A Novel Cognitive Reappraisal Intervention for Suicide Prevention

预防自杀的新型认知重评干预措施

• 批准号: 10478388
• 负责人: DIMITRIS N KIOSSES
• 金额: $ 42.73万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-23 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10478388
• 关键词: Administrative Supplement; Admission activity; Age; Antidepressive Agents; COVID-19; COVID-19 impact; Characteristics; Clinical; Clinical Trials; Elderly; Electroencephalography; Emotional; Emotions; Equilibrium; Event-Related Potentials; Exclusion Criteria; Feeling suicidal; Frequencies; Funding; Gender; Goals; Hospitalization; Intervention; Link; Measures; Mental Depression; Modeling; Mood stabilizers; National Institute of Mental Health; Neurobiology; Outcome; Parents; Participant; Patients; Pharmacotherapy; Phase; Population; Populations at Risk; Protocols documentation; Randomized; Research; Research Domain Criteria; Safety; Sampling; Severities; Stimulus; Strategic Planning; Suicide; Suicide attempt; Suicide prevention; Supportive care; Tablets; Techniques; Telephone; Testing; Vaccination; acceptability and feasibility; affective neuroscience; base; cognitive reappraisal; cost; design; emotion regulation; environmental adaptation; executive function; improved; innovation; middle age; novel; primary outcome; psychosocial; recruit; reducing suicide; suicidal behavior; suicidal risk; suicide rate; theories; therapy design; treatment effect

ABSTRACT The goal of the parent R33 is to test a novel emotion-regulation based psychosocial intervention designed to reduce suicide risk in middle-aged and older adults (50-90 years old) who have been discharged after a suicide-related hospitalization (i.e. for suicidal ideation or suicide attempt). Suicide rates in this group are alarmingly high, and reducing suicide rates in at-risk populations is a major NIMH priority. We developed a novel psychosocial intervention called “Cognitive Reappraisal Intervention for Suicide Prevention (CRISP),” which aims to improve cognitive reappraisal (i.e. modifying the appraisal of a situation to alter its emotional significance) (target), and reduce suicide risk (outcome). Our conceptual framework views suicidal ideation and behavior as failed attempts to regulate negative emotions and by improving cognitive reappraisal, an effective emotion regulation strategy, we expect to reduce suicide risk. Our theory is supported by studies showing that unsuccessful attempts to regulate negative emotions and decreased cognitive reappraisal are associated with increased suicidal ideation and behavior. The R33 phase aims to provide further evidence of target engagement of the optimized CRISP in a larger sample, evaluate the relationship of cognitive reappraisal with suicide risk as measured with Columbia Suicide Severity Rating Scale-C-SSRS and estimate implementation parameters for a large-scale clinical trial. A different sample of 75 middle-aged and older adults (using the same inclusion/exclusion criteria as for the R61 phase) will be randomized (2 to 1) to CRISP (N=60) or to Supportive Therapy (ST, a control treatment not designed to improve emotion regulation) (N=30). Assessments will be conducted on admission, at discharge, and at 6, 12 and 24 weeks post-discharge. Primary aims are: 1) CRISP participants will show improvement in cognitive reappraisal from discharge to end of treatment; and 2) improvement in cognitive reappraisal will be associated with suicide risk over 24 weeks. This administrative supplement aims to counterbalance the effect of COVID-19 on recruitment, therapy, and assessments. Due to COVID-19, we were unable to recruit any participants because we could not administer EEGs, which was the primary outcome of our study. We have recruited 35 out of 90 participants (38%) as of 8/30/2021. Because of a newly developed EEG safety protocol and the vaccination of our staff, we are planning to resume recruitment in September 2021. We have accumulated an unobligated balance which, if approved for no-cost extension, will fund the recruitment of 25 additional participants. This administrative supplement will fund the recruitment, therapy, and assessments of the remaining 30 participants.

摘要 父母R33的目标是测试一种新的基于情绪调节的心理社会干预，旨在 降低中老年人(50-90岁)在退休后出院的自杀风险 与自杀有关的住院治疗(即自杀意念或自杀未遂)。这组人的自杀率是 高得惊人的自杀率，降低高危人群的自杀率是NIMH的主要优先事项。 我们开发了一种新的心理社会干预方法，称为自杀的认知重估干预 预防(CRISP)，旨在改善认知重新评估(即将对情况的评估修改为 改变其情感意义)(目标)，并降低自杀风险(结果)。我们的概念框架视图 自杀意念和行为是调节负面情绪和改善认知的失败尝试 重新评估，这是一种有效的情绪调节策略，我们预计可以降低自杀风险。我们的理论得到了支持 研究表明，不成功的控制负面情绪的尝试会降低认知能力 重新评估与自杀念头和行为的增加有关。 R33阶段旨在提供优化CRISP在更大范围内目标交战的进一步证据 样本，评估认知再评价与哥伦比亚自杀测量的自杀风险之间的关系 严重程度评定量表-C-SSRS和估计大规模临床试验的实施参数。一个 75名中老年人的不同样本(使用与R61相同的纳入/排除标准 阶段)将随机(2比1)到CRISP(N=60)或支持疗法(ST，对照治疗不是 旨在改善情绪调节)(N=30)。评估将在入院、出院时进行， 出院后6周、12周、24周。主要目标是：1)干净利落的参与者将在 从出院到治疗结束的认知重新评估；和2)认知重新评估的改善将是 与超过24周的自杀风险有关。 这一行政补充旨在抵消新冠肺炎在招募、治疗和 评估。由于新冠肺炎的原因，我们无法招募任何参与者，因为我们无法管理 这是我们研究的主要结果。截至以下日期，我们已经招募了90名参与者中的35名(38%) 2021年8月30日。由于新开发的脑电安全规程和我们工作人员的疫苗接种，我们正在 计划于2021年9月恢复招聘。我们已经积累了一笔未承付余额，如果 已批准免费延期，将为额外招募25名参与者提供资金。这项管理工作 补助金将为其余30名参与者的招募、治疗和评估提供资金。

项目成果

An Emotion Regulation Tablet App for Middle-Aged and Older Adults at High Suicide Risk: Feasibility, Acceptability, and Two Case Studies.

• DOI: 10.1016/j.jagp.2021.08.015
• 发表时间: 2022-05-01
• 期刊: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
• 作者: Kiosses, Dimitris N;Monkovic, Jody;Putrino, David
• 通讯作者: Putrino, David