Alexithymia Intervention for Suicide (ALEXIS)

项目总结： 患有严重精神疾病(SMI)的退伍军人的自杀率高得难以对付。然而，目前可用的 尽管在退伍军人事务部范围内实施了 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，也是干预措施的关键目标。为了响应这种状态， 康复研究与发展服务(RR&D)S行为健康与社会融合计划 强调需要制定预防自杀的干预措施，以促进重新融入社会， 功能结果，并提高社会的整体参与度。与社会功能(SF)密切相关， 基础情感神经科学研究的广泛证据表明，有效的SF需要完好无损 情感意识。具体地说，情绪被认为提供了关于fificance的重要信息 社会环境，并帮助指导可能采取的行动，以驾驭这种情况。负面情绪 经验尤其具有关键的信息价值，表明需要调整自己的当前状态或 活动。由于不同的情绪可能需要使用不同的反应策略，缺乏或减少意识 经验丰富的感觉可能会使个人很难选择有效应对的应对策略 与社交场合有关，导致科普成绩不佳。与这些发现一致的是，最近的报告表明述情障碍，一种 以情绪意识差为特征的跨诊断临床综合征在 患有SMI人群的退伍军人和平民，最近的一项大型系统回顾和荟萃分析表明 述情障碍预测自杀意念和行为(分别具有较大和较小的效应)。相关的是， 以前的报告表明，述情障碍对治疗结果有不利影响。总而言之，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，尽管它普遍存在，慢性表现，与SMI和糟糕的SF有关，并对临床结果产生影响， 述情障碍对自杀风险的假定影响尚未在有SMI风险的退伍军人中进行调查 自杀。基于这些发现，这个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移动健康(移动健康)干预，旨在针对述情障碍和 较差的SF可降低患有SMI的退伍军人的自杀风险。采用概念验证设计，40名参与者将 每周参加针对情感意识和SF的小组心理教育课程，并与创新的 通过智能手机进行MHealth情感感知技能培训，以减少述情障碍，增强SF，减少 自杀风险。本研究的结果将为以下人群提供自杀风险的全面表征 具有SMI的退伍军人，提供初步可接受性和可行性数据，并将为制定 随机临床试验，以测试干预措施改善该人群自杀风险的效果。

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.