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Suicide Prevention Among Substance Abusing Homeless Youth

滥用药物的无家可归青少年的自杀预防

基本信息

批准号：
9221305
负责人：
NATASHA SLESNICK
金额：
$ 15.4万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-03-15 至 2019-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9221305
关键词：
Accident and Emergency department Address Adolescent Adult Age Alcohol abuse Alcohol or Other Drugs use Attention Behavior Cause of Death Childhood Chronic Cognitive Cognitive Therapy Complement Dangerousness Data Dehumanization Drops Drug abuse Drug usage Family Feeling hopeless Feeling suicidal Goals HIV risk Health Health Services Accessibility Health Status Healthcare Home environment Homeless Youth Homelessness Hospitalization Hospitals Impulsivity Intervention Life Light Literature Low income Mediating Mediator of activation protein Mental Depression Mental Health Mental Health Services Mental disorders Modeling Outcome Outcome Study Pilot Projects Population Premature Mortality Preventive Intervention Problem Solving Randomized Randomized Clinical Trials Recruitment Activity Reporting Research Risk Risk Factors Running Sampling Services Sexual abuse Shelter facility Social Network Social support Stress Suicide Suicide attempt Suicide prevention System Testing Theoretical model Time Victimization Vulnerable Populations Youth accomplished suicide alcohol use initiation base depressive symptoms distress tolerance effective intervention effectiveness trial experience follow up assessment follow-up foster care help-seeking behavior high risk population human capital improved physical abuse physical conditioning prevention service primary outcome psychologic public health relevance reducing suicide secondary outcome social social exclusion suicidal adolescent suicidal behavior suicidal risk suicide attempter theories treatment effect young adult

项目摘要

DESCRIPTION (provided by applicant): While research on homeless youth is increasing, there is a dearth of information regarding effective interventions for these youth. This is of significant concern because studies indicate that 70-95% report problem alcohol or drug use and 66% to 89% of homeless youth have a mental health disorder (Cauce et al., 2004). Suicide is the leading cause of death with up to 68% of youth reporting a lifetime suicide attempt (Rotheram-Borus & Milburn, 2004; Yoder, Whitbeck, & Hoyt, 2010). Among those who have attempted, an average of 6.2 attempts is reported. In addition, lifetime suicide ideation rates have ranged from 14% to 66.5% (Kingree et al., 2001; Merscham et al., 2010; Yoder, Whitbeck, & Hoyt, 2010). Some predictors of suicide among homeless youth have been identified. These include substance use, childhood physical and sexual abuse, victimization experiences while living on the streets, and psychological functioning, including depression, hopelessness, distress tolerance, impulse control, social support, and problem solving. This study uses general cognitive theory (Beck, 1967), complemented with concepts from two suicide specific theoretical models, to guide our intervention and conceptual change model. Consonant with the pilot R34 announcement, this study's goal is to pilot test an intervention that has previously demonstrated feasibility and promise with adolescent suicide attempters (Brent et al., 2009; Stanley et al., 2009) and efficacy with a low-income sample of adults, "The Cognitive Therapy Intervention for Suicide Attempters" (Brown et al., 2005). One-hundred fifty homeless youth with recent severe suicide ideation will be randomly assigned to the experimental cognitive therapy for suicide prevention (CTSP) + services as usual (SAU) (n=75) or to SAU alone (n=75). SAU includes those services normally offered through a local drop-in center. Follow-up assessments will be conducted at 3, 6, and 9-months post-baseline. It is hypothesized that youth receiving CTSP+SAU will show greater reductions in suicide ideation (primary outcome), substance use and depressive symptoms (secondary outcomes) over time compared to SAU alone. Furthermore, theoretically-derived mediators will be tested to shed light on mechanisms associated with change. The data from this study will be used to determine the initial efficacy of this promising intervention, and determine whether findings warrant a broader scale effectiveness trial. Ultimately, attention towards reducing suicide risk among these youth has the potential to reduce premature mortality, hospitalization and loss of human capital in a very high risk population of youth.