Suicide Prevention Among Substance Abusing Homeless Youth

滥用药物的无家可归青少年的自杀预防

基本信息

批准号：
9221305
负责人：
NATASHA SLESNICK
金额：
$ 15.4万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-03-15 至 2019-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9221305
关键词：
Accident and Emergency department Address Adolescent Adult Age Alcohol abuse Alcohol or Other Drugs use Attention Behavior Cause of Death Childhood Chronic Cognitive Cognitive Therapy Complement Dangerousness Data Dehumanization Drops Drug abuse Drug usage Family Feeling hopeless Feeling suicidal Goals HIV risk Health Health Services Accessibility Health Status Healthcare Home environment Homeless Youth Homelessness Hospitalization Hospitals Impulsivity Intervention Life Light Literature Low income Mediating Mediator of activation protein Mental Depression Mental Health Mental Health Services Mental disorders Modeling Outcome Outcome Study Pilot Projects Population Premature Mortality Preventive Intervention Problem Solving Randomized Randomized Clinical Trials Recruitment Activity Reporting Research Risk Risk Factors Running Sampling Services Sexual abuse Shelter facility Social Network Social support Stress Suicide Suicide attempt Suicide prevention System Testing Theoretical model Time Victimization Vulnerable Populations Youth accomplished suicide alcohol use initiation base depressive symptoms distress tolerance effective intervention effectiveness trial experience follow up assessment follow-up foster care help-seeking behavior high risk population human capital improved physical abuse physical conditioning prevention service primary outcome psychologic public health relevance reducing suicide secondary outcome social social exclusion suicidal adolescent suicidal behavior suicidal risk suicide attempter theories treatment effect young adult

项目摘要

DESCRIPTION (provided by applicant): While research on homeless youth is increasing, there is a dearth of information regarding effective interventions for these youth. This is of significant concern because studies indicate that 70-95% report problem alcohol or drug use and 66% to 89% of homeless youth have a mental health disorder (Cauce et al., 2004). Suicide is the leading cause of death with up to 68% of youth reporting a lifetime suicide attempt (Rotheram-Borus & Milburn, 2004; Yoder, Whitbeck, & Hoyt, 2010). Among those who have attempted, an average of 6.2 attempts is reported. In addition, lifetime suicide ideation rates have ranged from 14% to 66.5% (Kingree et al., 2001; Merscham et al., 2010; Yoder, Whitbeck, & Hoyt, 2010). Some predictors of suicide among homeless youth have been identified. These include substance use, childhood physical and sexual abuse, victimization experiences while living on the streets, and psychological functioning, including depression, hopelessness, distress tolerance, impulse control, social support, and problem solving. This study uses general cognitive theory (Beck, 1967), complemented with concepts from two suicide specific theoretical models, to guide our intervention and conceptual change model. Consonant with the pilot R34 announcement, this study's goal is to pilot test an intervention that has previously demonstrated feasibility and promise with adolescent suicide attempters (Brent et al., 2009; Stanley et al., 2009) and efficacy with a low-income sample of adults, "The Cognitive Therapy Intervention for Suicide Attempters" (Brown et al., 2005). One-hundred fifty homeless youth with recent severe suicide ideation will be randomly assigned to the experimental cognitive therapy for suicide prevention (CTSP) + services as usual (SAU) (n=75) or to SAU alone (n=75). SAU includes those services normally offered through a local drop-in center. Follow-up assessments will be conducted at 3, 6, and 9-months post-baseline. It is hypothesized that youth receiving CTSP+SAU will show greater reductions in suicide ideation (primary outcome), substance use and depressive symptoms (secondary outcomes) over time compared to SAU alone. Furthermore, theoretically-derived mediators will be tested to shed light on mechanisms associated with change. The data from this study will be used to determine the initial efficacy of this promising intervention, and determine whether findings warrant a broader scale effectiveness trial. Ultimately, attention towards reducing suicide risk among these youth has the potential to reduce premature mortality, hospitalization and loss of human capital in a very high risk population of youth.

描述（由申请人提供）：虽然对无家可归青少年的研究不断增加，但缺乏有关对这些青少年进行有效干预的信息，这一点值得关注，因为研究表明，70-95% 的青少年报告存在酗酒或吸毒问题，66% 的青少年报告存在酗酒或吸毒问题。 89% 的无家可归青少年患有精神健康障碍（Cauce 等人，2004 年），自杀是导致死亡的主要原因，高达 68% 的青少年报告一生有过自杀企图。（Rotheram-Borus 和 Milburn，2004 年；Yoder、Whitbeck 和 Hoyt，2010 年）据报告，尝试过自杀的人平均有 6.2 次。此外，终生自杀意念发生率在 14% 到 66.5% 之间（Kingree）。等人，2001；Merscham 等人，2010； 2010）已确定了无家可归青少年自杀的一些预测因素，其中包括药物使用、童年身体虐待和性虐待、流落街头的受害经历以及心理功能，包括抑郁、绝望、痛苦承受能力、冲动控制、社会支持。本研究使用一般认知理论（Beck，1967），辅以两种自杀特定理论模型的概念，来指导我们的干预和概念改变模型，与试点 R34 公告一致，本研究的目标是试点。测试一项干预措施，该干预措施先前已在青少年自杀企图者中证明了可行性和前景（Brent 等人，2009 年；Stanley 等人，2009 年），并在低收入成年人样本中验证了有效性，“针对自杀企图者的认知治疗干预”（ Brown 等人，2005）。一百五十名最近有严重自杀意念的无家可归的青少年将被随机分配接受预防自杀的实验性认知疗法（CTSP）+照常服务（SAU）。 (n=75) 或单独 SAU (n=75)，SAU 包括通常通过当地临时中心提供的服务，将在基线后 3、6 和 9 个月进行。研究发现，与单独使用 SAU 相比，随着时间的推移，接受 CTSP+SAU 的青少年自杀意念（主要结果）、物质使用和抑郁症状（次要结果）将出现更大程度的减少。这项研究的数据将用于确定这一有前途的干预措施的初步效果，并确定研究结果是否值得进行更广泛的有效性试验，最终，关注降低这些年轻人的自杀风险有可能。减少青年高危人群的过早死亡、住院治疗和人力资本损失。