Disorders - suicide or self-harm behaviours
Asarnow, J. R., Berk, M. S., Bedics, J., Adrian, M., Gallop, R., Cohen, J., Korslund, K., Hughes, J., Avina, C., Linehan, M. M., McCauley, E.
OBJECTIVE: This study evaluated mechanisms, mediation, and secondary/exploratory outcomes
in our randomized controlled trial evaluating dialectical behavior therapy (DBT) compared to individual and group supportive therapy (IGST). We
expand on previously reported results indicating a DBT advantage at posttreatment on planned suicide/self-harm outcomes, and greater self-harm
remission (absence of self-harm, post hoc exploratory outcome) during active-treatment and follow-up periods.\rMETHOD: This was a multi-site
randomized trial of 173 adolescents with prior suicide attempts, self-harm, and suicidal ideation. Randomization was to 6 months of DBT or IGST, with
outcomes monitored through 12 months. Youth emotion regulation was the primary mechanistic outcome.\rRESULTS: Compared to IGST, greater improvements
in youth emotion regulation were found in DBT through the treatment-period [t(498) = 2.36, p = .019] and 12-month study period (t(498) = 2.93, p =
.004). Their parents reported using more DBT skills: posttreatment t(497) = 4.12, p < .001); 12-month follow-up t(497) = 3.71, p < .001). Mediation
analyses predicted to self-harm remission during the 6- to 12-month follow-up, the prespecified outcome and only suicidality/self-harm variable with
a significant DBT effect at follow-up (DBT 49.3%; IGST 29.7%, p = .013). Improvements in youth emotion regulation during treatment mediated the
association between DBT and self-harm remission during follow-up (months 6-12, estimate 1.71, CI 1.01-2.87, p = .045). Youths in DBT reported lower
substance misuse, externalizing behavior, and total problems at posttreatment/6 months, and externalizing behavior throughout follow-up/12 months.
\rCONCLUSION: Results support the significance of emotion regulation as a treatment target for reducing self-harm, and indicate a DBT advantage on
substance misuse, externalizing behavior, and self-harm-remission, with 49.3% of youths in DBT achieving self-harm remission during follow-up.
\rCLINICAL TRIAL REGISTRATION INFORMATION: Collaborative Adolescent Research on Emotions and Suicide; https://www.clinicaltrials.gov/;
NCT01528020.
Journal of the American Academy of Child & Adolescent
Psychiatry, 01 : 01
- Year: 2021
- Problem: 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), Dialectical behavioural therapy
(DBT), Supportive
therapy
Yen, S.
The objective of this study was to
examine the feasibility, acceptability, and preliminary effects of an intervention, Skills to Enhance Positivity (STEP) that aims to increase
attention to positive emotions and experiences and to decrease suicidal events. STEP involves four in-person individual sessions delivered during an
inpatient psychiatric admission, followed by one month of weekly phone calls and daily text messages with mood monitoring and skills practice. A
pilot randomized controlled trial of STEP vs. enhanced treatment as usual (ETAU) was conducted with 52 adolescents. Results indicated that on average
83% of sessions were completed and that on 70% of days, participants engaged with the text-messaging component of the intervention. Acceptability for
both in-person and text-messaging components were also high, with satisfaction ratings averaging between good and excellent. STEP participants
reported fewer suicide events than ETAU participants (6 vs. 13) after six months of follow-up.
The Journal of Positive Psychology, 15(3) : 348-361
- Year: 2020
- 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), Service Delivery & Improvement, Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions, Mindfulness based
therapy, Meditation, Technology, interventions delivered using technology (e.g. online, SMS)
Wyman, P. A.
Importance: Suicide has been a leading manner of death for US Air Force personnel in recent years.
Universal prevention programs that reduce suicidal thoughts and behaviors in military populations have not been identified. Objective(s): To
determine whether the Wingman-Connect program for Airmen-in-training reduces suicidal ideation, depression, and occupational problems compared with a
stress management program and to test the underlying network health model positing that cohesive, healthy units are protective against suicidal
ideation. Design, Setting, and Participant(s): This cluster randomized clinical trial was conducted from October 2017 to October 2019 and compared
classes of personnel followed up for 6 months. The setting was a US Air Force technical training school, with participants studied to their first
base assignment, whether US or international. Participants in 216 classes were randomized, with an 84% retention rate. Data analysis was performed
from November 2019 to May 2020. Intervention(s): The Wingman-Connect program used group skill building for cohesion, shared purpose, and managing
career and personal stressors (3 blocks of 2 hours each). Stress management training covered cognitive and behavioral strategies (2 hours). Both
conditions had a 1-hour booster session, plus text messages. Main Outcomes and Measures: The primary outcomes were scores on the suicidal ideation
and depression scales of the Computerized Adaptive Test for Mental Health and self-reports of military occupational impairment. Class network
protective factors hypothesized to mediate the effect of Wingman-Connect were assessed with 4 measures: cohesion assessed perceptions that classmates
cooperate, work well together, and support each other; morale was measured with a single item used in other studies with military samples; healthy
class norms assessed perceptions of behaviors supported by classmates; and bonds to classmates were assessed by asking each participant to name
classmates whom they respect and would choose to spend time with. Result(s): A total of 215 classes including 1485 individuals (1222 men [82.3%];
mean [SD] age, 20.9 [3.1] years) participated; 748 individuals were enrolled in the Wingman-Connect program and 737 individuals were enrolled in the
stress management program. At 1 month, the Wingman-Connect group reported lower suicidal ideation severity (effect size [ES], -0.23; 95% CI, -0.39 to
-0.09; P =.001) and depression symptoms (ES, -0.24; 95% CI, -0.41 to -0.08; P =.002) and fewer occupational problems (ES, -0.14; 95% CI, -0.31 to -
0.02; P =.02). At 6 months, the Wingman-Connect group reported lower depression symptoms (ES, -0.16; 95% CI, -0.34 to -0.02; P =.03), whereas the
difference in suicidal ideation severity was not significant (ES, -0.13; 95% CI, -0.29 to 0.01; P =.06). The number needed to treat to produce 1
fewer participant with elevated depression at either follow-up point was 21. The benefits of the training on occupational problems did not extend
past 1 month. The Wingman-Connect program strengthened cohesive, healthy class units, which helped reduce suicidal ideation severity (estimate, -
0.035; 95% CI, -0.07 to -0.01; P =.02) and depression symptom scores (estimate, -0.039; 95% CI, -0.07 to -0.01; P =.02) at 1 month. Conclusions and
Relevance: Wingman-Connect is the first universal prevention program to reduce suicidal ideation and depression symptoms in a general Air Force
population. Group training that builds cohesive, healthy military units is promising for upstream suicide prevention and may be essential for
ecological validity. Extension of the program to the operational Air Force is recommended for maintaining continuity and testing the prevention
impact on suicidal behavior. Trial Registration: ClinicalTrials.gov Identifier: NCT04067401. Copyright © 2020 American Medical Association. All
rights reserved.
, 3(10) :
- Year: 2020
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Skills training
Torok, M.
BACKGROUND: Digital interventions that deliver psychological self-help
provide the opportunity to reach individuals at risk of suicide who do not access traditional health services. Our primary objective was to test
whether direct (targeting suicidality) and indirect (targeting depression) digital interventions are effective in reducing suicidal ideation and
behaviours, and our secondary analyses assessed whether direct interventions were more effective than indirect interventions.\rMETHODS: In this
systematic review and meta-analysis, we searched online databases MEDLINE, PubMed, PsycINFO, and Cochrane CENTRAL for randomised controlled trials
published between database inception to May 21, 2019. Superiority randomised controlled trials of self-guided digital interventions (app or web
based, which delivered theory-based therapeutic content) were included if they reported suicidal ideation, suicidal plans, or suicide attempts as an
outcome. Non-inferiority randomised controlled trials were excluded to ensure comparability of the effect. Data were extracted from published
reports, and intention-to-treat data were used if available. The primary outcome was the difference in mean scores of validated suicidal ideation
measures (Hedges'g) with the associated 95% CI for the analysis of digital intervention effectiveness on suicidal ideation. We also present funnel
plots of the primary outcome measure (suicidal ideation) for direct and indirect interventions to assess for publication bias. We calculated
I2 (with I2 CI) values to test heterogeneity. We used random-effects modelling for the meta-analyses to assess the primary and
secondary outcomes. This study is registered with PROSPERO, CRD42018102084.\rFINDINGS: The literature search yielded 739 articles (including manual
searching) for suicidality and 8842 articles for depression. After screening, 14 papers reporting on 16 studies were included in the narrative review
and meta-analysis. The 16 studies (ten on direct interventions and six on indirect interventions) provided baseline data for 4398 participants. The
primary outcome of overall post-intervention effect for suicidal ideation was small but significant immediately following the active intervention
phase (Hedges'g -0.18, 95% CI -0.27 to -0.10, p<0.0001; I2=0%, I2 CI 0.0-47.9). The secondary objective, comparing direct and
indirect interventions, showed that direct interventions (targeting suicidality) significantly reduced suicidal ideation at post-intervention (g -
0.23, 95% CI -0.35 to -0.11, p<0.0001; I2=17.6%, I2 CI 0.0-58.6), but indirect interventions (targeting depression) failed to
reach significance (g -0.12, 95% CI -0.25 to 0.01, p=0.071; I2=0%, I2 CI 0.0-30.7).\rINTERPRETATION: Self-guided digital
interventions directly targeting suicidal ideation are effective immediately post-intervention. Indirect interventions were not significant for
reducing suicidal ideation. Our findings suggest that digital interventions should be promoted and disseminated widely, especially where there is a
lack of, or minimal access to, health services.\rFUNDING: Australian National Health and Medical Research Council.\r\r[NOTE: See online supplement
for adolescent vs. adult subgroup analysis]
The Lancet. Digital Health, 2(1) : e25-
e36
- Year: 2020
- 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), Technology, interventions delivered using technology (e.g. online, SMS)
Szlyk, H.
Background: Youth suicide is a global public health
issue, and using technology is one strategy to increase participation in preventive interventions. However, there is minimal knowledge on how
technology-enhanced interventions for youth correspond to the stages of care, from illness or risk recognition to treatment follow-up. Objective(s):
This systematic review aims to examine the efficacy of technology-enhanced youth suicide prevention and interventions across the continuum of care.
Method(s): Four electronic databases were searched up to spring 2019 for youth suicide preventive interventions that used technology. The review was
not restricted by study design and eligible studies could report outcomes on suicidality or related behaviors, such as formal treatment initiation.
An adapted version of the Methodological Quality Ratings Scale was used to assess study quality. Result(s): A total of 26 studies were identified.
The findings support the emerging efficacy of technology-enhanced interventions, including a decline in suicidality and an increase in proactive
behaviors. However, evidence suggests that there are gaps in the continuum of care and recent study samples do not represent the diverse identities
of vulnerable youth. Conclusion(s): The majority of identified studies were conducted in school settings and were universal interventions that
aligned with the illness and risk recognition and help-seeking stages of the continuum of care. This field could be strengthened by having future
studies target the stages of assessment and treatment initiation, include diverse youth demographics, and examine the varying roles of providers and
technological components in emerging interventions. Copyright © 2020 Journal of Medical Internet Research. All rights reserved.
Journal of Medical
Internet Research, 22(10) :
- Year: 2020
- 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), Technology, interventions delivered using technology (e.g. online, SMS)
Speed, K. J.
Introduction: Nightmares have been tied to a myriad of adverse mental health outcomes
and are known to persist after treatment of other concerns such as posttraumatic stress, depression, and anxiety. When reaching clinical levels,
nightmare disorder is known to effect 2-6% of the general population, Although many treatments exist for nightmare disorder and posttraumatic
nightmares, Imagery Rehearsal Therapy has consistently been cited as the first line treatment. Mobile health (mHealth) technology has emerged as a
viable platform from which to deliver sleep medicine interventions. Method(s): We assessed the efficacy of an Imagery Rehearsal Therapy-based mobile
application (Dream EZ) developed by the National Center for Telehealth and Technology. College students (n = 99) were recruited in a two-part online
study and randomized to the treatment condition or waitlist control. Repeated measures analysis of variance were used to assess the efficacy of
smartphonebased mHealth application treatment (Dream EZ) in reduction of psychological symptoms (nightmare distress, PTSD symptoms, and suicide risk)
as compared to waitlist control. Result(s): Findings support the use of Dream EZ for nightmares distress reduction (main effect: p =.004, d = .57;
interaction: p =.049, d = .41). Results regarding effectiveness of Dream EZ in relation to reduction of PTSD symptoms (main effect: p = .415, d =
.17; interaction: p =.262, d = .23) showed no significant interactions between PTSD symptoms and treatment group assignment. In relation to changes
in suicidality (main effect: p =.007, d = .57; interaction: p =.758, d = .07), findings were nonsignificant. Conclusion(s): Use of nightmare-focused
treatment through a mHealth smartphone application may be a viable avenue for promoting management of nightmare distress in college students. These
findings present an opportunity to explore further options for increasing accessibility of sleep-focused treatment options in a challenging and
fast-paced population.
Sleep, 43 (SUPPL
1) : A420
- Year: 2020
- 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), Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other complementary & alternative
interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Ougrin, D.
Clinical guidelines recommend intensive community care service treatment (ICCS) to reduce adolescent psychiatric inpatient care. We have
previously reported that the addition of ICCS led to a substantial decrease in hospital use and improved school re-integration. The aim of this study
is to undertake a randomised controlled trial (RCT) comparing an inpatient admission followed by an early discharge supported by ICCS with usual
inpatient admission (treatment as usual; TAU). In this paper, we report the impact of ICCS on self-harm and other clinical and educational outcomes.
106 patients aged 12-18 admitted for psychiatric inpatient care were randomised (1:1) to either ICCS or TAU. Six months after randomisation, we
compared the two treatment arms on the number and severity of self-harm episodes, the functional impairment, severity of psychiatric symptoms,
clinical improvement, reading and mathematical ability, weight, height and the use of psychological therapy and medication. At six-month follow-up,
there were no differences between the two groups on most measures. Patients receiving ICCS were significantly less likely to report multiple episodes
(five or more) of self-harm (OR = 0.18, 95% CI: 0.05-0.64). Patients admitted to private inpatient units spent on average 118.4 (95% CI: 28.2-208.6)
fewer days in hospitals if they were in the ICCS group compared to TAU. The addition of ICCS to TAU may lower the risk of multiple self-harm and may
reduce the duration of inpatient stay, especially in those patients admitted for private care. Early discharge with ICCS appears to be a viable
alternative to standard inpatient treatment. Copyright © 2020, The Author(s).
European Child and Adolescent Psychiatry., :
- Year: 2020
- 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, Other service delivery and improvement
interventions
Nagamitsu, S.
Objectives: Health promotion for adolescents
is expected to prevent risk behaviors and improve their physical and mental health behaviors. This study was designed to verify the effectiveness of
2 adolescent health promotion interventions: a health checkup with a risk assessment interview and counseling (HCU) and self-monitoring with a
smartphone CBT application (app). Method(s): Participants were 217 adolescents (aged 13-18 years). They were randomly divided into 2 intervention
groups (an HCU group and an HCU with CBT app group) and a nonintervention group. HCU comprised a standardized physical examination along with a
structured interview and counseling for youth risk assessment. The CBT app was developed to monitor the user's emotions. It comprised a 1-week
lesson component and a 1-week worksheet production component. The primary outcome was the change in scores for depressive symptoms. Secondary
outcomes included changes in scores for self-esteem, quality of life, self-monitoring, and an adolescent health promotion scale. The outcomes were
evaluated at baseline and at 1, 2, and 4 months after baseline. The exploratory outcome was the presence of suicidal ideation during the observation
period. Intervention effects were estimated using logistic regression analysis. Result(s): In total, 94% of participants completed the 4-month
evaluation. Both intervention groups showed a significant effect in reduced scores for depressive symptoms at 1 month; however, these effects were
not continued at 2 and 4 months. No significant effects were seen in scores for the secondary outcomes. Twelve participants presented suicidal
ideation during the observation period; 6 were identified before entry, 5 were identified in the nonintervention group, and 1 was identified in the
HCU group. This result showed a significant intervention effect for the prevention of suicidal ideation. Conclusion(s): Although adolescent health
promotion interventions may be beneficial in the short term, the frequency of the HCU and further revision of the CBT app should be considered to
evaluate long-term effectiveness. R, ADOL, CBT Copyright © 2020
Journal of the
American Academy of Child and Adolescent Psychiatry, 59 (10 Supplement) : S141
- Year: 2020
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Melbye, S., Kessing, L. V., Bardram, J. E., Faurholt-Jepsen, M.
Background: Psychiatric
disorders often have an onset at an early age, and early identification and intervention help improve prognosis. A fine-grained, unobtrusive, and
effective way to monitor symptoms and level of function could help distinguish severe psychiatric health problems from normal behavior and
potentially lead to a more efficient use of clinical resources in the current health care system. The use of smartphones to monitor and treat
children, adolescents, and young adults with psychiatric disorders has been widely investigated. However, no systematic review concerning
smartphone-based monitoring and treatment in this population has been published. Objective(s): This systematic review aims at describing the
following 4 features of the eligible studies: (1) monitoring features such as self-assessment and automatically generated data, (2) treatment
delivered by the app, (3) adherence to self-monitoring, and (4) results of the individual studies. Method(s): We conducted a systematic literature
search of the PubMed, Embase, and PsycInfo databases. We searched for studies that (1) included a smartphone app to collect self-monitoring data, a
smartphone app to collect automatically generated smartphone-based data, or a smartphone-based system for treatment; (2) had participants who were
diagnosed with psychiatric disorders or received treatment for a psychiatric disorder, which was verified by an external clinician; (3) had
participants who were younger than 25 years; and (4) were published in a peer-reviewed journal. This systematic review was reported in accordance
with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias in each individual study was systematically
assessed. Result(s): A total of 2546 unique studies were identified through literature search; 15 of these fulfilled the criteria for inclusion.
These studies covered 8 different diagnostic groups: psychosis, eating disorders, depression, autism, self-harm, anxiety, substance abuse, and
suicidal behavior. Smartphone-based self-monitoring was used in all but 1 study, and 11 of them reported on the participants' adherence to self-
monitoring. Most studies were feasibility/pilot studies, and all studies on feasibility reported positive attitudes toward the use of smartphones for
self-monitoring. In 2 studies, automatically generated data were collected. Three studies were randomized controlled trials investigating the
effectiveness of smartphone-based monitoring and treatment, with 2 of these showing a positive treatment effect. In 2 randomized controlled trials,
the researchers were blinded for randomization, but the participants were not blinded in any of the studies. All studies were determined to be at
high risk of bias in several areas. Conclusion(s): Smartphones hold great potential as a modern, widely available technology platform to help
diagnose, monitor, and treat psychiatric disorders in children and adolescents. However, a higher level of homogeneity and rigor among studies
regarding their methodology and reporting of adherence would facilitate future reviews and meta-analyses. Copyright © Sigurd Melbye, Lars Vedel
Kessing, Jakob Eyvind Bardram, Maria Faurholt-Jepsen. Originally published in JMIR Mental Health (http://mental.jmir.org), 29.10.2020. This is an
open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which
permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is
properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/, as well as this copyright and
license information must be included.
JMIR Mental
Health, 7(10) :
- Year: 2020
- Problem: Anorexia Nervosa, Psychosis Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), First episode (psychosis only)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Martin-Villalba, I.
Introduction: The efficacy of dialectical behavior
therapy (DBT) in adolescents with non-suicidal self-injury (NSSI) or suicide attempts (SA) has been supported by two randomized clinical trials
(RCT). These studies could not be generalizable to the daily clinical routine and self-reported measures used may be unresponsive to the change
compared to the measures assessed by clinicians. Objective(s): This study evaluates the effectiveness of DBT compared with treatment as usual plus
group sessions (TAU + GS) in adolescents with suicidal risk in a mental health center, using selfreported measures and those evaluated by the
clinician. Method(s): 35 adolescents with repetitive NSSI and/or SA during the last 12 months were recruited and randomly assigned to DBT (n = 18) or
TAU + GS (n = 17), to receive both group and individual sessions for 16 weeks. The Columbia Suicide Severity Rating Scale (C-SSRS); the Beck
Depression Inventory (BDI-II) and the Suicidal Ideation Questionnaire (SIQ) as self-report measures and the Clinical Global Impressions (CGI) and
Children's Global Assessment Scale (CGAS) evaluated by clinicians, were included pre and post-treatment. Generalized linear models were constructed.
Result(s): The adolescents in DBT improved significantly in the CGAS (p <0.001) and in the CGI (p <0.049) compared to TAU + SG. The self-reported
measures showed no significant differences. Both the CGAS and the SIQ-JR improved significantly at the end of the treatment regardless of the
treatment. Conclusion(s): These results confirm the effectiveness of DBT in adolescents with suicidal risk in the daily routine. Clinical judgment
could potentially be more sensitive than self-report measures.
European Psychiatry, 63(Supplement 1) : S568
- Year: 2020
- 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)
Haruvi Catalan, L.
In recent years,
suicidal behaviors have shown substantial increase worldwide. This trend is also prominent in Israel and has led to a dramatic increase in mental
health treatment demand resulting in long wait times and low treatment acceptance rate. To address the critical need in crisis intervention for
children and adolescents at suicidal risk we developed an ultra-brief acute crisis intervention, based on Interpersonal Psychotherapy (IPT). IPT is
an evidence-based intervention for various psychopathologies among different age groups. The current adaptation of IPT-A is comprised of five weekly
sessions, followed by monthly follow-up caring email contacts to the patients and their parents, over a period of 3 months. This paper aims to review
the theoretical foundation of this intervention, describe the research design, and present preliminary results of a pilot study. Preliminary Results
from our samples of 26 adolescents indicate meaningful trends for both the suicidal ideation (SIQ) and depression (MFQ) outcome measures. Significant
interaction was found concerning suicidal ideation but not for depression. Main limitations include small sample size and stratified controls. The
treatment appears to be safe, feasible and acceptable and initial results show promising trends to support further study of the approach. © Copyright
© 2020 Haruvi Catalan, Levis Frenk, Adini Spigelman, Engelberg, Barzilay, Mufson, Apter, Benaroya Milshtein, Fennig and Klomek.
Frontiers in Psychiatry, 11 (no
pagination) :
- Year: 2020
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Interpersonal therapy (IPT)
Godwin, Jennifer W., Conduct
Problems Prevention Research Group.
How to mitigate the dramatic increase in the
number of self-inflicted deaths from suicide, alcohol-related liver disease, and drug overdose among young adults has become a critical public health
question. A promising area of study looks at interventions designed to address risk factors for the behaviors that precede these -often denoted-
\"deaths of despair.\" This paper examines whether a childhood intervention can have persistent positive effects by reducing adolescent and young
adulthood (age 25) behaviors that precede these deaths, including suicidal ideation, suicide attempts, hazardous drinking, and opioid use. These
analyses test the impact and mechanisms of action of Fast Track (FT), a comprehensive childhood intervention designed to decrease aggression and
delinquency in at-risk kindergarteners. We find that random assignment to FT significantly decreases the probability of exhibiting any behavior of
despair in adolescence and young adulthood. In addition, the intervention decreases the probability of suicidal ideation and hazardous drinking in
adolescence and young adulthood as well as opioid use in young adulthood. Additional analyses indicate that FT's improvements to children's
interpersonal (e.g., prosocial behavior, authority acceptance), intrapersonal (e.g., emotional recognition and regulation, social problem solving),
and academic skills in elementary and middle school partially mediate the intervention effect on adolescent and young adult behaviors of despair and
self-destruction. FT's improvements to interpersonal skills emerge as the strongest indirect pathway to reduce these harmful behaviors. This study
provides evidence that childhood interventions designed to improve these skills can decrease the behaviors associated with premature mortality.
(PsycInfo Database Record (c) 2021 APA, all rights reserved)
PNAS
Proceedings of the National Academy of Sciences of the United States of America, 117(50) : 31748-
31753
- Year: 2020
- 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)