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

基本信息

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
项目类别：
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

项目摘要

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.

项目概要据估计，非自杀性自伤 (NSSI) 会影响 13% 的年轻人，并且与相当大的负担，包括日常生活中的重大角色损害，患精神疾病的风险增加健康障碍、住院治疗、永久性疤痕反复出现也与终生罹患高风险有关。旨在减少 NSSI 的及时干预可能对改善心理产生重大影响。然而，大约 50% 的年轻人从未向任何人透露过他们的 NSSI，并且尽管信息披露和正式参与的比例很低，但寻求专业帮助的人却少得多。心理保健方面，患有 NSSI 的年轻人表示对数字心理健康感兴趣并接受研究表明 DMHI 在应用于治疗常见心理问题时是有效的。考虑到 NSSI 的患病率，这种行为有可能会导致抑郁和焦虑。导致严重和致命的结果，以及年轻人对 DMHI 的开放态度，DMHI 是一种有效且可用的 DMHI NSSI 可以提供独特、易于使用且可扩展的治疗方案，我们的目标是设计、开发和实施。对反复出现 NSSI 的年轻人进行低强度 DMHI 的可行性试验，可满足需要向不太可能接受正规治疗的个人提供服务。 DMHI 面临的两个主要挑战是保持参与者的参与和支持技能实施在危难的关键时刻，我们的 DMHI 将通过使用高度参与来应对挑战。交互式对话代理并通过评估教练的额外优势，我们的 DMHI 还将进行定制。通过生态瞬时评估来评估用户当前状态的内容和交互 NSSI 风险并启动相关的即时干预措施以支持用户实施新的应对措施策略。该项目的主要目标是：(1) 为患有反复发作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) 研究开展一项研究的可行性；自我引导 DMHI 治疗和低强度 DMHI 治疗的三臂随机对照试验与等待名单控制相比，辅导以 NSSI 行为和冲动的频率作为主要因素结果、自杀意念以及抑郁、焦虑和边缘性人格障碍症状的严重程度作为次要结果；（3）探索心理目标（情绪、认知、和行为调节；抵抗 NSSI 的自我效能）和参与目标（应用程序使用和主观 NSSI 频率和敦促的参与）该研究计划旨在为以下群体提供可扩展的 DMHI。 NSSI，基于经过验证的心理策略。