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.

项目概要： 然而，目前患有严重精神疾病（SMI）的退伍军人的自杀率非常高。 尽管在退伍军人事务部范围内实施了 丰富的自杀预防服务和全国自杀热线的开通代表了这种可怕的状况。 一个严重的公共卫生问题和干预措施的关键目标。 康复研究与开发服务 (RR&D) 的行为健康和重新融入社会计划 强调需要制定自杀预防干预措施，以加强社会重新融入， 功能成果，并提高社会功能（SF）的整体参与度， 基础情感神经科学研究的大量证据表明，有效的 SF 需要完整的 具体来说，情绪可以提供有关事物重要性的重要信息。 社交情境，并有助于指导应对此类情境的潜在行动。 经验在表明需要调整个人当前状态或 由于不同的情绪可能需要使用不同的应对策略，因此缺乏或减少了意识。 经历过的感受可能使个人难以选择有效应对的应对策略 与这些发现一致的是，最近的报告表明述情障碍是一种 以情绪意识差为特征的跨诊断临床综合征，在人群中非常普遍 退伍军人和具有 SMI 人群的平民，最近的一项大型系统回顾和荟萃分析表明 述情障碍预测自杀意念和行为（分别具有大和小效应）。 之前的报告表明述情障碍会对治疗结果产生不良影响。 研究结果表明述情障碍可能在影响退伍军人自杀风险和治疗反应方面发挥关键作用。 然而，尽管其普遍存在、慢性表现、与 SMI 和不良 SF 相关，并对临床结果产生影响， 尚未在患有 SMI 且有自杀风险的退伍军人中调查述情障碍对自杀风险的推定影响 基于这些发现，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移动健康干预措施，旨在针对述情障碍和 较差的 SF 可以降低患有 SMI 的退伍军人的自杀风险，采用概念验证设计，40 名参与者将进行研究。 参加每周针对情绪意识和 SF 的团体心理教育课程以及创新的课程 通过智能手机进行 mHealth 情绪意识技能培训，以减少述情障碍、增强 SF 并减少 本研究的结果将提供自杀风险的全面特征。 SMI 的退伍军人，提供初步的可接受性和可行性数据，并将为开发提供信息 随机临床试验，测试干预措施改善该人群自杀风险的功效。