Youth Nominated Support Team for Suicidal Adolescents at Clinical High Risk for Psychosis

青年提名支持团队，为临床精神病高危自杀青少年提供支持

基本信息

批准号：
10430596
负责人：
Jordan DeVylder
金额：
$ 27.49万
依托单位：
UNIVERSITY OF CALIFORNIA-IRVINE
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-03-11 至 2025-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10430596
关键词：
Address Adherence Adolescent Adolescent and Young Adult Caring Client Clinic Clinical Clinical Trials Collaborations Consensus Coordinated Specialty Care Data Development Diagnosis Dissemination and Implementation Distal Early Intervention Evidence based practice Family Family member Feasibility Studies Feeling hopeless Feeling suicidal Focus Groups Friends Funding Grant Health behavior Impairment Individual Intervention Interview Manuals Mental Health Mental Health Services Meta-Analysis Modeling Participant Persons Phase Population Practice Guidelines Preparation Prevalence Prevention approach Protocols documentation Provider Psychoses Psychotic Disorders Randomized Randomized Clinical Trials Randomized Controlled Trials Recording of previous events Recovery Reporting Research Personnel Resources Safety Schizophrenia Self-Injurious Behavior Services Signs and Symptoms Site Social isolation Social support Structure Suicide Suicide attempt Suicide prevention Testing Training Treatment Protocols United States Substance Abuse and Mental Health Services Administration Youth acceptability and feasibility active control aged base brief intervention clinical high risk for psychosis comparative efficacy cost effective depressive symptoms design duration of untreated psychosis efficacy testing evidence base experience feasibility testing follow-up health service use high risk high risk population intervention delivery meetings mortality person centered pilot trial preference prevention service preventive intervention programs psychoeducation psychoeducational psychosis risk randomized trial reducing suicide response social success suicidal suicidal adolescent suicidal behavior suicidal risk suicide rate support network telehealth treatment risk young adult

项目摘要

PROJECT SUMMARY / ABSTRACT Psychotic disorders are characterized by high rates of suicidal ideation and behavior, and the risk for suicide appears to be greatest during the earliest stages of psychosis. A recent meta-analysis showed that the majority of youth at clinical high-risk (CHR) for psychosis experience suicidal ideation, and that approximately one in five make at least one suicide attempt. There are, however, no suicide prevention interventions specifically tailored to the needs of transition-aged youth at CHR, and no current best practice guidelines for how to respond to suicide risk in this population. The Youth-Nominated Support Team (YST) intervention has recently been shown to reduce mortality among adolescents and is potentially highly adaptable within the context of existing CHR services. YST is intended as an adjunctive treatment and is primarily delivered towards support persons rather than the youth themselves, and therefore would not interfere or overlap with the already extensive direct services provided in CHR treatment settings. The proposed project intends to adapt the YST intervention for CHR populations and to provide pilot efficacy data for a larger subsequent randomized trial. Specifically, we aim to: (1) adapt YST for CHR based on stakeholder input (i.e., clients, family/friends, clinicians) and to develop a new treatment manual; (2) to implement YST in a single CHR clinic and to revise the intervention based on input from clients, providers, and support persons, and (3) to conduct a pilot randomized clinical trial at four SAMHSA funded CHR sites. For the first stage of this study, we intend to conduct six focus groups (two of clients, two of family members, and two of clinicians) to gather input on needs and preferences regarding suicide prevention. This information will be incorporated into the YST protocol through expert consensus meetings (i.e., study investigators, clinicians, and consultants) and used to develop a treatment manual. During the second stage of the project, we will conduct a small feasibility study using this intervention manual at the primary study site (N=8), and will again gather input from clients, providers, and support persons to further revise the treatment manual. In the final stage, we will conduct a pilot randomized clinical trial of the adapted YST intervention at four CHR clinics (N=70), comparing the adapted YST intervention to an active control condition consisting of safety planning, crisis resources, and means restriction. The proximal targets will be social connectedness, hope, and treatment engagement, and the distal targets suicidal ideation and behavior (e.g., attempts, preparatory actions). This study will provide the first clinical trial data for targeted suicide prevention among the CHR population. Findings will inform best practices for addressing suicide risk in the CHR phase of illness and facilitate the development of a subsequent larger randomized clinical trial incorporating additional CHR clinics to further test the efficacy of the adapted YST intervention and to identify underlying mechanisms of change.

项目摘要 /摘要精神病性疾病的特征是自杀念头和行为的高率，以及在精神病的最早阶段，自杀似乎是最大的。最近的荟萃分析表明临床高风险（CHR）的大多数青年进行精神病经历自杀构想，大约五分之一的人至少进行了一次自杀企图。但是，有没有针对Chr的过渡年轻青年的需求而定制的自杀性预防干预措施，并且没有有关如何在该人群中应对自杀风险的最佳实践指南。这青年提名的支持团队（YST）干预最近已被证明可以降低死亡率在青少年中，在现有CHR服务的背景下可能具有高度适应性。 YST旨在作为辅助治疗，主要是向支持人员提供的比青年本身，因此不会干扰或重叠已经广泛的 CHR治疗环境中提供的直接服务。拟议的项目打算适应YST 干预CHR人群，并为更大的随后提供试验疗效数据随机试验。具体而言，我们的目标是：（1）根据利益相关者的投入（即，客户，家人/朋友，临床医生）并制定新的治疗手册；（2）在单个CH诊所并根据客户，提供者和支持的投入来修改干预措施人和（3）在四个SAMHSA资助的CHR站点进行试验的随机临床试验。为了这项研究的第一阶段，我们打算进行六个焦点小组（两个客户，两个家庭成员和两名临床医生）收集有关自杀需求和偏好的意见预防。这些信息将通过专家共识将其纳入YST协议会议（即研究研究人员，临床医生和顾问），并用于开发治疗手动的。在项目的第二阶段，我们将使用此研究进行一项小型可行性研究主要研究站点的干预手册（n = 8），并将再次收集客户，提供者，并支持人员进一步修改治疗手册。在最后阶段，我们将进行飞行员在四个CHR诊所（n = 70）的改编的YST干预的随机临床试验，比较改编的YST干预措施针对由安全计划，危机资源组成的主动控制条件，意味着限制。近端目标是社会联系，希望和治疗参与以及远端目标是自杀的构想和行为（例如，尝试，准备动作）。这项研究将提供第一个临床试验数据，以预防针对性的自杀 CHR人口。调查结果将为解决自杀风险的最佳实践提供信息疾病并促进随后的大型随机临床试验的发展其他CHR诊所，以进一步测试适应的YST干预的功效并确定基本变化机制。