Accomplishment Scale, and positive psychiatry test batteries were administered at baseline, on day 2, and 1
week and 1 month after discharge. Result(s): On day 2, the RFPP-S group showed a greater reduction in PTSD symptoms (55%) and reactivity to trauma
and loss reminders (80%) compared with the control group (10% for both) (p50.001). A significantly greater reduction in C-SSRS score for RFPP-S
(80%), compared with treatment as usual (15%), was noted (p50.001), and RFPP-S showed more rapid stabilization (mean6SD52.060.5 days) and enhanced
postdischarge follow-up (100%) compared with treatment as usual (5.062.0 days and 50%, respectively) (p,0.05). RFPP-S, but not treatment as usual,
was associated with significant increases in well-being, flexible thinking, and coping skills (p,0.05). Hospital readmission due to suicidality 1
month after discharge was 0% for the RFPP-S group and 20% for the control group. Conclusion(s): RFPP-S was associated with reduced PTSD symptoms,
enhanced coping skills while experiencing trauma reminders, adoption of safety skills, rapid stabilization of acute crises of PTSD with suicidality,
adherence to post-emergency room visits and treatment, and favorable clinical outcomes. Copyright © 2022 Association for the Advancement of
Psychotherapy Inc.. All rights reserved.
American Journal of Psychotherapy, 75(3) : 114-
121
- Year: 2022
- Problem: Post Traumatic Stress Disorder, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Supportive
therapy, Other Psychological Interventions
Afsharnejad, B., Milbourn, B., Hayden-Evans, M., Baker-Young, E., Black, M. H., Thompson, C., McGarry, S., Grobler, M., Clifford, R., Zimmermann, F., Kacic, V., Hasking, P., Bolte, S., Romanos, M., Machingura, T., Girdler, S.
Despite suicide ideation being one of the most frequently
reported health issues impacting tertiary students, there is a paucity of research evaluating the efficacy of preventive interventions aimed at
improving mental health outcomes for students studying at two tertiary institutes. The current study evaluated the efficacy of the \"Talk-to-Me\"
Mass Open Online Course (MOOC) in improving tertiary students' abilities to support the mental health of themselves and their peers via a randomised
controlled trial design, comparing them to a waitlist control group. Overall, 129 tertiary students (M = 25.22 years, SD = 7.43; 80% female)
undertaking a health science or education course at two Western Australian universities were randomly allocated to either \"Talk-to-Me\" (n = 66) or
waitlist control (n = 63) groups. The participants' responses to suicidal statements (primary outcome), knowledge of mental health, generalised
self-efficacy, coping skills, and overall utility of the program (secondary outcomes) were collected at three timepoints (baseline 10-weeks and 24-
weeks from baseline). Assessment time and group interaction were explored using a random-effects regression model, examining changes in the primary
and secondary outcomes. Intention-to-treat analysis (N = 129) at 10-weeks demonstrated a significant improvement in generalised self-efficacy for
\"Talk-to-Me\" compared to the control group (ES = 0.36, p = .04), with only the \"Talk-to-Me\" participants reporting increased knowledge in
responding to suicidal ideation (primary outcome). This change was sustained for 24 weeks. Findings provide preliminary evidence suggesting that the
\"Talk-to-Me\" MOOC can effectively improve tertiary students' mental health and knowledge of how to support themselves and others in distress.
ACTRN12619000630112, registered 18-03-2019, anzctr.org.au.
European Child & Adolescent
Psychiatry, 04 : 04
- Year: 2022
- 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, Skills training
Zullo, L.
INTRODUCTION: The Interpersonal Psychological Theory of Suicide proposes two constructs that
serve as a final common pathway to suicidal ideation: thwarted belongingness and perceived burdensomeness. There have been few translations of this
theory to clinical care. This study aimed to address this limitation by targeting burden cognitions with novel interventions. METHOD(S): A pilot
clinical trial was conducted in an evidence-based intensive outpatient program for suicidal youth. Participants were 123 adolescents who completed
measures at intake, discharge, and one-month follow-up. The experimental group consisted of standard care plus study interventions, which was
compared with an active control group of standard care. Feedback on intervention acceptability was gathered through qualitative interviews with
parents and adolescents. RESULT(S): There was a statistically significant drop in thwarted belongingness at discharge and an improvement in perceived
burdensomeness at discharge (not statistically significant, small effect size). Feedback on acceptability was favorable and supported implementation.
CONCLUSION(S): This study adds to the literature by being the first to utilize the construct of perceived burdensomeness in clinical interventions
for suicidal youth; illustrating one potential avenue for translating theory to practice. The unexpected effects on thwarted belongingness have
implications for the role of these constructs in a treatment setting. Copyright © 2021 American Association of Suicidology.
Suicide & life threatening
behavior., 05 :
- Year: 2021
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Yu, T.
Suicidal individuals rarely seek help and receive professional
psychological intervention on their initiative. Internet-based cognitive behavioral therapy(iCBT) can increase availability and reduce stigma
compared to face-to-face interventions for suicide.However, conclusions about the effectiveness of iCBT on suicide are controversial. The review
aimed to determine the effectiveness of iCBT on reducing suicidal ideation (primary outcomes) and other outcomes related to suicide like suicide
attempts(secondary outcomes). PubMed, the Cochrane Library, EMBASEwere searched up to March 2020 for RCTs of iCBT which aimed to reduce suicide.The
potential bias was assessed by the Cochrane risk of bias tool. Data analyses wereperformed by RevMan5.3.Four studies meeting the eligibility criteria
were included which reported data on a total of 1225 participants. We found iCBT was associated with reducing an individual's suicidal ideation, and
first indications suggest that the treatment effect might be even more pronounced in the short term and in adults.Additionally, there was
insufficient evidence to prove its effectiveness in reducing suicide attempts and suicide death.Overall, iCBT can overcome the disadvantages of
traditional interventions and show promise on suicidal ideation. While ensuring safety and ethics, further studies are warranted, focusing on suicide
specific behavior like suicide attempts.
Psychology, health &
medicine, : 1-18
- Year: 2021
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Wu, S.
BACKGROUND:
The suicide of college students had been a social topic attracting people's attention, and the generation of suicidal ideation was an inevitable
link in the psychological process of suicidal behavior. It was the focus of many researches whether the pressure of college students with suicidal
ideation can be detected and relieved in time. OBJECTIVE(S): The study aimed to analyze the therapeutic effect of cognitive behaviour therapy on
psychological stress, depression, and other negative emotions of college students with suicide ideation. METHOD(S): 114 people from 1,158 college
students with suicide ideation in the Wuhan area were divided into an experimental group and a control group in this study. Students in the
experimental group were given with the cognitive behaviour therapy, and students in the control group were not intervened in any way. The suicide
ideation scale (despair, optimism, and sleep), psychological stress test rating, and self-reporting inventory (somatization, compulsion,
interpersonal relationship, depression, anxiety, hostility, terror, delusion, and psychosis) were used to evaluate the objects in the pre-test stage,
intermediate-test stage, and the tracking-test stage. The multivariate logistic regression was adopted to analyze the influencing factors of the
suicide ideation of the college student. RESULT(S): The suicide ideation of the college student was significantly positively correlated with the
psychological stress, depression, interpersonal sensitivity, anxiety, and psychosis (P > 0.05); the total score of suicide ideation, despair,
optimism, and sleep in the experimental group were lower than those in the control group (P < 0.05) in the intermediate-test stage and the tracking-
test stage (P < 0.05); the psychological stress, depression, and anxiety of the college students in the experimental group in the intermediate-test
and tracking-test stage were slighter than those in the control group (P < 0.05); the somatization, compulsion, and interpersonal relationship of
students in the experimental group were significantly lower than those in the control group (P < 0.05). CONCLUSION(S): The psychological stress,
depression, interpersonal sensitivity, anxiety, and psychosis were all risk factors for the college student to have suicide ideation. Negative
emotions such as psychological stress, emotional depression, and anxiety of the college student with suicide ideation could be improved effectively
by cognitive behaviour therapy, and the level of suicide ideation could be reduced finally.
Work, 06 :
- Year: 2021
- 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), Cognitive & behavioural therapies (CBT)
Wu, R., Zhong, S. Y., Wang, G. H., Wu, M.
Y., Xu, J. F., Zhu, H., Liu, L. L., Su, W. J., Cao, Z. Y., Jiang, C. L.
OBJECTIVES: Suicide is the fourth leading cause of
death for individuals aged 15-29 years, and early intervention on suicidal ideation and risk factors should be priortized. Brief mindfulness
meditation (BMM) is convenient and cost-effective in improving physical and mental well-being, but less is known about its efficacy for suicidal
ideation, stress and sleep quality. We investigated the effects of BMM on suicidal ideation, stress, and sleep quality for individuals with suicide
risk.\rMETHODS: Sixty-four college students with high suicidal ideation (aged 18-30 years) were randomly allocated to either a BMM (n = 32) or
control group (n = 32). The BMM was based on Anapanasati and core mindfulness concepts. Sixty participants completed all scheduled sessions including
pretest, one month of intervention or waiting, and posttest. Suicidal ideation was measured with the Beck Scale for Suicidal Ideation. Stress was
evaluated using the Perceived Stress Scale and salivary cortisol levels. Sleep was measured using the Pittsburgh Sleep Quality Index and actigraphy
accompanied with 7-day sleep diaries.\rRESULTS: Post-intervention, the BMM group showed significant decrease in suicidal ideation with a large effect
size; the decrease showed a medium effect size in the control group. The BMM group, but not the control group, showed significant decrease in morning
salivary cortisol and sleep latency, and improved sleep efficiency.\rCONCLUSIONS: BMM could help reduce suicidal ideation, stress, and sleep
disturbance for individuals with high suicidal ideation and it may implicate effective suicide prevention strategy.
Archives
of Suicide Research, : 1-16
- Year: 2021
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Mindfulness based
therapy, Meditation
Weinstein, S., Gruhn, M., West, A.
Aims: Suicide risk in pediatric bipolar disorder (BD) is a significant public health problem. To guide the development of targeted
suicide interventions for this at-risk population, this study examined (1) psychosocial correlates of suicidal ideation (SI) in youth with BD that
may dictate targets for intervention; (2) SI response to manualized psychotherapy for pediatric BD (Child-and Family-Focused Cognitive Behavioral
Therapy, CFF-CBT) versus treatment-as- usual (TAU); and (3) psychosocial factors corresponding to SI treatment response. Method(s): Participants
included 72 youth aged 7-13 (M = 9.19, SD = 1.61) with DSM-IV- TR bipolar I, II, or NOS and a parent/caregiver participating in a randomized trial
examining CFF-CBT versus TAU. Both treatments consisted of 11 weekly and 6 monthly sessions. Current SI and psychosocial correlates were assessed at
baseline, post-treatment, and 6-month follow-up. Result(s): Current ideation was prevalent: 41% endorsed any ideation, and 31% endorsed planful
ideation. Higher family rigidity and lower self-esteem were significant predictors of planful ideation at baseline (OR = 1.19, 0.89, respectively; p
< 0.05). Models examined changes in SI likelihood and intensity across treatment. All youth improved in SI across treatment (p < 0.05), but group
differences (CFF-CBT v. TAU) were not significant. Mediation analyses explored mechanisms of SI improvement across conditions; improvement in family
rigidity, self-esteem, and family functioning corresponded to reduction in SI across treatment (p < 0.05). Conclusion(s): Early intervention for
youth with BD may reduce SI even in a nonspecialized treatment. Results also highlight child self-esteem and family rigidity as key treatment targets
to reduce suicide risk in pediatric BD.
Bipolar Disorders, 23(SUPPL
1) : 47
- Year: 2021
- Problem: Bipolar 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), At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Waraan, L.
Attachment-Based Family Therapy (ABFT) is the only empirically supported family therapy model designed to treat adolescent depression,
including those at risk for suicide, and their families. ABFT aims to repair interpersonal ruptures and rebuild an emotionally protective parent-
child relationship. To study the effectiveness of ABFT compared with Treatment as Usual (TAU) in reducing suicidal ideation in clinically depressed
adolescents. Sixty adolescents (86.7% girls), aged 13 to 18years (M=14.9), with major depressive disorder referred to two CAMHS were randomized to
receive 16weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions according to the treatment manual. Suicidal ideation was measured with the
Suicidal Ideation Questionnaire-Junior at 4, 6, 8, 10, 12, 14, and 16weeks. Linear mixed models were fitted to test our hypothesis, time was the only
factor to have a significant effect on suicidal ideation t(31.05)=-3.32, p<.01. Participants in both treatment groups reported significantly reduced
suicidal ideation, but the majority were still in the clinical range after 16weeks of treatment. ABFT was not associated with more favorable outcomes
than TAU. Findings must be interpreted with caution given the study limitations.
Clinical child psychology and
psychiatry, 26(2) : 464-474
- Year: 2021
- 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: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Mann, J. J.
OBJECTIVE: The authors sought to identify scalable evidence-based
suicide prevention strategies. METHOD(S): A search of PubMed and Google Scholar identified 20,234 articles published between September 2005 and
December 2019, of which 97 were randomized controlled trials with suicidal behavior or ideation as primary outcomes or epidemiological studies of
limiting access to lethal means, using educational approaches, and the impact of antidepressant treatment. RESULT(S): Training primary care
physicians in depression recognition and treatment prevents suicide. Educating youths on depression and suicidal behavior, as well as active outreach
to psychiatric patients after discharge or a suicidal crisis, prevents suicidal behavior. Meta-analyses find that antidepressants prevent suicide
attempts, but individual randomized controlled trials appear to be underpowered. Ketamine reduces suicidal ideation in hours but is untested for
suicidal behavior prevention. Cognitive-behavioral therapy and dialectical behavior therapy prevent suicidal behavior. Active screening for suicidal
ideation or behavior is not proven to be better than just screening for depression. Education of gatekeepers about youth suicidal behavior lacks
effectiveness. No randomized trials have been reported for gatekeeper training for prevention of adult suicidal behavior. Algorithm-driven electronic
health record screening, Internet-based screening, and smartphone passive monitoring to identify high-risk patients are understudied. Means
restriction, including of firearms, prevents suicide but is sporadically employed in the United States, even though firearms are used in half of all
U.S. suicides. CONCLUSION(S): Training general practitioners warrants wider implementation and testing in other nonpsychiatrist physician settings.
Active follow-up of patients after discharge or a suicide-related crisis should be routine, and restricting firearm access by at-risk individuals
warrants wider use. Combination approaches in health care systems show promise in reducing suicide in several countries, but evaluating the benefit
attributable to each component is essential. Further suicide rate reduction requires evaluating newer approaches, such as electronic health record-
derived algorithms, Internet-based screening methods, ketamine's potential benefit for preventing attempts, and passive monitoring of acute suicide
risk change.
The American journal of
psychiatry, : appiajp202020060864
- Year: 2021
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any)
Kothgassner, O. D.
BACKGROUND: Given the widespread nature and clinical consequences of self-harm and suicidal ideation among adolescents,
establishing the efficacy of developmentally appropriate treatments that reduce both self-harm and suicidal ideation in the context of broader
adolescent psychopathology is critical. METHOD(S): We conducted a systematic review and meta-analysis of the Dialectical Behaviour Therapy for
Adolescents (DBT-A) literature on treating self-injury in adolescents (12-19 years). We searched for eligible trials and treatment evaluations
published prior to July 2020 in MEDLINE/PubMed, Scopus, Google Scholar, EMBASE, and the Cochrane Library databases for clinical trials. Twenty-one
studies were identified [five randomized-controlled trials (RCTs), three controlled clinical trials (CCTs), and 13 pre-post evaluations]. We
extracted data for predefined primary (self-harm, suicidal ideation) and secondary outcomes (borderline personality symptoms; BPD) and calculated
treatment effects for RCTs/CCTs and pre-post evaluations. This meta-analysis was pre-registered with OSF: osf.io/v83e7. RESULT(S): Overall, the
studies comprised 1673 adolescents. Compared to control groups, DBT-A showed small to moderate effects for reducing self-harm (g = -0.44; 95% CI -
0.81 to -0.07) and suicidal ideation (g = -0.31, 95% CI -0.52 to -0.09). Pre-post evaluations suggested large effects for all outcomes (self-harm: g
= -0.98, 95% CI -1.15 to -0.81; suicidal ideation: g = -1.16, 95% CI -1.51 to -0.80; BPD symptoms: g = -0.97, 95% CI -1.31 to -0.63). CONCLUSION(S):
DBT-A appears to be a valuable treatment in reducing both adolescent self-harm and suicidal ideation. However, evidence that DBT-A reduces BPD
symptoms was only found in pre-post evaluations.
Psychological medicine, 51(7) : 1057
-1067
- Year: 2021
- 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), Dialectical behavioural therapy
(DBT)
Klim-Conforti, Paula
Objective: To evaluate the impact of a Harry Potter-based mental health literacy curriculum,
imparting cognitive behavioral therapy (CBT) skills, on suicidality and well-being in middle-schoolers. Methods: Students (aged 11-14; grades 7-8)
who received a 3-month teacher-delivered intervention embedded in the language arts curriculum (N = 200) were compared to a wait-list control group
(N = 230) in the largest urban school board in Canada. Suicidality defined as a composite measure of self-reported suicidal ideation and attempts
[primary outcome], self-reported emotion dysregulation, interpersonal chaos, confusion about self, and impulsivity [Life Problems Inventory (LPI)]
and self-reported depression and anxiety symptoms [Revised Child Anxiety and Depression Scale (RCADS)] were the outcomes of interest. Measurements
occurred prior to and after curriculum delivery with independent t-tests used to compare mean change scores between groups clustered by class.
Results: Thirty-seven English teachers in 46 classes across 15 schools comprised the planned study cohort. Composite suicidality scores were
significantly worse in the control than intervention group at endpoint (0.05 +/- 0.54 vs. 0.17 +/- 0.47, t = -2.60, df = 428, p = 0.01). There were
also significant improvements in LPI and RCADS scores in the intervention group compared to controls (LPI:-3.74 +/- 7.98 vs. 1.16 +/- 10.77 t = 5.28,
df = 428, p < .001; RCADS: (-3.08 +/- 5.49 vs. -1.51 +/- 6.53 t = 2.96, df = 429, p = 0.01). Sub-analyses revealed that these improvements were
largely driven by a significant difference in scores in girls. Limitations: Sample size constraints as study terminated prematurely during COVID
pandemic. Conclusions: This study demonstrates significant improvement in suicidality, emotional regulation, self-concept, interpersonal
difficulties, depression and anxiety in youth, particularly girls following this intervention. Replication studies in larger samples are needed to
confirm these results. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
, 286 : 134-
141
- Year: 2021
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
King, C. A.
This
study examined the effectiveness of LET's CONNECT (LC), a community mentorship program based on the positive youth development model. Participants
were 218 youth (66.5% girls), ages 12 to 15, who reported peer victimization, bullying perpetration, and/or low social connectedness. These youth
were randomized to LC or the control group (community resource information). The LC program linked youth to community mentors who connected with
youth and facilitated their involvement in social growth activities across a 16-month period. Outcomes were assessed at 6 and 16 months with self-
report measures of social and community connectedness, thwarted belongingness, depression, self-esteem, and suicidal ideation and behavior. In
intent-to-treat analyses, LC was associated with modest positive effects for social connectedness, self-esteem, and depression. It had no effects on
suicidal ideation or behavior. Results suggest that LC has the potential to positively impact the developmental trajectories of youth dealing with
the interpersonal challenges of victimization, bullying perpetration, or low social connectedness. LC implementation challenges and directions for
further research are also discussed. Copyright © 2021 Society for Community Research and Action.
American journal of community
psychology., 09 :
- Year: 2021
- Problem: 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, Other service delivery and improvement
interventions