A Mobile Intervention for Suicide Prevention For Middle-aged And Older Adults After a Suicide-Related Hospitalization

中老年人因自杀住院后预防自杀的移动干预

基本信息

批准号：
10559578
负责人：
DIMITRIS N KIOSSES
金额：
$ 77.87万
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：
2022
资助国家：
美国
起止时间：
2022-02-01 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10559578
关键词：
Admission activity Affect Age Blinded Characteristics Charge Clinical Clinical Trials Data Educational Materials Elderly Emotional Emotions Evaluation Exclusion Criteria Family Feeling suicidal Goals Hospitalization Hospitals Inpatients Intervention Interviewer Link Loneliness Measures Mental Depression Modeling National Institute of Mental Health Outcome Participant Patient Self-Report Patients Persons Phase Population Population Intervention Populations at Risk Prevention Psychotherapy Questionnaires Randomized Research Assistant Sampling Schedule Severities Signal Transduction Social Workers Suicide Suicide attempt Suicide prevention Tablets Techniques Testing Text Training Update acceptability and feasibility attentional control cognitive control cognitive reappraisal dosage emotion regulation high risk high risk population improved innovation instrument meetings member middle age novel perceived stress psychosocial reducing suicide sex stressor suicidal behavior suicidal risk suicide rate telecoaching therapy design treatment as usual usual care arm virtual

项目摘要

ABSTRACT The goal of this project is to refine and test WellPATH-PREVENT, a novel, mobile, principally stand-alone psychosocial intervention designed to improve cognitive reappraisal ability (target) and reduce suicide risk (outcome) in middle-aged and older adults (50-90 years old) who have been discharged after a suicide-related hospitalization (i.e. for suicidal ideation or suicide attempt). Suicide rates in this group are alarmingly high, and reducing suicide rates in at-risk populations is a major NIMH priority. Our conceptual framework views suicidal ideation and behavior as failed attempts to regulate negative emotions, and by improving cognitive reappraisal, an effective emotion regulation strategy, we expect to reduce suicide risk. WellPATH-PREVENT focuses on the training, coaching, and use of WellPATH app, a tablet-app that incorporates triggers, negative emotions, and personalized easy-to-use cognitive reappraisal techniques. The patient uses the tablet during emotionally charged situations and scheduled training sessions. The R61 phase is a proof-of-concept phase and its goals are to test WellPATH-PREVENT’s target engagement and optimization (6 vs. 12 weeks duration). Interventionists will administer WellPATH-PREVENT to 40 middle-aged and older adults (50-90 years old) after a suicide-related hospitalization. Research assistants, unaware of the study aims, will conduct assessments at study entry (admission/during hospitalization), discharge, 6 and 12 weeks post-discharge. Target engagement will be assessed with electrocortical measures (i.e. late positive potential, LPP), self-reported affect during an emotion regulation task, and Emotion Regulation Questionnaire (ERQ), an interviewer-administered instrument of cognitive reappraisal. The R33 phase aims to provide further evidence of target engagement of the optimized WellPATH- PREVENT in a larger sample, evaluate the relationship of cognitive reappraisal with suicide risk as measured with Columbia Suicide Severity Rating Scale (C-SSRS), examine preliminary signal of efficacy, and obtain implementation parameters for a large-scale clinical trial. A unique sample of 75 middle-aged and older adults (using the same inclusion/exclusion criteria as for the R61 phase) will be randomized (2 to 1) to WellPATH- PREVENT (N=50) or to Attention Control Usual Care (AC-UC) (a control condition with parallel delivery and a tablet that doesn’t include WellPATH) (N=25). Assessments will be conducted at study entry (admission/during hospitalization), discharge, 6, 12 and 24 weeks post-discharge. Primary aims are: 1) WellPATH-PREVENT participants will show improvement in cognitive reappraisal from discharge to end of treatment; 2) improvement in cognitive reappraisal in WellPATH-PREVENT participants will be associated with suicide risk over 24 weeks; and 3) examination of preliminary signal of efficacy of WellPATH-PREVENT vs. AC-UC on cognitive reappraisal and on suicide risk over 24 weeks.

抽象的该项目的目的是完善和测试Path-Path-Path-privent，这是一种小说，移动的，主要是独立的 psychosocial intervention designed to improve cognitive reappraisal ability (target) and reduce suicide risk （结果）在自杀相关后出院的中年和老年人（50-90岁） hospitalization (i.e. for suicidal ideation or suicide attempt). Suicide rates in this group are alarmingly high, and 降低高危人群中的自杀率是NIMH的主要优先级。我们的概念框架认为自杀构想，并被视为调节负面的失败尝试情绪，并通过改善认知重新评估，这是一种有效的情感调节策略，我们希望降低自杀风险。平板电脑应用结合触发器，负面情绪和个性化易于使用的认知重新标记技术。 R61阶段是概念验证阶段ATS目标是测试井路先驱的目标参与和优化（持续时间为6周）。自杀相关的住院后，有40名中年和老年人（50-90岁）助理不知道该研究的目的，将在研究入学时进行评估（入学/期间住院），分期收取后6周和12周。在情绪调节期间，电程式措施（即晚期积极潜力，LPP），自我报告的影响任务和情绪调节问卷（ERQ），一种认知的访谈者仪器重新评估。 R33阶段旨在提供进一步的证据，证明稳定井路的目标参与 - 在较大样本中，请评估认知重新评估与自杀风险的关系使用哥伦比亚自杀严重程度评级量表（C-SSR），检查疗效的预后信号并获得。大规模临床试验的实施参数。（使用与R61相相同的包含/排除标准）将被随机（2至1）与wellpath- 预防（n = 50）或授课控制常规护理（AC-UC）（具有平行交付和A的控制条件不包括WellPath的平板电脑（n = 25）。住院），分期后6、12和24周。参与者将从出院到治疗结束时的认知重新评估； 2）改进在Path-Path-Path-Path-Path-Path参与者的认知重新评估中，将在24周内与自杀风险有关； 3）检查WellPath-part的疗效与AC-UC对认知功效的初步信号在24周内重新评估和自杀风险。