Pilot RCT of the Attempted Suicide Short Intervention Program (ASSIP) adapted for rapid delivery during hospitalization to adult suicide attempt patients with substance use problems

Author(s):  
Kenneth R. Conner ◽  
Jaclyn C. Kearns ◽  
Erika C. Esposito ◽  
Edmund Pizzarello ◽  
Timothy J. Wiegand ◽  
...  
2021 ◽  
Author(s):  
Nicolas JC Stapelberg ◽  
Candice Bowman ◽  
Sabine Woerwag-Mehta ◽  
Sarah Walker ◽  
Angela Davis ◽  
...  

Abstract Background Despite being preventable, suicide is a leading cause of death and a major global public health problem. For every death by suicide, many more suicide attempts are undertaken, and this presents as a critical risk factor for suicide. Currently there are limited treatment options with limited underpinning research for those who present to Emergency Departments with suicidal behaviour. The aim of this study is to assess if adding one of two structured suicide specific psychological interventions (Attempted Suicide Short Intervention Program [ASSIP] or Brief Cognitive Behavioural Therapy [CBT] for Suicide Prevention) to a standardised clinical care approach (Suicide Prevention Pathway [SPP]) improves outcomes for consumers presenting to a Mental Health Service with a suicide attempt. Methods This is a randomised controlled trial with blinding of those assessing the outcomes. People who attempt suicide or experience suicidality after a suicide attempt, present to the Gold Coast Mental Health and Specialist Services, are placed on the Suicide Prevention Pathway (SPP) and meet the eligibility criteria, are offered the opportunity to participate. A total of 411 participants will be recruited for the study, with 137 allocated to each cohort (participants are randomised to SPP, ASSIP + SPP, or CBT + SPP). The primary outcomes of this study are re-presentation to hospital with suicide attempt and/or suicidal ideations. Death by suicide rates will also be examined. Self-reported level of suicidality, depression, anxiety, stress, resilience, problem-solving skills, self- and therapist-reported level of therapeutic engagement are also being examined. Psychometric data are collected at baseline, end of interventions, 6,12, and 24 months. Discussion This project will move both ASSIP and Brief CBT from efficacy to effectiveness research, with clear aims of assessing the addition of two structured psychological interventions to treatment as usual, providing a cost-benefit analysis of the interventions, thus delivering outcomes providing a clear pathway for rapid translation of successful interventions. Trials registration : NCT04072666 - Registered on 28th August 2019 on Clinical Trials US Gov (https://www.clinicaltrials.gov/ct2/show/NCT04072666?term=NCT04072666&draw=2&rank=1) and ANZCTR (https://www.anzctr.org.au/TrialSearch.aspx)


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Nicolas J. C. Stapelberg ◽  
Candice Bowman ◽  
Sabine Woerwag-Mehta ◽  
Sarah Walker ◽  
Angela Davies ◽  
...  

Abstract Background Despite being preventable, suicide is a leading cause of death and a major global public health problem. For every death by suicide, many more suicide attempts are undertaken, and this presents as a critical risk factor for suicide. Currently, there are limited treatment options with limited underpinning research for those who present to emergency departments with suicidal behaviour. The aim of this study is to assess if adding one of two structured suicide-specific psychological interventions (Attempted Suicide Short Intervention Program [ASSIP] or Brief Cognitive Behavioural Therapy [CBT] for Suicide Prevention) to a standardised clinical care approach (Suicide Prevention Pathway [SPP]) improves the outcomes for consumers presenting to a Mental Health Service with a suicide attempt. Methods This is a randomised controlled trial with blinding of those assessing the outcomes. People who attempt suicide or experience suicidality after a suicide attempt, present to the Gold Coast Mental Health and Specialist Services, are placed on the Suicide Prevention Pathway (SPP), and meet the eligibility criteria, are offered the opportunity to participate. A total of 411 participants will be recruited for the study, with 137 allocated to each cohort (participants are randomised to SPP, ASSIP + SPP, or CBT + SPP). The primary outcomes of this study are re-presentation to hospitals with suicide attempts. Presentations with suicidal ideation will also be examined (in a descriptive analysis) to ascertain whether a rise in suicidal ideation is commensurate with a fall in suicide attempts (which might indicate an increase in help-seeking behaviours). Death by suicide rates will also be examined to ensure that representations with a suicide attempt are not due to participants dying, but due to a potential improvement in mental health. For participants without a subsequent suicide attempt, the total number of days from enrolment to the last assessment (24 months) will be calculated. Self-reported levels of suicidality, depression, anxiety, stress, resilience, problem-solving skills, and self- and therapist-reported level of therapeutic engagement are also being examined. Psychometric data are collected at baseline, end of interventions, and 6,12, and 24 months. Discussion This project will move both ASSIP and Brief CBT from efficacy to effectiveness research, with clear aims of assessing the addition of two structured psychological interventions to treatment as usual, providing a cost-benefit analysis of the interventions, thus delivering outcomes providing a clear pathway for rapid translation of successful interventions. Trials registration ClinicalTrials.govNCT04072666. Registered on 28 August 2019


Psichologija ◽  
2012 ◽  
Vol 45 ◽  
pp. 55-69
Author(s):  
Jurgita Rimkevičienė ◽  
Danutė Gailienė

Suicidologijoje stokojama duomenų apie psichoaktyvių medžiagų vartojimo vaidmenį savižudybės procese bei impulsyvių ir neimpulsyvių mėginimų nusižudyti skirtumus. Šiame tyrime atlikta 15 vartojančių alkoholį arba narkotikus asmenų, per paskutinius metus mėginusių nusižudyti, kokybinių interviu teminė analizė. Tyrimas leido išskirti ne du, kaip aprašoma literatūroje, o tris mėginimų nusižudyti tipus, būdingus vartojantiems psichoaktyvias medžiagas: planuoti, neplanuoti ir mėginimai nusižudyti „aptemus sąmonei“, ir aprašyti visiems jiems būdingus bruožus. Nepaisant kai kurių ribotumų, šis tyrimas gali pasiūlyti vertingų įžvalgų vertinant vartojančių psichoaktyvias medžiagas asmenų suicidinę riziką.Pagrindiniai žodžiai: mėginimas nusižudyti, savižudybės procesas, psichoaktyvios medžiagos, alkoholis, narkotikai.THE TYPES OF SUICIDE PROCESS AMONG PSYCHOACTIVE SUBSTANCE USERS Jurgita Rimkevičienė, Danutė Gailienė Summary Research regarding the role of psychoactive substance use in the process of suicide is lacking in current sui­cidology. In addition to this, evidence shows that im­pulsive suicide attempts are common among substance users. However there is no clear understanding of the impulsive suicide process. That makes it difficult to combine results of different studies and create clear guidelines for impulsive suicide risk evaluation. The purpose of this research is to depict the impulsive and non-impulsive process of suicide among psychoactive substance users. The participants of the study were 15 psycho­active substance (10 – alcohol, 5 – drug) users, who had attempted suicide during the last year. 8 of them attempted once, 4 – two or three times, other 3 – more than 5 times. All participants – 4 women and 11 men were patients from Vilnius Centre for Addictive Disorders and Vilnius Mental Health Centre. Quali­tative interviews based on Suicide Intent Scale were conducted about the suicide attempt or attempts. A thematic analysis of the interviews was used to depict the process of suicide. This study led to distinguishing 3 different types of attempted suicide – planned, unplanned and suicide attempts during a “blackout” – which are typical for psychoactive substance users. Both unplanned suicide attempts and suicide attempts during a “blackout” can be called impulsive, though the latter diverged by their hastiness, aggressiveness, inability to control one’s behaviour, intensive feeling of anger, serious danger caused to health and wellbeing, as well as a follo­wing amnesia of a major part of the suicide attempt. Intensive emotions, especially anger and stressors in interpersonal relationships, had a major impact for the respondents in the process of suicide. According to the participants of the survey, substance use had intensified their suicidal crisis having a clear effect on their emotional, relationship and other difficulties. In addition, alcohol and drug use was considered as one of the suicide methods. Despite several restrictions of the research, the study results provide some valuable insight in the suicide risk evaluation among psycho­active substance users. Key words: suicide attempt, suicide process, psychoactive substances, alcohol, drugs.


Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 337-343 ◽  
Author(s):  
Mariann Ring ◽  
Anja Gysin-Maillart

Abstract. Background: The therapeutic alliance may be a moderating factor of outcome in the Attempted Suicide Short Intervention Program (ASSIP). Aims: This study investigates the two components of the therapeutic alliance, patients' satisfaction with the therapeutic relationship and therapeutic outcome and their associations with suicidal ideation over time. Method: A total of 120 patients (55% female; mean age = 36 years) with a history of attempted suicide were randomly allocated to either the intervention group ( N = 60) or the control group ( N = 60). Patients' satisfaction with the therapeutic relationship and outcome were measured with the two subscales of the Helping Alliance Questionnaire. The Beck Scale of Suicide Ideation was used to measure suicidal ideation in this 24-month follow-up study. Results: The ASSIP group showed that patients' satisfaction with therapeutic relationship and outcome increased significantly from the first to the third session. Higher satisfaction with therapeutic outcome correlated significantly with lower suicidal ideation at follow-up. Conversely, the control group showed no significant results. Limitations: The collaborative approach adopted in the initial clinical interview of the control group could possibly have influenced the results of both scales. Conclusion: In particular, the component satisfaction with therapeutic outcome seems crucial to the subjectively perceived satisfaction of treatment and is associated with lower suicidal ideation over time. Thus, an enhanced understanding of components of the therapeutic alliance plays an important role in the development of interventions for suicidal patients.


2021 ◽  
Vol 129 (s1) ◽  
pp. 110-114
Author(s):  
Kalina Isela Martínez Martínez ◽  
María Eugenia Contreras-Pérez ◽  
Eric F. Wagner

Research has shown that an intervention process with adolescents involving the parents may achieve better results since the interaction with the parents is a protective factor itself. The brief intervention program for adolescents starting substance use is an intervention used in Mexican clinical centers with adolescents who have experienced problems with their substance use but do not present dependency symptoms. The family context is key to the genesis and progression of behavior problems, including substance use, among children and adolescents. An intervention process that involves parents may achieve better results in preventing substance use problems in adolescents


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