Adapting Dialectical Behavior Therapy for Children with Suicidality and/or Self-H

对有自杀倾向和/或自我 H 的儿童采用辩证行为疗法

基本信息

批准号：
8543757
负责人：
Francheska Perepletchikova
金额：
$ 23.9万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2015-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8543757
关键词：
11 year old 14 year old Accident and Emergency department Adaptive Behaviors Address Adolescence Adolescent Adult Affect Age Aggressive behavior Algorithms American Behavior Behavior Therapy Behavioral Biometry Bite Caregivers Caring Case Management Categories Cause of Death Child Child Abuse and Neglect Childhood Classification Client Clinical Clinical Psychology Clinical Trials Competence Consultations Coping Skills Death Rate Development Dialectical behavior therapy Doctor of Philosophy Drops Economic Burden Educational Materials Emotional Epidemic Etiology Evaluation Evidence based treatment Family Feeling Feeling suicidal Fostering Future Genetic Goals Health Personnel Home environment Hospitalization Individual Inpatients Intervention Interview Knowledge Life Cycle Stages Manuals Measures Medical Mental Depression Mentors Modeling Moods Neurobiology Patients Pharmaceutical Preparations Phase Pilot Projects Post-Traumatic Stress Disorders Procedures Property Psychometrics Psychopathology Psychotherapy Questionnaires Rage Randomized Clinical Trials Reading Recording of previous events Reporting Research Research Personnel Research Project Grants Research Support Risk Risk Factors Selection Criteria Self-Injurious Behavior Self-control as a personality trait Services Societies Subjects Selections Suicide Suicide attempt Supervision Symptoms System Target Populations Techniques Training Training Activity Trauma Treatment Efficacy Universities Validation Validity and Reliability Videotape Violence Visit Work Youth accomplished suicide aged caregiver education child protective service coping cost cost effective depressive symptoms early onset emotion regulation experience foster care ideation improved maltreated children maltreatment meetings mortality prognostic psychosocial research and development satisfaction skills skills training social skills suicidal suicidal adolescent suicidal behavior treatment adherence treatment as usual trial comparing

项目摘要

Suicide and suicidal behaviors in youth are occurring at an epidemic rate. In the past 20 years death rates for suicide for youth 5 to 14 years of age have doubled. In 2005, suicide was the sixth leading cause of death in the USA for 5- to 14-year-olds and the third leading cause of death for 10- to 14-year-olds. The medical cost of suicide for Americans aged 0 to 20 approaches $1 billion a year. Although completed suicides are less frequent in childhood than in adolescence, the rate of 14.4 suicide attempts for every suicide in 10- to 11-year- olds indicates that suicide attempts are quite frequent in childhood. Further, suicidality is strongly associated with non-suicidal self-harm behaviors (e.g., cutting) as up to 40% of those who engage in self-harm report having suicidal ideations and up to 85% have attempted suicide at least once. Despite the urgent need, there are no empirically supported treatments, including psychosocial and pharmacological interventions, to address suicidality and self-harm behaviors in at risk children. The proposed research project will involve adapting Dialectical Behavior Therapy (DBT) for maltreated children (ages 7 to 12) with suicidality (ideations and attempts) and/or self-harm behaviors. DBT is an empirically supported intervention for adults with suicidality and self-harm behaviors, and is currently the only empirically supported intervention for suicidal adolescents. DBT engages patients in treatment and is cost effective, as clients receiving this treatment require fewer psychiatric hospitalizations and emergency room visits. Candidate: Dr. Perepletchikova received her Ph.D. in Clinical Psychology from Yale University. She has extensive clinical experience working with children and their families, expertise in treatment integrity of psychotherapy research, received intensive training in DBT, and has worked clinically with adults and adolescents using DBT model. Further, her preliminary studies support feasibility, acceptability and initial efficacy of DBT skills training for children. Training goals: 1) work closely with experts in the field of psychotherapy development research; 2) acquire knowledge in childhood maltreatment research and interventions, suicidality and self-harm behaviors, and interfacing with the child protective services system; 3) acquire expertise in conducting randomized clinical trials; 4) take courses in biostatistics and fundamentals of clinical trials; and 5) acquire knowledge on the neurobiological effects of trauma, and genetic and environmental predictors of risk and resiliency, to better understand the etiology of these symptoms in children. Research goals: 1) adapt established adult/adolescent DBT treatment manuals and treatment integrity measures for DBT for children; and 2) conduct a pilot randomized clinical trial comparing DBT for children with Treatment-As-Usual with maltreated children in state custody with suicidality and/or self- harm behaviors. The proposed training activities and research project will allow Dr. Perepletchikova to transition into an independent investigator with a specific focus on addressing the needs of maltreated children, including suicidality and self-harm behaviors.

青少年的自杀和自杀行为正在以流行的速度发生。过去20年的死亡率 5 至 14 岁青少年的自杀人数增加了一倍。 2005年，自杀是第六大死因是美国 5 至 14 岁儿童的第三大死因，也是 10 至 14 岁儿童的第三大死因。医疗费用为 0 至 20 岁的美国人每年自杀造成的损失接近 10 亿美元。尽管完成自杀的人数较少儿童期的自杀率高于青春期，10 至 11 年间每自杀一次，就有 14.4 次自杀未遂的比率 olds 表明自杀企图在童年时期相当频繁。此外，自杀与自杀密切相关高达 40% 的自残者报告有非自杀性自残行为（例如割伤）有自杀念头，并且高达 85% 的人至少尝试过自杀一次。尽管需求迫切，但没有经验支持的治疗方法，包括心理社会和药物干预，来解决高危儿童的自杀和自残行为。拟议的研究项目将涉及适应针对受虐待且有自杀倾向的儿童（7 至 12 岁）的辩证行为疗法 (DBT) 尝试）和/或自残行为。 DBT 是针对有自杀倾向的成年人的一种有经验支持的干预措施和自残行为，是目前唯一有经验支持的针对自杀青少年的干预措施。 DBT 让患者参与治疗，并且具有成本效益，因为接受这种治疗的客户需要更少的药物精神病住院和急诊室就诊。候选人：Perepletchikova 博士获得博士学位。在耶鲁大学临床心理学。她在儿童及其儿童方面拥有丰富的临床经验家庭、心理治疗研究治疗完整性方面的专业知识、接受过 DBT 强化培训，并拥有使用 DBT 模型对成人和青少年进行临床工作。此外，她的初步研究支持儿童DBT技能培训的可行性、可接受性和初步效果。培训目标：1）紧密合作心理治疗发展研究领域的专家； 2）获得有关儿童虐待的知识研究和干预、自杀和自残行为以及与儿童保护者的互动服务体系； 3）获得进行随机临床试验的专业知识； 4）学习生物统计学课程和临床试验的基础知识； 5）获得有关创伤的神经生物学影响的知识，以及风险和复原力的遗传和环境预测因子，以更好地了解这些风险的病因儿童症状。研究目标：1) 改编现有的成人/青少年 DBT 治疗手册和儿童 DBT 治疗诚信措施； 2) 进行一项试点随机临床试验，比较针对在国家监护下受到虐待、有自杀倾向和/或自我毁灭的儿童进行常规治疗的 DBT 伤害行为。拟议的培训活动和研究项目将使 Perepletchikova 博士能够转变为独立调查员，特别关注解决受虐待儿童的需求，包括自杀和自残行为。