Prevention of Suicidality in College Students: A Common Core Process Approach

预防大学生自杀：共同的核心过程方法

• 批准号: 7687964
• 负责人: STEVEN C HAYES
• 金额: $ 56.77万
• 依托单位: UNIVERSITY OF NEVADA RENO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-19 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7687964
• 关键词: 20 year old; Affect; Alcohol abuse; American; Anxiety; Anxiety Disorders; Counseling; Disease; Education; Emotions; Foundations; Frequencies; Gender; Health; Hour; Institution; Intervention; Lead; Life; Mediator of activation protein; Mental Health; Mental Health Associations; Monitor; Mood Disorders; Outcome; Participant; Pharmaceutical Preparations; Prevention; Prevention program; Preventive Intervention; Problem behavior; Process; Public Health; Race; Randomized; Randomized Controlled Clinical Trials; Reporting; Risk Behaviors; Self-Injurious Behavior; Severities; Social Problems; Structure; Students; Substance abuse problem; Suicide; Suicide attempt; Suicide prevention; Symptoms; Testing; Thinking; United States; Visit; accomplished suicide; base; behavioral health; brief prevention intervention; chronic pain; college; cost; depression; distress tolerance; experience; follow-up; group intervention; help-seeking behavior; intervention effect; mindfulness; physical conditioning; prevent; psychoeducational; psychologic; psychosocial; public health relevance; response; satisfaction; social; suicidal; treatment effect; university student

DESCRIPTION (provided by applicant): Suicide and suicidality is a substantial public health problem among the 16 million college students in the United States: in a given year 9% seriously consider suicide and 1.3% reported having actually attempted suicide (American College Health Association, 2007). While treatment is helpful (Schwartz, 2006), 90% of those college students who commit suicide never sought help within their institution (Gallagher, 2006). Prevention is a logical response, but few broad scale suicide prevention programs targeted specifically toward college students have been tested. Part of the problem is that suicidality is not just the end result of any one disorder it can be an aspect of a wide variety of problems including drug and alcohol abuse (Mean et al., 2005), affective disorders (Moscicki, 2001), anxiety disorders (Sareen, Houlahan, Cox, & Asmundson, 2005), thought disorders (Siris, 2001), problems in social relationships (Helliwell, 2007), and some physical health problems (e.g., Tang & Crane, 2006). There is substantial and growing evidence that experiential avoidance -- the tendency to avoid unwanted emotions and negative thoughts -- is a core common process that contributes to the diverse psychological and behavior problems that lead to suicidality and suicide (e.g., Hayes et al., 1996; Hayes, Strosahl, Wilson, Bissett, Pistorello et al., 2004). Acceptance and mindfulness-oriented interventions have been shown to reduce experiential avoidance and thereby reduce the common psychological problems that are predictive of suicidality (Hayes et al, 2006). This project proposes to evaluate an acceptance and mindfulness-based intervention Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999) -- in a randomized trial in which 720 18 to 20 year old college freshmen are assigned in three annual waves of 240 students each to receive either ACT or a didactic course on adjustment to the psychological challenges of college life. The impact of the intervention will be assessed on: (a) experiential avoidance, (b) a range of psychological, behavioral, health, and academic problems that are known to predict suicidality, and (c) the frequency or severity of suicidality, self-injury, suicide attempts, ER visits, and other risky behaviors. These processes and outcomes will be monitored for two to three years (depending on the wave of intervention). A preventive intervention for college students could be readily disseminated within the higher education structure, suggesting that a successful classroom-based preventative approach could have broad public health implications. PUBLIC HEALTH RELEVANCE: Suicide and suicidality among the nation's 16 million college students is a substantial public health problem (American College Health Association, 2007) that needs to be prevented. Because it is known that experiential avoidance -- the tendency to avoid unwanted emotions and negative thoughts -- is a core common process that contributes to the diverse psychological and behavior problems that lead to suicidality and suicide (Hayes et al., 1996; Hayes et al., 2004), the present project tests the impact of an acceptance and mindfulness-oriented intervention (Hayes et al., 1999) that has been shown to reduce experiential avoidance and thereby reduce the common psychological problems that are predictive of suicidality (Hayes et al, 2006). If successful, a preventive intervention for college students could be readily disseminated within the higher education structure, giving such an approach broad public health implications.

自杀和自杀倾向是美国1600万大学生中的一个重大公共卫生问题：在给定的一年中，9%的大学生认真考虑自杀，1.3%的大学生实际上试图自杀（美国大学健康协会，2007）。虽然治疗是有帮助的（Schwartz，2006），但90%自杀的大学生从未在他们的机构内寻求帮助（Gallagher，2006）。预防是一个合乎逻辑的反应，但很少有大规模的自杀预防计划专门针对大学生进行了测试。问题的一部分在于自杀不仅仅是任何一种疾病的最终结果 它可以是包括药物和酒精滥用在内的多种问题的一个方面（Mean等人，2005）、情感障碍（Moscicki，2001）、焦虑症（Sareen，Houlahan，考克斯，& Asmundson，2005）、思维障碍（Siris，2001）、社会关系问题（Helliwell，2007）和一些身体健康问题（例如，Tang和起重机，2006）。有大量和越来越多的证据表明，经验性回避-避免不想要的情绪和消极思想的倾向-是一个核心的共同过程，有助于导致自杀和自杀的各种心理和行为问题（例如，Hayes等人，1996; Hayes，Strosahl，Wilson，Bissett，Pistorello等人，2004年）。接受和正念导向的干预措施已被证明可以减少经验回避，从而减少预测自杀的常见心理问题（Hayes et al，2006）。本项目旨在评估基于接受和正念的干预 接受和承诺疗法（ACT; Hayes，Strosahl和Wilson，1999）-在一项随机试验中，720名18至20岁的大学新生被分配到三个年度波，每个240名学生接受ACT或关于适应大学生活心理挑战的教学课程。将评估干预的影响：（a）经验性回避，（B）已知可预测自杀倾向的一系列心理、行为、健康和学术问题，以及（c）自杀倾向、自伤、自杀企图、急诊室就诊和其他危险行为的频率或严重程度。这些进程和结果将被监测两到三年（取决于干预的浪潮）。对大学生的预防性干预可以很容易地在高等教育结构中传播，这表明一个成功的以课堂为基础的预防性方法可能会产生广泛的公共卫生影响。公共卫生相关性：全国1600万大学生的自杀和自杀倾向是一个重大的公共卫生问题（美国大学健康协会，2007年），需要预防。因为众所周知，经验性回避--避免不想要的情绪和消极思想的倾向--是一个核心的共同过程，它导致了导致自杀和自杀的各种心理和行为问题（Hayes et al.，1996; Hayes等人，2004年），本项目测试的影响，接受和正念导向的干预（海斯等人，1999），已被证明可以减少经验性回避，从而减少预测自杀倾向的常见心理问题（Hayes等人，2006）。如果成功的话，大学生的预防性干预措施可以很容易地在高等教育结构中传播，使这种方法具有广泛的公共卫生意义。