Impact of clinician Virtual Human Interaction training in Emotional Self-Awareness on patients Suicidal Ideation and Suicide Crisis Syndrome: a Randomized Controlled Trial

临床医生虚拟人际互动训练对情绪自我意识对患者自杀意念和自杀危机综合症的影响：随机对照试验

• 批准号: 10415520
• 负责人: Igor Galynker
• 金额: $ 10.16万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-23 至 2021-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10415520
• 关键词: Acute; Affect; Attention; Barbering; Caring; Cause of Death; Clinical Skills; Code; Communication; Control Groups; Data; Dimensions; Double-blind trial; Educational Intervention; Educational process of instructing; Emotional; Emotions; Empathy; Equipment and supply inventories; Evaluation; Feedback; Feeling suicidal; Fostering; Goals; Grant; Human; Industry Standard; Intake; Intervention; Life; Mediating; Mediator of activation protein; Medical Education; Mental Health; Methods; Online Systems; Outcome; Outpatients; Paper; Participant; Patient Education; Patients; Persons; Preparation; Process; Psychiatry; Publishing; Questionnaires; Randomized; Randomized Controlled Trials; Reporting; Research; Risk; Risk Assessment; Role; Savings; Self Perception; Severities; Suicide; Suicide prevention; Syndrome; System; Testing; Therapeutic; Time; Training; United States; Work; clinical encounter; coronavirus disease; evidence base; experimental group; follow up assessment; follow-up; high risk; human old age (65+); improved; indexing; innovation; instrument; novel; programs; prospective; response; scaffold; skills; suicidal; suicidal behavior; suicidal patient; suicidal risk; suicide rate; virtual human

Project Summary/Abstract Despite years of research and intensified public attention, suicide rates continue to climb and suicide remains a leading cause of death for 18-65 year-olds in the United States. Half of suicide decedents see a clinician in the months prior to dying by suicide providing a unique opportunity for a potentially life-saving intervention. Working with suicidal patients is highly stressful for clinicians and often elicits powerful negative emotional responses that may adversely affect suicidal outcomes. Possible reasons lie in that negative emotional responses may result in less empathic communication and unwitting rejection of the patient, which are liable to damage the therapeutic alliance. Thus there is a need for clinician training in effective management of their negative emotions towards suicidal patients, which would result in the improvement of suicidal outcomes. To be impactful, the training must be web-based, scalable and easy to disseminate. In this project, we will adress this critical need and use Vitrual Human Interaction (VHI) to train outpatient clinicians in emotional self-awarenss (ESA), which includes both recognition of one’s own negative emotional respones and ability to engage in verbal empathic communication with acutely suicidal patients. Further, we will establish if the VHI ESA training intervention for clinicians will be superior to the VHI Control condition of risk assessment in reducing their patients’ suicidal ideation and the severity of their Suicide Crisis Syndrome. We will also determine if therapeutic alliance is a mediator of the relationship between clinicians’ ESA and their patients’ suicidal outcomes. For this purpose, we will use our established empathy-teaching platform and we will assess verbal empathy with the Empathic Communication Coding System, and will assess the impact of clinician training with our novel validated instruments: the Therapist Response Questionnaire – Suicide Form which assesses negative emotional responses to suicidal patients, and the Suicide Crisis Inventory, which predicts near-term suicidal behavior. If we are sucessful, the proposed work may have a broad impact on clinician training and practice by adding an ESA dimension to clinicians’ training in evidence-based suicide risk assessment. Suicide is preventable and it is our goal to create an industry-standard platform to train clinicians in ESA, thereby improving their skills and confidence in interacting with suicidal patients, which can ultimately save lives.

项目总结/摘要 尽管经过多年的研究和公众的关注，自杀率仍在继续攀升， 自杀仍然是美国18 - 65岁人群的主要死因。一半自杀 死者在自杀前几个月看过临床医生，这提供了一个独特的机会， 进行可能挽救生命的干预与有自杀倾向的病人一起工作压力很大， 临床医生和往往elelevens强大的负面情绪反应，可能会产生不利影响， 自杀的后果。可能的原因在于，消极的情绪反应可能会导致更少的 同情的沟通和病人的不知情的拒绝，这可能会损害 治疗联盟因此，需要对临床医生进行有效管理其 对自杀患者的负面情绪，这将导致自杀的改善 结果。为了产生影响，培训必须基于网络，可扩展，易于传播。 在这个项目中，我们将解决这一关键需求，并使用虚拟人机交互（VHI）来训练 门诊临床医生在情绪自我意识（ESA），其中包括识别一个人的 自己的负面情绪反应和能力，从事口头移情沟通， 有强烈自杀倾向的病人此外，我们将确定VHI ESA培训干预是否适用于 临床医生将优于VHI控制条件的风险评估，以减少他们的病人， 自杀意念和自杀危机综合症的严重程度。我们还将确定， 治疗联盟是临床医生的ESA与患者的ESA之间关系的中介者 自杀的后果。为此，我们将利用我们建立的同情教学平台， 我们将用移情沟通编码系统评估言语移情，并将评估 临床医生培训的影响与我们的新型验证仪器：治疗师的反应 问卷-自杀表，用于评估自杀患者的负面情绪反应， 以及自杀危机调查表，预测近期的自杀行为。如果我们成功了， 通过增加ESA，拟议的工作可能会对临床医生的培训和实践产生广泛的影响 临床医生在循证自杀风险评估方面的培训。自杀是 我们的目标是创建一个行业标准平台，以培训ESA的临床医生， 从而提高他们与自杀患者互动的技能和信心， 最终拯救生命。

项目成果

Assessing the predictive ability of the Suicide Crisis Inventory for near-term suicidal behavior using machine learning approaches.

• DOI: 10.1002/mpr.1863
• 发表时间: 2021-03
• 期刊: International journal of methods in psychiatric research
• 影响因子: 3.1
• 作者: Parghi N;Chennapragada L;Barzilay S;Newkirk S;Ahmedani B;Lok B;Galynker I
• 通讯作者: Galynker I

Behind therapists' emotional responses to suicidal patients: A study of the narrative crisis model of suicide and clinicians' emotions.

• DOI: 10.1111/sltb.12730
• 发表时间: 2021-08
• 期刊: Suicide & life-threatening behavior
• 影响因子: 3.2
• 作者: Ying G;Chennapragada L;Musser ED;Galynker I
• 通讯作者: Galynker I

Using Virtual Patients to Assess and Improve Clinicians' Emotional Self-awareness: a Randomized Controlled Study.

使用虚拟患者评估和提高临床医生的情绪自我意识：一项随机对照研究。

• DOI: 10.1007/s40596-023-01909-z
• 发表时间: 2024
• 期刊: Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
• 作者: Sarli,Giuseppe;Rogers,MeganL;Bloch-Elkouby,Sarah;Lawrence,OliviaC;GomesdeSiqueira,Alexandre;Yao,Heng;Lok,Benjamin;Foster,Adriana;Galynker,Igor
• 通讯作者: Galynker,Igor

Two sides of the same coin? Empirical examination of two proposed characterizations of acute suicidal crises: Suicide crisis syndrome and acute suicidal affective disturbance.

同一枚硬币的两面？

• DOI: 10.1016/j.jpsychires.2023.05.001
• 发表时间: 2023
• 期刊: Journal of psychiatric research
• 影响因子: 4.8
• 作者: Rogers,MeganL;Jeon,MinEun;Zheng,Sifan;Richards,JenelleA;Joiner,ThomasE;Galynker,Igor
• 通讯作者: Galynker,Igor

Perceived clinical utility of the suicide crisis syndrome: A multisite pilot study.

自杀危机综合症的临床效用：多中心试点研究。

• DOI: 10.1037/ser0000779
• 发表时间: 2023
• 期刊: Psychological services
• 影响因子: 2.3
• 作者: Mitelman,AlexisM;Bafna,Anokhi;Rogers,MeganL;White,Betsy;Karsen,Ethan;Vaaler,Arne;Wolfe,AmberR;Goncearenco,Inna;Galynker,Igor
• 通讯作者: Galynker,Igor