Alexithymia Intervention for Suicide (ALEXIS)

自杀述情障碍 (ALEXIS)

• 批准号: 10588348
• 负责人: DAVID KIMHY
• 金额: --
• 依托单位: JAMES J PETERS VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10588348
• 关键词: Address; Affect; Affective; Aggressive behavior; Alexithymias; Awareness; Bipolar Disorder; Cellular Phone; Chronic; Clinical; Clinical Trials; Data; Development; Dose; Emotional; Emotions; Feeling; Feeling suicidal; Goals; Hospitals; Individual; Intervention; Interview; Link; Mental Depression; Mental Health; Meta-Analysis; Methods; Neurosciences Research; Numbness; Outcome; Participant; Patients; Pilot Projects; Play; Population; Post-Traumatic Stress Disorders; Prevalence; Psychotherapy; Public Health; Quality of life; Recording of previous events; Rehabilitation therapy; Reporting; Risk; Sampling; Schizophrenia; Services; Signal Transduction; Social Functioning; Societies; Structure; Substance Use Disorder; Suicide; Suicide attempt; Suicide prevention; Symptoms; Syndrome; Technology; Treatment Efficacy; Treatment outcome; Veterans; Violence; acceptability and feasibility; affective neuroscience; behavioral health; clinical diagnostics; design; digital; efficacy testing; emotional experience; experience; feasibility testing; functional outcomes; improved; indexing; informant; innovation; mHealth; novel; novel strategies; pharmacologic; prevention service; preventive intervention; programs; psychoeducation; psychoeducational; psychosis risk; randomized, clinical trials; recruit; reducing suicide; rehabilitation research; research and development; response; service utilization; severe mental illness; skills training; social; social situation; suicidal; suicidal behavior; suicidal risk; suicide hotline; suicide rate; systematic review; therapy design; therapy development; treatment response

Project Summary: Suicide rates among veterans with Serious Mental Illness (SMI) are intractably high. Yet, at present available treatments offer only minimal to limited benefits to ameliorate this risk, despite a VA-wide implementation of enriched suicide prevention services and the availability of a national suicide hotline. This dire state represents a serious public health concern and a critical target for interventions. In response to this state, the Rehabilitation Research & Development Service (RR&D)’s Behavioral Health & Social Reintegration Program has highlighted the need for development of suicide prevention interventions that enhance social reintegration, functional outcomes, and improve overall participation in society. Germane to Social Functioning (SF), extensive evidence from basic affective neuroscience research indicates that effective SF requires intact emotion awareness. Specifically, emotions are posited to provide crucial information about the significance of social situations and help to guide potential actions to be taken to navigate such situations. Negative emotional experiences in particular have critical informational value in signaling the need to adjust one’s current state or activity. As different emotions may call for the use of distinct response strategies, lack of or reduced awareness of experienced feelings may make it difficult for individuals to choose response strategies for dealing effectively with social situations, resulting in poor SF. Consistent with these findings, recent reports indicate alexithymia, a transdiagnostic clinical syndrome characterized by poor emotion awareness, to be highly prevalent among veteran and civilians with SMI populations, with a recent large systematic review and meta-analysis indicating alexithymia predicting suicide ideation and behavior (with large and small effect sizes, respectively). Relatedly, previous reports indicate alexithymia has a detrimental impact on treatment outcomes. Altogether, these findings suggest alexithymia may play a key role in impacting suicide risk and treatment response in veterans. Yet, despite its pervasiveness, chronic presentation, link to SMI and poor SF, and impact on clinical outcomes, the putative impact of alexithymia on suicide risk has not been investigated in veterans with SMI at risk of suicide. Building on these findings, the goal of this project is to test the feasibility and acceptability of a novel, blended psychoeducation and digital mHealth (mobile health) intervention designed to target alexithymia and poor SF to reduce suicide risk in veterans with SMI. Employing a proof-of-concept design, 40 participants will attend weekly group psychoeducation sessions targeting emotion awareness and SF along with an innovative mHealth emotion awareness skill training via smartphone to reduce alexithymia, enhance SF, and reduce suicide risk. Results from the present study will provide comprehensive characterization of suicide risk among veterans with SMI, provide preliminary acceptability and feasibility data, and will inform the development of a randomized clinical trial to test the efficacy of the intervention to ameliorate suicide risk in this population.

项目摘要： 患有严重精神疾病（SMI）的退伍军人的自杀率很高。但是，目前可用 治疗仅提供最小的利益，以改善这种风险，目的地是VA范围的实施 丰富的自杀预防服务和国家自杀热线的可用性。这个可怕的状态代表 严重的公共卫生问题和干预措施的关键目标。为了应对这种状态， 康复研究与发展服务（RR＆D）的行为健康与社会重返社会计划 已经强调了开发自杀预防干预措施的需求，以增强社会重返社会， 功能成果，并改善社会的整体参与。与社会功能（SF）的隐密性， 基本情感神经科学研究的大量证据表明，有效的SF需要完整 情感意识。特殊的情绪是提供有关重要信息的重要信息 社交场合，并有助于指导潜在的行动以应对此类情况。负面情绪 特别是经验在信号中具有关键的信息价值，以调整当前状态或 活动。由于不同的情绪可能要求使用不同的响应策略，缺乏或降低意识 经验丰富的感觉可能会使个人很难选择有效交易的响应策略 在社交情况下，导致SF差。与这些发现一致，最近的报告表明Alexithhymia，A 经诊断的临床综合征的特征是情绪意识不佳，在高度普遍存在 老兵和平民有SMI人口，最近进行了大量的系统审查和荟萃分析，表明 障碍症可以预测自杀的想法和行为（分别具有较大和小的效应大小）。有关的， 先前的报道表明，障碍症对治疗结果有不利影响。这些，这些 研究结果表明，急诊症可能在影响退伍军人的自杀风险和治疗反应中起关键作用。 然而，希望它的普遍性，长期表现，与SMI和差异不良的联系以及对临床结果的影响， 尚未在具有SMI风险的退伍军人中调查过障碍症对自杀风险的推定影响 自杀。在这些发现的基础上，该项目的目标是测试小说的可行性和可接受性， 混合心理教育和数字MHealth（移动健康）干预措施，旨在针对运动障碍和 SF较差，以降低SMI退伍军人的自杀风险。采用概念验证设计，40名参与者将 参加针对情感意识和科幻小说的每周小组心理教育课程以及创新的 通过智能手机培训MHealth的情感意识技能技巧，以减少Alectymia，增强SF并减少 自杀风险。本研究的结果将提供自杀风险的全面表征 具有SMI的退伍军人，提供初步的可接受性和可行性数据，并将告知开发 随机临床试验，以测试干预措施在该人群中改善自杀风险的效率。