Brief Interventions for Short-Term Suicide Risk Reduction in Military Populations
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 97
- 试验地点
- 1
- 主要终点
- Estimated Proportion of Participants With Suicide Attempt
研究概览
简要总结
The purpose of the proposed study is to identify the most effective brief interventions for reducing short-term risk for suicide attempts in "real world" military triage settings, and to identify potential mechanisms of change underlying the interventions' impact on subsequent suicide attempts. We will randomize 360 patients to one of three commonly-used crisis interventions delivered as routine care in the mental health triage system: (1) Treatment As Usual (TAU); (2) Standard Crisis Response Plan (S-CRP); or (3) Enhanced Crisis Response Plan with Reasons For Living (E-CRP). The following hypotheses will be tested:
- The enhanced crisis response plan (E-CRP) intervention will contribute to significantly decreased risk for suicide attempts and hospitalization during follow-up relative to the standard crisis response plan alone (S-CRP) and treatment as usual (TAU).
- The standard crisis response plan (S-CRP) intervention will contribute to significantly decreased risk for suicide attempts and hospitalization during follow-up relative to treatment as usual (TAU).
- Greater ambivalence about suicide and faster recall of reasons for living will mediate the relationship between intervention and reduced risk for suicide attempt during follow-up.
详细描述
The CRP has been proposed as an alternative to TAU for the short-term management of suicidal patients and is now in widespread use, but has never been empirically tested. The CRP is purported to reduce suicide risk via unique mechanisms that directly suicide risk, notably suicidal ambivalence (i.e., the relative balance between the wish to live and the wish to die) and problem solving. Because suicidal ambivalence has gained support as an active mechanism for reducing suicide risk, the present study will also seek to augment this underlying mechanism by directly engaging the suicidal patient in a discussion about their reasons for living, thereby potentially increasing the potency of the CRP.
The present study therefore entails a component analysis of crisis interventions. As such, we anticipate ordered effects, whereby the S-CRP and E-CRP conditions will show significantly better outcomes than TAU, and E-CRP will demonstrate significantly better outcomes than the standard CRP condition.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Triple (Participant, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Active duty
- •18 years of age or older
- •Reporting current suicidal ideation with intent to die, or a suicide attempt within the past two weeks
- •Able to speak and understand the English language
- •Able to complete the informed consent process
排除标准
- •Severe psychiatric or medical conditions that preclude the ability to provide informed consent or participation in outpatient treatment
研究组 & 干预措施
Standard Crisis Response Plan (S-CRP)
CRP includes the following intervention components:
- suicide risk assessment
- supportive listening
- identify personal warning signs
- identify self-management skills
- identify social support contacts
- provision of professional and crisis contact information
- referral to mental health treatment and community resources
干预措施: Enhanced Crisis Response Plan (E-CRP) (Behavioral)
Standard Crisis Response Plan (S-CRP)
CRP includes the following intervention components:
- suicide risk assessment
- supportive listening
- identify personal warning signs
- identify self-management skills
- identify social support contacts
- provision of professional and crisis contact information
- referral to mental health treatment and community resources
干预措施: Standard Crisis Response Plan (S-CRP) (Behavioral)
Enhanced Crisis Response Plan (E-CRP)
The E-CRP includes the following intervention components:
- suicide risk assessment
- supportive listening
- identify personal warning signs
- identify self-management skills
- identify reasons for living
- identify social support contacts
- provision of professional and crisis contact information
- referral to mental health treatment and community resources
干预措施: Enhanced Crisis Response Plan (E-CRP) (Behavioral)
Treatment As Usual (TAU)
TAU includes the following intervention components:
- suicide risk assessment
- supportive listening
- provision of professional and crisis contact information
- referral to mental health treatment and community resources
- verbal contract for safety
干预措施: Treatment As Usual (TAU) (Behavioral)
结局指标
主要结局
Estimated Proportion of Participants With Suicide Attempt
时间窗: 6 months
Suicide attempts were assessed using the Suicide Attempt Self Injury Interview (SASII; Linehan et al., 2006). The SASII is a valid and reliable clinician-administered interview for categorizing suicide-related and self-injurious behaviors. Suicide attempt was defined as behavior that is self-directed and deliberately results in injury or the potential for injury to oneself for which there is evidence, whether implicit or explicit, of suicidal intent
次要结局
- Inpatient Psychiatric Hospitalization Days(6 months)
- Beck Scale for Suicide Ideation (BSSI)(1 month, 3 months, and 6 months)