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：
8700519
负责人：
Francheska Perepletchikova
金额：
$ 24.89万
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 2016-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8700519
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.

年轻人的自杀和自杀行为以流行率发生。在过去20年中的死亡率 5至14岁的青年自杀增加了一倍。 2005年，自杀是第六位死亡原因美国为5至14岁，是10至14岁的第三大死亡原因。医疗费用每年为0至20岁的美国人的自杀。尽管完成的自杀较少童年时期的频繁而不是青春期，每次自杀的率在10至11年中的自杀率。老年人表明，自杀企图在童年时期很常见。此外，自杀性密切相关以非杀害自我伤害的行为（例如，削减）为自我伤害报告的人中有40％具有自杀念头和多达85％的自杀率至少一次自杀。尽管需要迫切需要没有经验支持的治疗方法，包括社会心理和药理干预措施，以解决自杀和自我伤害的行为在风险的儿童中。拟议的研究项目将涉及适应患有自杀性的虐待儿童（7至12岁）的辩证行为疗法（DBT）尝试）和/或自我伤害行为。 DBT是针对自杀性成年人的经验支持的干预措施和自我伤害的行为，目前是自杀青少年的唯一经验支持的干预措施。 DBT吸引患者进行治疗，并且具有成本效益，因为接受此治疗的客户需要更少精神科住院和急诊就诊。候选人：Perepletchikova博士获得博士学位。在耶鲁大学的临床心理学。她与儿童及其他们的临床经验丰富家庭，心理治疗研究的治疗完整性专业知识，接受了DBT的深入培训，并且使用DBT模型与成人和青少年一起临床工作。此外，她的初步研究支持 DBT技能培训对儿童的可行性，可接受性和最初功效。培训目标：1）与心理治疗发展研究领域的专家； 2）获取儿童虐待方面的知识研究和干预措施，自杀性和自我伤害行为以及与儿童保护性接触服务系统； 3）获得进行随机临床试验的专业知识； 4）参加生物统计学课程和临床试验的基本面； 5）获取有关创伤的神经生物学影响的知识，风险和弹性的遗传和环境预测指标，以更好地了解这些病因儿童的症状。研究目标：1）适应已建立的成人/青少年DBT治疗手册和儿童DBT的治疗完整性度量； 2）进行比较的试验随机临床试验 DBT适用于与虐待儿童接受自杀和/或自我拘留的儿童治疗的儿童伤害行为。拟议的培训活动和研究项目将使Perepletchikova博士能够过渡到独立调查员，特别着眼于满足虐待儿童的需求，包括自杀和自我伤害行为。