Alexithymia Intervention for Suicide (ALEXIS)

自杀述情障碍 (ALEXIS)

• 批准号: 10588348
• 负责人: DAVID KIMHY
• 金额: --
• 依托单位: JAMES J PETERS VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10588348
• 关键词: Address; Affect; Affective; Aggressive behavior; Alexithymias; Awareness; Bipolar Disorder; Cellular Phone; Chronic; Clinical; Clinical Trials; Data; Development; Dose; Emotional; Emotions; Feeling; Feeling suicidal; Goals; Hospitals; Individual; Intervention; Interview; Link; Mental Depression; Mental Health; Meta-Analysis; Methods; Neurosciences Research; Numbness; Outcome; Participant; Patients; Pilot Projects; Play; Population; Post-Traumatic Stress Disorders; Prevalence; Psychotherapy; Public Health; Quality of life; Recording of previous events; Rehabilitation therapy; Reporting; Risk; Sampling; Schizophrenia; Services; Signal Transduction; Social Functioning; Societies; Structure; Substance Use Disorder; Suicide; Suicide attempt; Suicide prevention; Symptoms; Syndrome; Technology; Treatment Efficacy; Treatment outcome; Veterans; Violence; acceptability and feasibility; affective neuroscience; behavioral health; clinical diagnostics; design; digital; efficacy testing; emotional experience; experience; feasibility testing; functional outcomes; improved; indexing; informant; innovation; mHealth; novel; novel strategies; pharmacologic; prevention service; preventive intervention; programs; psychoeducation; psychoeducational; psychosis risk; randomized, clinical trials; recruit; reducing suicide; rehabilitation research; research and development; response; service utilization; severe mental illness; skills training; social; social situation; suicidal; suicidal behavior; suicidal risk; suicide hotline; suicide rate; systematic review; therapy design; therapy development; treatment response

Project Summary: Suicide rates among veterans with Serious Mental Illness (SMI) are intractably high. Yet, at present available treatments offer only minimal to limited benefits to ameliorate this risk, despite a VA-wide implementation of enriched suicide prevention services and the availability of a national suicide hotline. This dire state represents a serious public health concern and a critical target for interventions. In response to this state, the Rehabilitation Research & Development Service (RR&D)’s Behavioral Health & Social Reintegration Program has highlighted the need for development of suicide prevention interventions that enhance social reintegration, functional outcomes, and improve overall participation in society. Germane to Social Functioning (SF), extensive evidence from basic affective neuroscience research indicates that effective SF requires intact emotion awareness. Specifically, emotions are posited to provide crucial information about the significance of social situations and help to guide potential actions to be taken to navigate such situations. Negative emotional experiences in particular have critical informational value in signaling the need to adjust one’s current state or activity. As different emotions may call for the use of distinct response strategies, lack of or reduced awareness of experienced feelings may make it difficult for individuals to choose response strategies for dealing effectively with social situations, resulting in poor SF. Consistent with these findings, recent reports indicate alexithymia, a transdiagnostic clinical syndrome characterized by poor emotion awareness, to be highly prevalent among veteran and civilians with SMI populations, with a recent large systematic review and meta-analysis indicating alexithymia predicting suicide ideation and behavior (with large and small effect sizes, respectively). Relatedly, previous reports indicate alexithymia has a detrimental impact on treatment outcomes. Altogether, these findings suggest alexithymia may play a key role in impacting suicide risk and treatment response in veterans. Yet, despite its pervasiveness, chronic presentation, link to SMI and poor SF, and impact on clinical outcomes, the putative impact of alexithymia on suicide risk has not been investigated in veterans with SMI at risk of suicide. Building on these findings, the goal of this project is to test the feasibility and acceptability of a novel, blended psychoeducation and digital mHealth (mobile health) intervention designed to target alexithymia and poor SF to reduce suicide risk in veterans with SMI. Employing a proof-of-concept design, 40 participants will attend weekly group psychoeducation sessions targeting emotion awareness and SF along with an innovative mHealth emotion awareness skill training via smartphone to reduce alexithymia, enhance SF, and reduce suicide risk. Results from the present study will provide comprehensive characterization of suicide risk among veterans with SMI, provide preliminary acceptability and feasibility data, and will inform the development of a randomized clinical trial to test the efficacy of the intervention to ameliorate suicide risk in this population.

项目概要： 患有严重精神疾病（SMI）的退伍军人的自杀率非常高。然而，目前可用的 尽管VA范围内实施了 丰富了自杀预防服务，并开通了全国自杀热线。这种可怕的状态代表着 这是一个严重的公共卫生问题，也是一个重要的干预目标。为响应此状态， 康复研究与发展服务（RR&D）的行为健康和社会融合方案 强调需要制定预防自杀的干预措施，以促进社会重新融合， 功能性成果，并改善社会的整体参与。德国社会功能（SF）， 来自基础情感神经科学研究的大量证据表明，有效的SF需要完整的 情绪意识具体地说，情绪被假定为提供关于以下重要性的关键信息： 社交情境，并帮助指导要采取的潜在行动来驾驭这些情境。负面情绪 特别是经验具有重要的信息价值，表明需要调整一个人的当前状态， 活动由于不同的情绪可能要求使用不同的反应策略，缺乏或减少意识 经验丰富的感受可能会使个人难以选择有效应对的应对策略 社会状况，导致SF差。与这些发现一致，最近的报告表明述情障碍， 以情绪意识差为特征的跨诊断临床综合征，在 退伍军人和患有SMI人群的平民，最近的一项大型系统综述和荟萃分析表明， 述情障碍可预测自杀想法和行为（效应量分别为大和小）。相关地， 之前的报告表明述情障碍对治疗结果有不利影响。总之，这些 研究结果表明，述情障碍可能在影响退伍军人的自杀风险和治疗反应方面发挥关键作用。 然而，尽管它的普遍性，慢性表现，与SMI和SF差的联系，以及对临床结果的影响， 尚未在患有重度精神分裂症的退伍军人中研究述情障碍对自杀风险的推定影响， 自杀基于这些发现，本项目的目标是测试一部小说的可行性和可接受性， 混合心理教育和数字mHealth（移动的健康）干预，旨在针对述情障碍， 低SF降低SMI退伍军人的自杀风险。采用概念验证设计，40名参与者将 参加每周一次的团体心理教育课程，目标是情绪意识和SF沿着创新的 通过智能手机进行mHealth情绪意识技能培训，以减少述情障碍，增强SF，并减少 自杀风险本研究的结果将提供自杀风险的综合特征， 退伍军人与SMI，提供初步的可接受性和可行性数据，并将告知发展， 随机临床试验，以测试干预措施改善这一人群自杀风险的有效性。