Disorders - Suicide or self-harm behaviours
Britton, Willoughby. B., Lepp, Nathaniel. E., Niles, Halsey. F., Rocha, Tomas., Fisher, Nathan. E., Gold, Jonathan. S.
The current study is a pilot trial to examine the effects of a nonelective, classroom-based, teacher-implemented, mindfulness meditation intervention on standard clinical measures of mental health and affect in middle school children. A total of 101 healthy sixth-grade students (55 boys, 46 girls) were randomized to either an Asian history course with daily mindfulness meditation practice (intervention group) or an African history course with a matched experiential activity (active control group). Self-reported measures included the Youth Self Report (YSR), a modified Spielberger State-Trait Anxiety Inventory, and the Cognitive and Affective Mindfulness Measure -Revised. Both groups decreased significantly on clinical syndrome subscales and affect but did not differ in the extent of their improvements. Meditators were significantly less likely to develop suicidal ideation or thoughts of self-harm than controls. These results suggest that mindfulness training may yield both unique and non-specific benefits that are shared by other novel activities.; Copyright © 2014 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
Journal of School Psychology, 52(3) : 263-278
- Year: 2014
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy
Christensen, Helen., Batterham, Philip. J., O'Dea, Bridianne.
Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals' posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain.;
International Journal of Environmental Research & Public Health, 11(8) : 8193-8212
- Year: 2014
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Technology, interventions delivered using technology (e.g. online, SMS)
Esposito-Smythers, C., Hadley, W., Brown, L. K., McKnight, P., Short, J., Weismoore, J., Miller, A. B., Schaefer, K., Martinson, L., Perloe, A.
Alcohol abuse, suicidal behavior, and HIV infection constitute three significant public health problems. Adolescents in mental health treatment are at heightened risk for the development of all three of these often inter-related problems. Yet, prevention programs that target all three of these areas have not been tested. The primary purpose of this study was to evaluate the efficacy of a familybased cognitive behavioral protocol designed to prevent alcohol dependence, suicidal behavior, and HIV risk behaviors among teens receiving communitymental health services in a randomized Stage I clinical trial. This protocol targets knowledge and coping skills deficits, inaccurate cognitions, communication problems, and maladaptive parenting behaviors found to be associated with the onset and progression of youth alcohol abuse, suicidality, and HIV risk behaviors.Eight-one adolescents (ages 12-18) receiving communitymental health treatment and their parents were randomly assigned to the prevention protocol (n=41) or an assessment-only control condition (n=40) as an adjunct to outpatient care. The prevention protocol included attendance at two workshops and an individualized booster session held one month later. Outcome was assessed at post-intervention, 6 month, and 12 month follow-ups. Results revealed greater increases in knowledge (HIV related), change in relevant cognition (e.g., perceived susceptibility, self-efficacy), comfort discussing sexual risk and alcohol/drug related issues, and some parental monitoring behaviors among youth who received the prevention protocol relative to controls (small to large effects sizes). They also reported greater reductions in binge drinking and increased condomuse with casual partners relative to youth in the control condition (small to large effect sizes). Differences in drinking days and condom use with serious partners were not found. There was also some evidence to suggest that the prevention program was associated with greater reductions in recent suicidal ideation and suicide attempts (small to large effect sizes) though results varied by assessment measure. Overall, results provide preliminary evidence to suggest that augmenting standard mental health treatment with a comprehensive family based prevention programthat targets multiple high risk behaviors may hold promise in offsetting the developmental trajectory alcohol abuse and othermaladaptive outcomes. Further testing of this type of protocol is warranted.
Alcoholism: Clinical & Experimental Research, 38 : 307A
- Year: 2014
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Harlow, A. F., Bohanna, I., Clough, A.
RESULTS: The search yielded 229 articles; 90 abstracts were assessed, and 11 articles describing nine programs were reviewed. Two Australian programs and seven American programs were included. Programs were culturally tailored, flexible, and incorporated multiple-levels of prevention. No randomized controlled trials were found, and many programs employed ad hoc evaluations, poor program description, and no process evaluation. CONCLUSION: Despite culturally appropriate content, the results of the review indicate that more controlled study designs using planned evaluations and valid outcome measures are needed in research on indigenous youth suicide prevention. Such changes may positively influence the future of research on indigenous youth suicide prevention as the outcomes and efficacy will be more reliable. BACKGROUND: Indigenous young people have significantly higher suicide rates than their non-indigenous counterparts. There is a need for culturally appropriate and effective suicide prevention programs for this demographic. AIMS: This review assesses suicide prevention programs that have been evaluated for indigenous youth in Australia, Canada, New Zealand, and the United States. METHOD: The databases MEDLINE and PsycINFO were searched for publications on suicide prevention programs targeting indigenous youth that include reports on evaluations and outcomes. Program content, indigenous involvement, evaluation design, program implementation, and outcomes were assessed for each article.
Crisis, 35(5) : 310-321
- Year: 2014
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
Alavi, A., Sharifi, B., Ghanizadeh, A., Dehbozorgi, G.
Objective: To evaluate the effectiveness of a Cognitive-Behavioral therapy (CBT) for suicide prevention in decreasing suicidal ideation and hopelessness in a sample of depressed 12 to 18 year-old adolescents who had at least one previous suicidal attempt.; Methods: In a clinical trial, 30 depressed adolescents who attempted suicide in the recent 3 months were selected using simple sampling method and divided randomly into intervention and wait-list control groups. Both groups received psychiatric interventions as routine. The intervention group received a 12 session (once a week) of CBT program according to the package developed by Stanley et al, including psychoeducational interventions and individual and family skills training modules. All of the patients were evaluated by Scale for Suicidal Ideation, Beck's hopelessness Inventory, and Beck's Depression Inventory before the intervention and after 12 weeks.; Findings: There were significant differences between the two groups regarding the scores of the above mentioned scales after 12 weeks. Fifty-four to 77 percent decreases in the mean scores of the used scales were observed in the invention group. There were no significant changes in the scores of the control wait-list group. The differences between pre- and post-intervention scores in the intervention group were significant.; Conclusion: CBT is an effective method in reducing suicidal ideation and hopelessness in the depressed adolescents with previous suicidal attempts.;
Iranian Journal of Pediatrics, 23(4) : 467-472
- Year: 2013
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
, Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Parker, B., Turner, W.
Background: The sexual abuse of children and adolescents is a significant worldwide problem. It is associated with a wide variety of negative psychological, social and physical consequences for the victims. These effects can often be seen immediately following sexual abuse, but they may manifest later on and sometimes only in adult life. There are a number of different interventions aimed at helping children and adolescents who have been sexually abused, and psychoanalytic/psychodynamic psychotherapy has a long-established tradition of being used for such victims. In this review, we set out to find the evidence for its effectiveness specifically in children and adolescents who have been sexually abused. Objectives: To assess the effectiveness of psychoanalytic/psychodynamic psychotherapy for children and adolescents who have been sexually abused. Search methods: We searched the following databases in May 2013: CENTRAL, Ovid MEDLINE, Embase, PsycINFO, CINAHL, Sociological Abstracts, Social Science Citation Index, Conference Proceedings Citation Index - Social Science and Humanities, LILACS and WorldCat. We also searched three trials registers, checked the reference lists of relevant studies and contacted known experts. Selection criteria: Randomised and quasi-randomised trials comparing psychoanalytic/psychodynamic psychotherapy with treatment as usual or no treatment/waiting list control for children and adolescents up to age of 18 who had experienced sexual abuse at any time prior to the intervention. Data collection and analysis: The review authors (BP and WT) independently screened search results to identify studies that met eligibility criteria. Main results: No studies were identified that met the inclusion criteria for this review. Authors' conclusions: There are no randomised and quasi-randomised trials that compare psychoanalytic/psychodynamic therapy with treatment as usual, no treatment or waiting list control for children and adolescents who have been sexually abused. As a result, we cannot draw any conclusions as to the effectiveness of psychoanalytic/psychodynamic psychotherapy for this population. This important gap emphasises the need for further research into the effectiveness of psychoanalytic/psychodynamic psychotherapy in this population. Such research should ideally be in the form of methodologically high-quality, large-scale randomised controlled trials. If these are not conducted, future systematic reviews on this subject may need to consider including other lower quality evidence in order to avoid overlooking important research. Copyright © 2013 The Cochrane Collaboration.
Cochrane Database of Systematic Reviews, 2013 (7) (no pagination)(CD008162) :
- Year: 2013
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Psychodynamic/Psychoanalysis
De Silva, S., Parker, A., Purcell, R., Callahan, P., Liu, P., Hetrick, S.
Background: Suicide and self-harm (SSH) in young people is a major cause of disability-adjusted life years. Effective interventions are of critical importance to reducing the mortality and morbidity associated with SSH. Aims: To investigate the extent and nature of research on interventions to prevent and treat SSH in young people using evidence mapping. Method: A systematic search for SSH intervention studies was conducted (participant mean age between 6 - 25 years). The studies were restricted to high-quality evidence in the form of systematic reviews, meta-analyses, and controlled trials. Results: Thirty-eight controlled studies and six systematic reviews met the study inclusion criteria. The majority (n = 32) involved psychological interventions. Few studies (n = 9) involved treating young people with recognized mental disorders or substance abuse (n = 1) which also addressed SSH. Conclusion: The map was restricted to RCTs, CCTs, systematic reviews, and meta-analyses, and thus might have neglected important information from other study designs. The effectiveness of interventions within the trials was not evaluated. The evidence base for SSH interventions in young people is not well established, which hampers best-practice efforts in this area. Promising interventions that need further research include school-based prevention programs with a skills training component, individual CBT interventions, interpersonal psychotherapy, and attachment-based family therapy. Gaps in the research exist in evaluations of interventions for SSH in young people with identifiable psychopathology, particularly substance use disorder, and research that classifies participants on the basis of their suicidal intent. (PsycINFO Database Record (c) 2013 APA, all rights reserved). (journal abstract)
Crisis, 34(4) : 223-232
- Year: 2013
- Problem: Non-suicidal self-harm behaviours
, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Complementary & Alternative Interventions (CAM)
, Service Delivery & Improvement, Psychological Interventions (any)
Crowe, M., Inder, M., Moor, S., Luty, S. E., Carter, J.
Objective: Rates of attempting and completing suicide are high in Bipolar Disorder (BD) with death due to suicide in 10-15% of patients (Simon, Hunkeler et al. 2007), up to 60-fold higher than in the general population (Neves, Malloy-Dinez et al. 2009). The high lethality of suicidal acts in bipolar disorders is suggested by a much lower ratio of attempts: suicide (approximately 3:1) than in the general population (approximately 30:1) (Baldessarini, Tondo et al. 2006). The association between BD and suicide attempts is wellestablished, however there is fairly limited prospective data reported and many studies exclude patients who have alcohol and/ or drug abuse/dependence, other Axis 1 comorbidity or suicidal ideation (Crowe, Whitehead et al. 2010). Methods: One hundred young people (15-36 years) were recruited to take part in an 18-month randomised controlled trial of Interpersonal and Social Rhythm Therapy (IPSRT) and Specialist Supportive Care (SSC). Participants were randomised to each therapy in addition to medication management from a psychiatrist. Data on lifetime suicide attempts was collected as baseline weeks 26, 52, 78, 104, 130, and 156, with additional questions on suicidal behaviour. Descriptive analyses including frequencies, percentages, means and standard deviations were undertaken on demographic, clinical and suicide data. Chi-square analyses and independent t-test were done to compare the characteristics of those participants who completed with those who were non-completers. Results: At baseline previous suicide attempts were common with 48 participants (7 males, 41 females) assessed by the treating psychiatrist as having attempted suicide. In the six months preceding the study, a total of 11 (22.9%) individuals, all female, made suicide attempts. The vast majority of participants at the time of the attempt indicated they wished to die with 2/3rds believing their attempt would result in death. In the 6 months prior to the study commencement, there were a total of 11 individuals who made attempts with a total of 18 actual attempts made. Over the course of the intervention and follow up period (156 weeks), 15 individuals made subsequent suicide attempts with a total of 28 attempts. During the course of the study there was one death by suicide. There were no statistical differences found in demographic, clinical or suicidal behaviour characteristics indicating no significant differences in these groups. Discussion: There were no statistical differences in the characteristics of suicide risk factors (gender, age, age of onset, previous attempts, substance or alcohol use disorder and anxiety disorder) between those we were able to follow-up (n = 73) and those that were lost to follow-up (n = 27). While there may be an association between the psychotherapy interventions and the reduction in suicide attempts, there are also other possible factors that could explain this. Larger numbers would be required before an association could be made more definitively. However these results add to the growing evidence that adjunctive psychosocial interventions may contribute to a reduction in suicide risk in bipolar individuals.
Bipolar Disorders, 15 : 97
- Year: 2013
- Problem: Bipolar Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
, Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Balaguru, V., Sharma, J., Waheed, W.
Background: Schools appear an obvious place to deliver suicide prevention interventions for children and adolescents. The complexity of suicide interventions lead to a paucity of good quality evidence. An alternate approach of information gathering is needed to identify and collate evidence from existing interventions. Scope: We completed a realist review of school-based suicide interventions. This is a novel method of understanding complex interventions that uses an iterative approach. In this review, we attempt to clarify and lay out what type of suicide intervention programme might be useful in schools, based on the local needs and context. Conclusion: It is possible to develop and implement an evidence-based suicide intervention in schools by understanding the different processes that can contribute to success or failure of these interventions in a real-world setting. (copyright) 2012 Association for Child and Adolescent Mental Health.
Child & Adolescent Mental Health, 18(3) : 131-139
- Year: 2013
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
Muriungi, S. K., Ndetei, D. M.
Objective. To determine the effectiveness of psycho-education on symptom severity in depression, hopelessness, suicidality, anxiety and risk of substance abuse among para-medical students at Kenya Medical Training College (KMTC). Methodology. A clinical trial drew experimental (N=1 181) and control (N=1 926) groups from different KMTC campuses. Self-administered questionnaires were used to collect data: the researcher-designed social demographic questionnaire was used at baseline only, while Beck's Depression Inventory, Beck's Hopelessness Scale, Beck's Suicide Ideation Scale, Beck's Anxiety Inventory and World Health Organization alcohol, smoking and substance involvement screening test (ASSIST) (for drug abuse) were used for baseline, mid-point and end-point assessments at 3-month intervals. The experimental group received a total of 16 hours of structured psycho-education. All study participants gave informed consent. Results. Overall, there was no significant reduction in symptom severity between the experimental and control groups at 3 months (p>0.05) but there was a significant difference at 6 months (p<0.05). Conclusion. Psycho-education was effective in reducing the severity of symptoms of depression, hopelessness, suicidality, anxiety and risk of substance abuse at 6 months.
South African Journal of Psychiatry, 19(2) : 41-50
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
, Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation
Ono, Y., Sakai, A., Otsuka, K., Uda, H., Oyama, H., Ishizuka, N., Awata, S., Ishida, Y., Iwasa, H., Kamei, Y., Motohashi, Y., Nakamura, J., Nishi, N., Watanabe, N., Yotsumoto, T., Nakagawa, A., Suzuki, Y., Tajima, M., Tanaka, E., Sakai, H., Yonemoto, N.
Background: Multilevel and multimodal interventions have been suggested for suicide prevention. However, few studies have reported the outcomes of such interventions for suicidal behaviours. Methods: We examined the effectiveness of a community-based multimodal intervention for suicide prevention in rural areas with high suicide rates, compared with a parallel prevention-as-usual control group, covering a total of 631,133 persons. The effectiveness was also examined in highly populated areas near metropolitan cities (1,319,972 persons). The intervention started in July 2006, and continued for 3.5 years. The primary outcome was the incidence of composite outcome, consisting of completed suicides and suicide attempts requiring admission to an emergency ward for critical care. We compared the rate ratios (RRs) of the outcomes adjusted by sex, age group, region, period and interaction terms. Analyses were performed on an intention-to-treat basis and stratified by sex and age groups. Findings: In the rural areas, the overall median adherence of the intervention was significantly higher. The RR of the composite outcome in the intervention group decreased 7% compared with that of the control group. Subgroup analyses demonstrated heterogeneous effects among subpopulations: the RR of the composite outcome in the intervention group was significantly lower in males (RR = 0.77, 95% CI 0.59 - 0.998, p = 0.0485) and the RR of suicide attempts was significantly lower in males (RR = 0.39, 95% CI 0.22 - 0.68, p = 0.001) and the elderly (RR = 0.35, 95% CI 0.17 - 0.71, p = 0.004). The intervention had no effect on the RR of the composite outcome in the highly populated areas. Interpretation: Our findings suggest that this community-based multimodal intervention for suicide prevention could be implemented in rural areas, but not in highly populated areas. The effectiveness of the intervention was shown for males and for the elderly in rural areas. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)
PLoS ONE, 8(10) :
- Year: 2013
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Controlled clinical trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement interventions
Klimes-Dougan, B., Klingbeil, D. A., Meller, S. J.
Background: While the ultimate goal of adolescent suicide-prevention efforts is to decrease the incidence of death by suicide, a critical intermediary goal is directing youths toward effective sources of assistance.; Aim: To comprehensively review the universal prevention literature and examine the effects of universal prevention programs on student's attitudes and behaviors related to help-seeking.; Method: We systematically reviewed studies that assessed help-seeking outcomes including prevention efforts utilizing (1) psychoeducational curricula, (2) gatekeeper training, and (3) public service messaging directed at youths. Of the studies reviewed, 17 studies evaluated the help-seeking outcomes. These studies were identified through a range of sources (e.g., searching online databases, examining references of published articles on suicide prevention).; Results: The results of this review suggest that suicide-prevention programming has a limited impact on help-seeking behavior. Although there was some evidence that suicide-prevention programs had a positive impact on students' help-seeking attitudes and behaviors, there was also evidence of no effects or iatrogenic effects. Sex and risk status were moderators of program effects on students help-seeking.; Conclusions: Caution is warranted when considering which suicidal prevention interventions best optimize the intended goals. The impact on adolescents' help-seeking behavior is a key concern for educators and mental-health professionals.;
Crisis, 34(2) : 82-97
- Year: 2013
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)