Digital Mental Health Intervention for Nonsuicidal Self-Injury in Young Adults

针对年轻人非自杀性自残的数字心理健康干预

• 批准号: 10591569
• 负责人: DAVID CURTIS MOHR
• 金额: $ 28万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-14 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10591569
• 关键词: Address; Adherence; Adolescent; Affect; Age; Anxiety; Attitude; Behavior; Behavioral; Borderline Personality Disorder; Cicatrix; Cognitive; Collaborations; Collection; Coping Skills; Data; Development; Disclosure; Distress; Ecological momentary assessment; Education; Effectiveness; Effectiveness of Interventions; Elderly; Emotional; Ethnic Origin; Feeling suicidal; Frequencies; Fright; Future; Gender; Goals; Hospitalization; Human; Impairment; Individual; Intervention; Investigational Therapies; Life; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methods; Motivation; Outcome; Outcome Assessment; Participant; Performance; Persons; Population; Population Intervention; Prevalence; Procedures; Race; Randomized; Randomized, Controlled Trials; Recording of previous events; Regulation; Reporting; Research; Resources; Risk; Role; Self Efficacy; Self-Injurious Behavior; Services; Severities; Social isolation; Suicide; Suicide prevention; Symptoms; Time; Tissues; Trauma; Waiting Lists; Work; Workplace; age group; arm; behavior change; cost; cost effective; demographics; design; digital mental health; effectiveness validation; emotion regulation; evidence base; experience; feasibility trial; follow-up; high risk; improved; interest; lifetime risk; non-suicidal self injury; patient engagement; preference; primary outcome; programs; psychiatric comorbidity; psychoeducation; psychoeducational; psychologic; recruit; secondary outcome; skills; skills training; social stigma; suicidal; suicidal risk; therapy design; usability; user centered design; young adult

PROJECT SUMMARY Nonsuicidal self-injury (NSSI) is estimated to affect 13% of young adults and is associated with considerable burden, including significant role impairment in daily life, increased risk of developing a mental health disorder, hospitalization, permanent scarring. Repeated NSSI is also associated with high lifetime risk of suicide. Timely interventions aimed at NSSI reduction could have a significant impact on improving mental health and suicide prevention. However, around 50% of young adults never disclose their NSSI to anyone, and far fewer ever seek professional help. Despite these low rates of disclosure and engagement with formal mental healthcare, young people with NSSI report interest in, and receptivity to, digital mental health interventions (DMHIs). Research has shown the effectiveness of DMHIs when applied to treat common mental health conditions, such as depression and anxiety. Given NSSI’s prevalence, the potential for the behavior to result in severe and lethal outcomes, and young adults’ openness to DMHIs, an effective and usable DMHI for NSSI could provide a unique, accessible, and scalable treatment option. We aim to design, develop, and conduct a feasibility trial for a low-intensity DMHI for young adults with repeated NSSI, which can meet the need to provide services to individuals unlikely to engage in formal treatment. Two key challenges for DMHIs are maintaining participant engagement and supporting skill implementation in critical moments of distress. Our DMHI will address challenges with engagement through the use of a highly interactive conversational agent and by evaluating the added benefit of a coach. Our DMHI will also tailor content and interactions to the user’s current state, by using ecological momentary assessment to assess NSSI risk and initiate relevant in-the-moment interventions to support users in implementing new coping strategies. The primary goals of the project are to: (1) design and develop a DMHI for young adults with repeated NSSI, in close collaboration with potential users from this population; (2) examine the feasibility of conducting a 3-arm randomized control trial of the self-guided DMHI treatment and the DMHI treatment with low-intensity coaching, compared to a wait-list control, with frequency of NSSI behaviors and urges as the primary outcomes, and suicidal ideation and depression, anxiety, and borderline personality disorder symptom severity as secondary outcomes; and (3) explore the mediational effects of psychological targets (emotional, cognitive, and behavioral regulation; self-efficacy to resist NSSI) and engagement targets (app use and subjective engagement) on NSSI frequency and urges. This program of research aims to produce a scalable DMHI for NSSI, based on validated psychological strategies.

项目摘要 非杀伤性自伤（NSSI）估计会影响13％的年轻人，并且与 大量伯恩（Burnen），包括在日常生活中的重要作用障碍，增加了发展心理的风险 健康障碍，住院，永久性疤痕。重复的NSSI也与高终身风险有关 自杀。针对NSSI减少的及时干预措施可能会对改善心理的重大影响 健康和自杀预防。但是，约有50％的年轻人从未向任何人透露其NSSI，并且 寻求专业帮助的少得多。尽管披露率很低，并且与正式互动 心理保健，NSSI的年轻人报告了数字心理健康的兴趣和接受性 干预措施（DMHIS）。研究表明，应用DMHI的有效性用于治疗共同的心理 健康状况，例如抑郁和动画。考虑到NSS​​I的流行，行为的潜力 导致严重和致命的结果，以及年轻人对DMHIS的开放性，这是一个有效且可用的DMHI NSSI可以提供独特，可访问且可扩展的治疗选择。我们旨在设计，开发和 对重复NSSI的年轻人进行低强度DMHI的可行性试验，可以满足 需要为个人提供正式治疗的个人提供服务。 DMHI的两个主要挑战是维持参与者的参与和支持技能实施 在关键时刻。我们的DMHI将通过高度使用参与来应对挑战 交互式对话代理，并通过评估教练的额外好处。我们的DMHI也将裁缝 通过使用生态瞬时评估来评估用户当前状态的内容和互动 NSSI风险并启动相关时刻的干预措施，以支持用户实施新应对 策略。 该项目的主要目标是：（1）为重复的年轻人设计和开发DMHI NSSI与该人群的潜在用户密切合作； （2）检查进行A的可行性 自引导DMHI处理和DMHI治疗的3臂随机对照试验低强度 与等待列表的控制相比，教练的频率是NSSI的行为和冲动作为主要的 结果，自杀的思想和抑郁，动画和边缘性人格症状严重程度 作为次要结果； （3）探索心理目标的中介作用（情感，认知， 和行为调节；抵抗NSSI和参与目标的自我效能感（应用和主观 参与）在NSSI频率和冲动方面。该研究计划旨在生产可扩展的DMHI NSSI，基于经过验证的心理策略。