A Brief Mobile App Reduces Nonsuicidal and Suicidal Self-Injury: Evidence From Three Randomized Controlled Trials
A Brief Mobile App Reduces Nonsuicidal and Suicidal Self-Injury: Evidence From Three Randomized Controlled Trials
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DOI：
10.1037/ccp0000093
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发表时间：
2016-06-01
影响因子：
5.9
通讯作者：
Nock, Matthew K.
中科院分区：
文献类型：
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作者：
Franklin, Joseph C.;Fox, Kathryn R.;Nock, Matthew K.
目的：自伤思想和行为(SITB)是传统干预手段无法大规模解决的重大公共卫生问题。这一系列研究的目标是采取初步步骤，开发一种有效的SITB治疗方法，这种治疗方法可以很容易地大规模应用。方法：我们创建了一个简短(1-2分钟)的类似游戏的应用程序，名为治疗评估条件(TEC)，旨在增加对SITBS的厌恶，减少对自我的厌恶。在3项独立的研究中，我们从专注于自我伤害和精神病理学的网络论坛(NS=114、131和163)招募了有近期和严重SITB病史的参与者，并随机分配他们接受移动治疗TEC应用程序或控制应用程序的访问，为期1个月。我们测试了TEC对自杀意念、自杀计划和自杀行为的自割、非自杀性自伤的频率的影响。结果：分析表明，与对照组APP相比，TEC对除自杀意念外的所有SITB都产生了适度的减少。在所有研究中，最大和最一致的减少是自我切割事件(32%-40%)、自杀计划(21%-59%)和自杀行为(33%-77%)。3项研究中的两项表明，TEC影响了其预期的治疗目标，这些目标的更大变化与SITB的更大削减相关。在治疗后1个月的随访中，TEC的效果没有得到维持。结论：像这里测试的那样的简短移动干预的未来版本可能有可能大规模减少SITB和相关行为。
Objective: Self-injurious thoughts and behaviors (SITBs) are a major public health problem that traditional interventions have been unable to address on a large scale. The goal of this series of studies was to take initial steps toward developing an effective SITB treatment that can be easily delivered on a very large scale. Method: We created a brief (1-2 min), game-like app called Therapeutic Evaluative Conditioning (TEC), designed to increase aversion to SITBs and decrease aversion to the self. In 3 separate studies, we recruited participants with recent and severe histories of SITBs from web forums focused on self-injury and psychopathology (Ns = 114, 131, and 163) and randomly assigned them to receive access to the mobile treatment TEC app or a control app for 1 month. We tested the effect of TEC on the frequency of self-cutting, nonsuicidal self-injury more generally, suicide ideation, suicide plans, and suicidal behaviors. Results: Analyses showed that, compared with the control app, TEC produced moderate reductions for all SITBs except suicide ideation. Across studies, the largest and most consistent reductions were for self-cutting episodes (32%-40%), suicide plans (21%-59%), and suicidal behaviors (33%-77%). Two of the 3 studies showed that TEC impacted its intended treatment targets and that greater change in these targets was associated with greater SITB reductions. TEC effects were not maintained at the 1-month posttreatment follow-up. Conclusions: Future versions of brief, mobile interventions like that tested here may have the potential to reduce SITBs and related behaviors on a large scale.