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: 8073482
• 负责人: STEVEN C HAYES
• 金额: $ 52.88万
• 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/8073482
• 关键词: 20 year old; Affect; Alcohol abuse; American; Anxiety; Anxiety Disorders; Counseling; Disease; Drug abuse; Education; Emotions; Foundations; Frequencies; Gender; Health; Hour; Institution; Intervention; Lead; Life; Mediator of activation protein; Mental Depression; Mental Health; Mental Health Associations; Monitor; Mood Disorders; Outcome; Participant; Prevention; Prevention program; Preventive Intervention; Problem behavior; Process; Public Health; Race; Randomized; 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; distress tolerance; experience; follow-up; group intervention; help-seeking behavior; intervention effect; mindfulness; physical conditioning; prevent; psychoeducational; psychologic; psychosocial; randomized trial; 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.

描述（由申请人提供）：自杀和自杀是美国1600万大学生的一个重大公共卫生问题：在给定的一年中，有9％的人认真考虑自杀，1.3％的人报告实际上尝试过自杀（美国大学健康协会，2007年）。虽然治疗很有帮助（Schwartz，2006年），但自杀自杀的那些大学生中有90％从未在其机构内寻求帮助（Gallagher，2006年）。预防是一种合乎逻辑的回应，但是对针对大学生的专门针对大学生的大规模预防计划进行了测试。 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 （例如Tang＆Crane，2006）。有充分的证据表明，经验避免的避免情绪和负面思想的趋势是一个核心共同过程，它导致了导致自杀和自杀的多种心理和行为问题（例如，Hayes等，1996; Hayes，Hayes，Hayes，Strosahl，Strosahl，Wilson，Wilson，Bissett，Pistorelloello et al。已经证明接受和面向正念的干预措施可减少体验式回避，从而减少预测自杀性的常见心理问题（Hayes等，2006）。该项目建议评估基于正念和正念的干预接受和承诺疗法（ACT； Hayes，Strosahl和Wilson，1999年） - 在一项随机试验中，其中720 18至20岁的大学新生分配了三个年度的240名学生，每个人都会接受ACT或一项对大学心理挑战的调整课程，以接受ACT或教义课程。将评估干预措施的影响：（a）经验避免，（b）已知可以预测自杀性的一系列心理，行为，健康和学术问题，以及（c）自杀，自杀，自杀，自杀企图，ER访问，访问和其他冒险行为的频率或严重性。这些过程和结果将被监测两到三年（取决于干预浪潮）。可以在高等教育结构中容易传播给大学生的预防性干预，这表明成功的基于课堂的预防方法可能具有广泛的公共卫生影响。公共卫生相关性：全国1600万大学生中的自杀和自杀是一个实质性的公共卫生问题（美国大学健康协会，2007年），需要预防。 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从而减少了预测自杀性的常见心理问题（Hayes等，2006）。如果成功的话，可以在高等教育结构中容易传播给大学生的预防性干预，从而赋予公共卫生的广泛影响。