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Baker JC, Grover S, Gunn LH, Charles C, Rikli H, Franks MJ, Khazem LR, Williams S, Ammendola E, Washington C, Bennette M, Starkey A, Schnecke K, Cain S, Bryan CJ, Cramer RJ. Group brief cognitive behavioral therapy for suicide prevention compared to dialectal behavior therapy skills group for military service members: a study protocol of a randomized controlled trial. BMC Psychiatry 2023; 23:904. [PMID: 38053122 PMCID: PMC10696749 DOI: 10.1186/s12888-023-05282-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Suicide is a pressing matter for the military. Not only does it pose a health risk, but suicide also compromises operational readiness. Despite provision of suicide prevention clinical best practices, the Department of Defense suffers several challenges (e.g., clinician shortages) limiting the agency's ability to effectively respond to service member suicide. Implementation of evidence-based suicide-specific group therapy is a possible solution to service member well-being needs and system challenges. Service members can also gain coping skills useful beyond managing suicidal thoughts and behaviors. METHODS This 2-arm non-inferiority randomized controlled trial compares a group therapy format of Brief Cognitive Behavioral Therapy (i.e., G-BCBT) with Dialectical Behavior Therapy (DBT) Skills Group. Both therapies are delivered in-person at a United States Naval Medical Center. Participants (N = 136) are active-duty service members with recent suicidal thoughts or suicidal behavior. Evaluation features electronically delivered questionnaires at baseline, after each treatment session, and at 3- and 6-month follow-up. DISCUSSION The primary outcome concerns G-BCBT impacts on suicidal ideation. Secondary outcomes of interest are suicide attempt, psychological distress (e.g., symptoms of depression, anxiety), and self-regulatory skills (e.g., emotion regulation). We also examine self-regulatory skills as treatment moderators. Clinical trial strengths and limitations are reviewed. TRIAL REGISTRATION This study was registered at Clinicaltrials.gov (protocol NCT05401838).
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Affiliation(s)
- Justin C Baker
- The Ohio State University Wexner Medical Center, 1960 Kenny Road, Columbus, OH, 43210, USA.
| | - Shawna Grover
- Naval Medical Center Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA, 23708, USA
| | - Laura H Gunn
- University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Cindy Charles
- University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Heather Rikli
- University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Michael J Franks
- Naval Medical Center Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA, 23708, USA
| | - Lauren R Khazem
- The Ohio State University Wexner Medical Center, 1960 Kenny Road, Columbus, OH, 43210, USA
| | - Sean Williams
- The Ohio State University Wexner Medical Center, 1960 Kenny Road, Columbus, OH, 43210, USA
| | - Ennio Ammendola
- The Ohio State University Wexner Medical Center, 1960 Kenny Road, Columbus, OH, 43210, USA
| | - Cherita Washington
- University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Marquita Bennette
- Naval Medical Center Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA, 23708, USA
| | - Austin Starkey
- The Ohio State University Wexner Medical Center, 1960 Kenny Road, Columbus, OH, 43210, USA
- Louisiana State University, 236 Audubon Hall, Baton Rouge, LA, 70803, USA
| | - Kelly Schnecke
- The Ohio State University Wexner Medical Center, 1960 Kenny Road, Columbus, OH, 43210, USA
| | - Shannon Cain
- University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Craig J Bryan
- The Ohio State University Wexner Medical Center, 1960 Kenny Road, Columbus, OH, 43210, USA
| | - Robert J Cramer
- University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
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Colmenero-Navarrete L, García-Sancho E, Salguero JM. Relationship Between Emotion Regulation and Suicide Ideation and Attempt in Adults and Adolescents: A Systematic Review. Arch Suicide Res 2022; 26:1702-1735. [PMID: 34821201 DOI: 10.1080/13811118.2021.1999872] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Suicide is one of the main causes of death in adults and adolescents, so research focused on identifying risk factors for suicidal behavior is needed. In recent years, emotion regulation, mainly the presence of difficulties regulating one's own negative emotions, has been associated with negative mental health outcomes. OBJECTIVE The purpose of this study was to systematically review the available evidence on the association between emotion regulation and suicide (ideation and attempt) in both adults and adolescents. METHOD A systematic search of scientific articles published in English and Spanish was carried out through the databases PsycINFO, MEDLINE, Scopus, and the Cochrane Library. RESULTS We identified 76 eligible studies, of which 70 reported that people with difficulties in emotion regulation reported higher levels of suicide ideation and more suicide attempts. The results were consistent in adolescents and adults, in clinical and general population samples, and when studies assessed both emotion regulation processes and strategies. However, few studies were longitudinal and most of them were with women. CONCLUSIONS We discuss the theoretical implications of the results, suggesting that actual psychological models might benefit from considering individual differences in ER in understanding why people engage in suicide behavior. Clinical implications are also discussed.HIGHLIGHTSDifficulties regulating one's emotions is associated with suicide behavior (SI and SA).Consistent results at all the ages and in the clinical and general population.Individual differences in ER could help researchers to understand suicide.
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BIS sensitivity, BAS sensitivity, and recent suicide attempts. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2022.111552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Khoshfetrat A, Scully D, Fassbender C. Effects of behavioral inhibition/activation systems on anger rumination and anger expression through Difficulty in Emotion Regulation. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2022.111574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Relations between parental response to children's negative emotions and suicidal ideation in chinese adolescents: Internalizing problems, emotion regulation, and perceived relationship quality with parents as mediators. J Affect Disord 2022; 301:205-216. [PMID: 35033594 DOI: 10.1016/j.jad.2022.01.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 11/22/2022]
Abstract
Past work points to the crucial role of parents' responses to children's negative emotions (PRCNE) in adolescents' socioemotional adjustment. The presence of suicidal ideation (SI) is an important sign of significant distress and suicide risk. However, research on the relations between PRCNE and adolescents' SI is lacking. This research aimed to investigate whether parental reactions to children's negative emotions (PRCNE) was related to adolescents' SI and, if so, through which processes. This research utilized data from a sample of Chinese adolescent families (N = 4,574; Parents: 35.81% males, M = 44.07 years old; Adolescents: 55.40% males, M = 16.28 years old), with parents giving their reports on PRCNE and adolescents self-evaluating their psychosocial development (i.e., internalizing problems, emotion regulation, perceived relationship quality with parents) and SI. We examined the relations between six types of PRCNE and adolescents' SI, and analyzed the mediating roles of adolescents' internalizing problems, emotion regulation (i.e., cognitive reappraisal and expressive suppression), and perceived relationship quality with parents. The results showed that emotion-focused response, problem-focused response, and expression encouragement negatively predicted, while punitive response and distress response positively predicted adolescents' SI. However, no statistically significant association emerged between minimization and adolescents' SI. Moreover, adolescents' internalizing problems, usage of expressive suppression, and perceived relationship quality with parents could mediate the relations between PRCNE and adolescents' SI. Contrary to our hypothesis, the results did not support an indirect effect of PRCNE on adolescents' SI through adolescents' cognitive reappraisal. The present research illuminates adolescents' SI by emphasizing the roles of PRCNE. The findings also highlight the importance of paying attention to adolescents' internalizing problems, expressive suppression, and perceived relationship quality with parents in relation to PRCNE in interventions aimed at reducing adolescents' SI.
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Childhood adversity affects symptomatology via behavioral inhibition in patients with obsessive-compulsive disorder. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02718-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Perchtold-Stefan CM, Fink A, Bauer JF, Rominger C, Papousek I. High avoidance and low approach motivation affect cognitive reappraisal generation in the face of anger. CURRENT PSYCHOLOGY 2021; 42:5793-5803. [PMID: 36987512 PMCID: PMC10039092 DOI: 10.1007/s12144-021-01917-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
AbstractThis study investigates the link between the revised reinforcement sensitivity theory (RST) and individuals’ capacity to spontaneously invent alternate appraisals for aversive events. Eighty-two women completed the Reappraisal Inventiveness Test for anger-eliciting situations, and quantity and quality of reappraisal ideas were correlated with BIS, BAS, and FFFS sensitivity (RST-Personality Questionnaire). Results revealed that high BIS and high FFFS reduced the total number of reappraisal ideas, indicating that combined heightened sensitivity of the two avoidance systems may deplete individuals’ repertoire of potential reappraisals. RST effects on the quality of generated reappraisals were also found. High BIS and low BAS lowered individuals’ propensity to produce positive re-interpretations, which are considered a more adaptive reappraisal tactic. High FFFS sensitivity was linked to a lower preference for problem-oriented reappraisals. This study underlines that certain interactions of motivational subsystems may be particularly detrimental for successful reappraisal of anger-eliciting events. Our findings reveal potential links between revised RST effects and adaptive emotion regulation.
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Affiliation(s)
| | - Andreas Fink
- Department of Psychology, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
| | - Jonathan F. Bauer
- Department of Psychology, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
| | - Christian Rominger
- Department of Psychology, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
| | - Ilona Papousek
- Department of Psychology, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
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Söğüt M, Yedidağ E, Ray-Yol E, Özdemir AB, Altan-Atalay A. Problem Orientation and Psychological Distress Among Adolescents: Do Cognitive Emotion Regulation Strategies Mediate Their Relationship? Psychol Rep 2021; 125:2317-2336. [PMID: 34037485 DOI: 10.1177/00332941211018802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adolescence is a critical period for the development of attitudes and skills crucial in determining vulnerability for psychological distress. The current study aimed to focus on the association of problem orientation and cognitive emotion regulation strategies with psychological distress and demonstrate the mediator roles of adaptive and maladaptive cognitive emotion regulation strategies in the association of problem orientation with psychological distress. Data were collected from 335 adolescents (167 female) aged 14-to-18 years (M= 14.7, SD= .95) via measures of problem orientation, cognitive emotion regulation, and psychological distress. The results revealed that maladaptive emotion regulation strategies (self-blame and other-blame) mediated the association of negative problem orientation with psychological distress. The findings emphasize the crucial roles of blaming-focused strategies in this relationship.
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Affiliation(s)
- Meryem Söğüt
- Department of Psychology, Koç University, Istanbul, Turkey
| | - Ecem Yedidağ
- Department of Psychology, Koç University, Istanbul, Turkey
| | - Elcin Ray-Yol
- Department of Psychology, 3653University of Guelph, Guelph, Ontario, Canada
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Khosravani V, Berk M, Sharifi Bastan F, Samimi Ardestani SM, Wrobel A. The effects of childhood emotional maltreatment and alexithymia on depressive and manic symptoms and suicidal ideation in females with bipolar disorder: emotion dysregulation as a mediator. Int J Psychiatry Clin Pract 2021; 25:90-102. [PMID: 33559512 DOI: 10.1080/13651501.2021.1879867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The relations of childhood emotional maltreatment and alexithymia to the clinical course of bipolar disorder (BD) have been widely recognised. Difficulties in regulating emotions may explain these relationships. The current study evaluated the effects of childhood emotional maltreatment and alexithymia on depressive and manic symptoms as well as suicidal ideation in female patients with BD. Emotion dysregulation was evaluated as a mediating factor. METHODS Three hundred hospitalised female patients with a diagnosis of BD provided information regarding their history of childhood emotional maltreatment, alexithymia, difficulties in emotion regulation, depressive and manic symptoms, and suicidal ideation. A series of structural equation models (SEMs) were calculated to assess the associations between these variables. RESULTS Childhood emotional abuse and difficulty in identifying feelings were indirectly associated with depressive and manic symptoms as well as suicidal ideation. This association was mediated by emotion dysregulation. This association remained significant after depressive and manic symptoms were controlled in the model. CONCLUSIONS This study indicates that patients with BD who experienced emotional abuse during childhood and have difficulties identifying emotions report greater emotion dysregulation. These individuals, in turn, are more likely to experience more severe depressive and manic symptoms as well as suicidal ideation.Key pointsChildhood emotional maltreatment and emotional and clinical factors in bipolar disorder were assessed.Childhood emotional abuse indirectly affected clinical factors via emotion dysregulation.Difficulty in identifying feelings was linked to clinical factors via emotional dysregulation.Emotional dysregulation affected the links of childhood emotional maltreatment and difficulty in identifying feelings on suicidal ideation after controlling for clinical symptoms.Emotional dysregulation dimensions of impulse, strategies, and goals emerge in relation to suicidal ideation.
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Affiliation(s)
- Vahid Khosravani
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Michael Berk
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.,Department of Psychiatry, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen, Parkville, Australia
| | | | - Seyed Mehdi Samimi Ardestani
- Departments of Psychiatry, Behavioral Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anna Wrobel
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia.,Orygen, Parkville, Australia
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