Mindfulness-Based Cognitive Therapy for Preventing Suicide in Military Veterans

描述(由申请人提供)： 标题：基于正念的认知疗法预防退伍军人自杀研究：安娜·克莱恩博士目标：这项建议的目的是在抑郁症基于正念的认知疗法的基础上，对VA高危自杀名单上的患者实施和评估基于正念的团体干预，以满足自杀退伍军人的特殊需求(基于正念的认知疗法-S)。MBCT在抑郁症患者中显示了积极的结果，而正念方法在管理经常伴随自杀行为的情绪失调和冲动方面表现出了有效性。这项建议的主要目的是进行一项随机对照试验，比较MBCT-S和常规治疗(TAU)，以获得关键治疗结果的数据。感兴趣的主要结果包括自杀事件(广义上定义为包括一系列与自杀有关的想法和行为)和自杀企图。这两个结果都将使用哥伦比亚自杀严重程度评定表中的项目进行操作。此外，我们还将探讨干预对自杀意念、抑郁和绝望的影响，采用贝克自杀意念量表、贝克抑郁问卷和贝克绝望量表测量自杀意念、抑郁和绝望。方法：本研究将采用随机对照试验，将164名退伍军人随机分配到新泽西州退伍军人保健系统的自杀高危名单中，接受S联合常规治疗或仅接受常规治疗。两组将在基线以及基线后4、8、24和52周就自杀意念、自杀企图和其他感兴趣的结果的标准化测量进行比较。我们的大型两校区设施每年接待12,000名独特的精神疾病患者，每月约有15名新患者加入高风险名单，确保有足够的人口在这个单一地点注册研究。结果：这项研究有可能为大量自杀退伍军人增加经济有效的治疗选择范围，而循证心理治疗对这些退伍军人来说是非常有限的。它还可能启动一项新的研究，解决自杀干预方面的一个关键空白。如果有效，这种疗法将加强退伍军人管理局现有的自杀预防努力，并减少试图或完成自杀的退伍军人数量。

DESCRIPTION (provided by applicant): Title: Mindfulness-Based Cognitive Therapy for Preventing Suicide in Military Veterans Investigator: Anna Kline, Ph.D. Objectives: The aim of this proposal is to implement and evaluate a mindfulness-based group intervention for patients on the VA high risk for suicide list based on the Mindfulness Based Cognitive Therapy (MBCT) program for depression, modified to address the special needs of suicidal veterans (MBCT-S). MBCT has shown positive outcomes with depressed patients, while the mindfulness approach has demonstrated effectiveness in managing the emotional dysregulation and impulsivity that frequently accompany suicidal behavior. The primary aim of this proposal is to conduct a randomized controlled trial comparing MBCT-S to treatment as usual (TAU) to obtain data on key treatment outcomes. Primary outcomes of interest include suicide events (defined broadly to include a range of suicide-related thoughts and behaviors) and suicide attempts. Both outcomes will be operationalized using items from the Columbia Suicide Severity Rating Scale. Additionally, we will explore the effects of the intervention on suicide ideation, depression and hopelessness measured by the Beck Scale for Suicide Ideation, the Beck Depression Inventory and the Beck Hopelessness Scale. Methods: The study will involve a randomized-controlled trial, in which 164 veterans assigned to the high-risk for suicide list at the VA New Jersey Health Care System (VANJ) will be randomly assigned to MBCT-S plus treatment-as-usual (TAU) or TAU only. The two groups will be compared at baseline and at 4, 8, 24 and 52 weeks post-baseline on standardized measures of suicidal ideation, attempts and other outcomes of interest. Our large, two-campus facility, which sees 12,000 unique mental health patients per year, adds approximately 15 new patients to the high risk list per month, insuring an ample population for study enrollment at this single site. Outcomes: This study has the potential to increase the range of cost effective treatment alternatives for the sizeable number of suicidal veterans for whom evidence-based psychotherapies are severely limited. It may also initiate a new line of research addressing a key gap in interventions for suicide. If effective, the therapy will enhance the VA's existing suicide prevention efforts and reduce the number of veterans who attempt or complete suicide.