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Godinho A, Schell C, Cunningham JA. Remaining Between the Cracks - The Long-Term Effect of Different Suicide Risk Exclusion Criterion on Outcomes of an Online Intervention for Depression. CRISIS 2024; 45:100-107. [PMID: 37605900 DOI: 10.1027/0227-5910/a000923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Background: Previous studies have demonstrated that excluding individuals at risk of suicide from online depression interventions can impact recruited sample characteristics. Aim: To determine if a small change in suicide risk exclusion criterion led to differences in the usage and effectiveness of an Internet depression intervention at 6 months of follow-up. Method: A partial sample of a recently completed online depression intervention trial was divided into two groups: those with no risk of suicide versus those with some risk. The two groups were compared for baseline demographic and clinical measures, as well as intervention uptake and treatment success across 6 months. Results: Overall, individuals with less risk of suicide at baseline reported significantly less severe clinical symptoms. Both groups interacted with the intervention at the same rate, but specific use of modules was different. Finally, the impact of intervention usage on outcomes over time did not vary by group. Limitations: While different suicide risk exclusion criteria can change recruited sample characteristics, it remains unclear how these differences impact intervention uptake and success. Conclusion: Overall, the findings suggest that researchers should exercise caution when excluding individuals at risk of suicide, as they greatly benefit from web-based interventions.
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Affiliation(s)
- Alexandra Godinho
- Humber River Health Research Institute, Humber River Health, Toronto, ON, Canada
| | - Christina Schell
- Centre for Addiction and Mental Health, Institute of Mental Health and Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, ON, Canada
| | - John A Cunningham
- Centre for Addiction and Mental Health, Institute of Mental Health and Policy Research, Toronto, ON, Canada
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Department of Psychiatry, University of Toronto, ON, Canada
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2
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Hill RM, Hussain Z, Vieyra B, Gallagher A. Reporting Ethical Procedures in Suicide Prevention Research: Current Status and Recommendations. Arch Suicide Res 2023; 27:1373-1390. [PMID: 36415164 DOI: 10.1080/13811118.2022.2131493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Ethical concerns frequently arise in suicide prevention research regarding participant safety and confidentiality. Despite a substantial literature on managing and navigating ethical concerns in suicide research, little attention has been paid to the reporting of ethical procedures. Furthermore, standard procedures for reporting ethical risk management procedures have not been developed. METHOD A review of the current literature was performed to examine the current state of reporting of ethical procedures within suicide research. Articles published in 2020 (N = 263) from three suicide-focused publications were screened and then coded (n = 131) to identify reporting of procedures for the ethical conduct of research and suicide risk management steps taken by the research teams. RESULTS The majority of articles reported ethical review or approval (84.7%) and reported the use of an informed consent process (77.9%). Only 28.2% included risk mitigation procedures. Of those 29.7% of those articles reported conducting risk evaluation, 66.7% reported resource dissemination, and 51.4% reported an intervention. CONCLUSION As empirical support for brief interventions accrues, suicide prevention researchers should consider establishing standards for the reporting of procedures to ensure the safety of participants with suicidal risk.HighlightsReporting suicide safety protocols helps ensure high ethical standards in research.Fewer than 1/3 of articles reviewed reported risk mitigation procedures in 2020.Standard procedures for reporting safety protocols in suicide research are needed.
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3
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Haghish EF, Czajkowski NO, von Soest T. Predicting suicide attempts among Norwegian adolescents without using suicide-related items: a machine learning approach. Front Psychiatry 2023; 14:1216791. [PMID: 37822798 PMCID: PMC10562596 DOI: 10.3389/fpsyt.2023.1216791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023] Open
Abstract
Introduction Research on the classification models of suicide attempts has predominantly depended on the collection of sensitive data related to suicide. Gathering this type of information at the population level can be challenging, especially when it pertains to adolescents. We addressed two main objectives: (1) the feasibility of classifying adolescents at high risk of attempting suicide without relying on specific suicide-related survey items such as history of suicide attempts, suicide plan, or suicide ideation, and (2) identifying the most important predictors of suicide attempts among adolescents. Methods Nationwide survey data from 173,664 Norwegian adolescents (ages 13-18) were utilized to train a binary classification model, using 169 questionnaire items. The Extreme Gradient Boosting (XGBoost) algorithm was fine-tuned to classify adolescent suicide attempts, and the most important predictors were identified. Results XGBoost achieved a sensitivity of 77% with a specificity of 90%, and an AUC of 92.1% and an AUPRC of 47.1%. A coherent set of predictors in the domains of internalizing problems, substance use, interpersonal relationships, and victimization were pinpointed as the most important items related to recent suicide attempts. Conclusion This study underscores the potential of machine learning for screening adolescent suicide attempts on a population scale without requiring sensitive suicide-related survey items. Future research investigating the etiology of suicidal behavior may direct particular attention to internalizing problems, interpersonal relationships, victimization, and substance use.
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Affiliation(s)
- E. F. Haghish
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Nikolai O. Czajkowski
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Division of Mental and Physical Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Tilmann von Soest
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
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4
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Mehta P, Zimba O, Gasparyan AY, Seiil B, Yessirkepov M. Ethics Committees: Structure, Roles, and Issues. J Korean Med Sci 2023; 38:e198. [PMID: 37365729 DOI: 10.3346/jkms.2023.38.e198] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/17/2023] [Indexed: 06/28/2023] Open
Abstract
An Ethics Committee (EC) is an independent body composed of members with expertise in both scientific and nonscientific arenas which functions to ensure the protection of human rights and the well-being of research subjects based on six basic principles of autonomy, justice, beneficence, nonmaleficence, confidentiality, and honesty. MEDLINE, Scopus, and Directory of Open Access Journals were searched for studies relevant to this topic. This review is focused on the types of research articles that need EC approval, the submission process, and exemptions. It further highlights the constitution of ECs, their duties, the review process, and the assessment of the risk-benefit of the proposed research including privacy issues. It's pertinent for academicians and researchers to abide by the rules and regulations put forth by ECs for upholding of human rights and protecting research subjects primarily, as well as avoiding other issues like retraction of publications. Despite various issues of cost, backlogs, lack of expertise, lesser representation of laypersons, need for multiple approvals for multisite projects, conflicts of interest, and monitoring of ongoing research for the continued safety of participants, the ECs form the central force in regulating research and participant safety. Data safety and monitoring boards complement the ECs for carrying out continuous monitoring for better protection of research subjects. The establishment of ECs has ensured safe study designs, the safety of human subjects along with the protection of researchers from before the initiation until the completion of a study.
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Affiliation(s)
- Pankti Mehta
- Department of Clinical Immunology and Rheumatology, King George's Medical University, Lucknow, India.
| | - Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Armen Yuri Gasparyan
- Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust (Teaching Trust of the University of Birmingham, UK), Russells Hall Hospital, Dudley, UK
| | - Birzhan Seiil
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
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5
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Kassinopoulos O, Vasiliou V, Karekla M. Overcoming challenges in adherence and engagement digital interventions: The development of the ALGEApp for chronic pain management. Internet Interv 2023; 32:100611. [PMID: 36910302 PMCID: PMC9999164 DOI: 10.1016/j.invent.2023.100611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/22/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023] Open
Abstract
Despite the growing body of evidence for the effectiveness of clinic-based interventions in increasing daily functioning in individuals with chronic pain, many sufferers still remain untreated or inadequately treated. Digital psychological interventions have been proposed as a means to overcome many of the barriers to face-to-face treatment (e.g., access, mobility, transportation problems) with the aim to improve health care for persons with chronic conditions in the convenience of their own space and time (home care). The main challenge of digital interventions however, is low user engagement and adherence. Focusing on users' engagement during the design phase of a digital intervention development can increase adherence, effectiveness, and acceptability. The purpose of this paper is to illustrate how we leveraged a recently proposed four-dimensional framework with evidence-based best practices and recommendations to develop a new digital intervention for chronic pain management, called the ALGEApp. A detailed presentation of how ALGEApp was designed and developed to adopt the recommendations and how this can aid engagement within digital interventions is proposed.
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Affiliation(s)
| | - Vasilis Vasiliou
- NHS South Wales Clinical Psychology (PsyD) Programme, School of Psychology, University of Cardiff & Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, United Kingdom of Great Britain and Northern Ireland
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6
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Andriessen K. Doing the Right Thing - Ethical Issues in Designing Suicide Prevention Studies. CRISIS 2023; 44:1-6. [PMID: 36752309 DOI: 10.1027/0227-5910/a000899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
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7
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Sander LB, Spangenberg L, La Sala L, Van Ballegooijen W. Editorial: Digital suicide prevention. Front Digit Health 2023; 5:1148356. [PMID: 36937249 PMCID: PMC10020690 DOI: 10.3389/fdgth.2023.1148356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/03/2023] [Indexed: 03/06/2023] Open
Affiliation(s)
- Lasse Bosse Sander
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Correspondence: Lasse Bosse Sander
| | - Lena Spangenberg
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Louise La Sala
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Wouter Van Ballegooijen
- Department of Clinical, Neuro and Developmental Psychology & Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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8
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Godinho A, Schell C, Cunningham JA. Widening the Cracks. CRISIS 2022; 43:455-459. [PMID: 35915972 DOI: 10.1027/0227-5910/a000872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Alexandra Godinho
- Institute of Mental Health and Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Christina Schell
- Institute of Mental Health and Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, ON, Canada
| | - John A Cunningham
- Institute of Mental Health and Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.,Department of Psychiatry, University of Toronto, ON, Canada
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9
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Büscher R, Beisemann M, Doebler P, Micklitz HM, Kerkhof A, Cuijpers P, Batterham PJ, Calear AL, Christensen H, De Jaegere E, Domhardt M, Erlangsen A, Eylem van Bergeijk O, Hill R, Lungu A, Mühlmann C, Pettit JW, Portzky G, Steubl LS, van Spijker BAJ, Tighe J, Werner-Seidler A, Wilks CR, Sander LB. Digital cognitive-behavioural therapy to reduce suicidal ideation and behaviours: a systematic review and meta-analysis of individual participant data. EVIDENCE-BASED MENTAL HEALTH 2022; 25:e8-e17. [PMID: 36535686 PMCID: PMC9811070 DOI: 10.1136/ebmental-2022-300540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/08/2022] [Indexed: 01/07/2023]
Abstract
QUESTION Digital interventions based on cognitive-behavioural therapy (iCBT) is associated with reductions in suicidal ideation. However, fine-grained analyses of effects and potential effect-moderating variables are missing. This study aimed to investigate the effectiveness of iCBT on suicidal ideation, effect moderators, effects on suicide attempts and predictors of adherence. STUDY SELECTION AND ANALYSIS We systematically searched CENTRAL, PsycINFO, Embase and PubMed for randomised controlled trials that investigated iCBT for suicidal ideation or behaviours. Participants reporting baseline suicidal ideation were eligible. We conducted a one-stage individual participant data (IPD) meta-analysis. Suicidal ideation was the primary outcome, analysed as three indices: severity of suicidal ideation, reliable changes and treatment response. FINDINGS We included IPD from nine out of ten eligible trials (2037 participants). iCBT showed significant reductions of suicidal ideation compared with control conditions across all indices (severity: b=-0.247, 95% CI -0.322 to -0.173; reliable changes: b=0.633, 95% CI 0.408 to 0.859; treatment response: b=0.606, 95% CI 0.410 to 0.801). In iCBT, the rate of reliable improvement was 40.5% (controls: 27.3%); the deterioration rate was 2.8% (controls: 5.1%). No participant-level moderator effects were identified. The effects on treatment response were higher for trials with waitlist-controls compared with active controls. There were insufficient data on suicide attempts. Human support and female gender predicted treatment adherence. The main source of potential bias was missing outcome data. CONCLUSIONS The current evidence indicates that iCBT is effective in reducing suicidal ideation irrespective of age, gender and previous suicide attempts. Future studies should rigorously assess suicidal behaviour and drop-out reasons.
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Affiliation(s)
- Rebekka Büscher
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marie Beisemann
- Department of Statistics, TU Dortmund University, Dortmund, Germany
| | - Philipp Doebler
- Department of Statistics, TU Dortmund University, Dortmund, Germany
| | - Hannah M Micklitz
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ad Kerkhof
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands,International Institute for Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Philip J Batterham
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Alison L Calear
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Helen Christensen
- Black Dog Institute, UNSW Sydney, Randwick, New South Wales, Australia,School of Medicine, UNSW, Sydney, New South Wales, Australia
| | - Eva De Jaegere
- Department of Head and Skin, Flemish Centre of Expertise in Suicide Prevention, Ghent University, Gent, Belgium
| | - Matthias Domhardt
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Annette Erlangsen
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia,Danish Research Institute for Suicide Prevention, Copenhagen Research Centre for Mental Health, Copenhagen, Denmark
| | | | - Ryan Hill
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Anita Lungu
- Lyra Health Inc, Burlingame, California, USA
| | - Charlotte Mühlmann
- Danish Research Institute for Suicide Prevention, Copenhagen Research Centre for Mental Health, Copenhagen, Denmark
| | - Jeremy W Pettit
- Department of Psychology, Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Gwendolyn Portzky
- Department of Head and Skin, Flemish Centre of Expertise in Suicide Prevention, Ghent University, Gent, Belgium
| | - Lena S Steubl
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Bregje A J van Spijker
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Joseph Tighe
- Black Dog Institute, UNSW Sydney, Randwick, New South Wales, Australia
| | | | - Chelsey R Wilks
- Department of Psychological Sciences, University of Missouri-St Louis, St Louis, Missouri, USA
| | - Lasse B Sander
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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10
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Comtois KA, Mata-Greve F, Johnson M, Pullmann MD, Mosser B, Arean P. Effectiveness of Mental Health Apps for Distress During COVID-19 in US Unemployed and Essential Workers: Remote Pragmatic Randomized Clinical Trial. JMIR Mhealth Uhealth 2022; 10:e41689. [PMID: 36191176 PMCID: PMC9642829 DOI: 10.2196/41689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/15/2022] [Accepted: 09/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the general public was concerned about the mental health impacts of unemployment due to COVID-19 and the stress essential workers experienced during this time. Several reports indicated that people in distress were turning to digital technology, but there was little evidence about the impact of these tools on mitigating distress. OBJECTIVE This study seeks to determine the acceptability, feasibility, usability, and effectiveness of mobile mental health apps for decreasing mental health symptoms in essential workers and unemployed individuals with suicide risk. METHODS We recruited participants who indicated that they were unemployed because of COVID-19 or were COVID-19-designated essential workers. Participants were randomized to 1 of 4 free commercial mobile apps for managing distress that were (1) highly rated by PsyberGuide and (2) met the criteria for intervention features these participants indicated were desirable in a previous survey. Participants used the apps for 4 weeks and completed baseline and 4-week self-assessments of depression, anxiety emotional regulation, and suicide risk. RESULTS We found no differences between the apps in any outcome but did find significant changes in depression and anxiety over time (Patient Health Questionnaire [PHQ]-9: estimate=-1.5, SE 0.2, 95% CI -1.1 to -1.8, P<.001; Generalized Anxiety Disorder Scale [GAD]-7: estimate=-1.3, SE 0.2, 95% CI -1.0 to -1.6, P<.001). We found no significant changes in suicidal behavior (Suicide Behaviors Questionnaire-Revised [SBQ-R]) or emotional regulation (Difficulties in Emotion Regulation Scale - Short Form [DERS-SF]) for the 4 weeks. We did find a significant dose-response pattern for changes in depression and anxiety. Using the app at least once a week resulted in greater improvements in treatment conditions over time on depression (estimate=-0.6, SE 0.2, 95% CI 1.0-0.2, P=.003) and anxiety (estimate=0.1, SE 0.2, 95% CI 0.4-0.6, P=.78). There was no association between app frequency and changes in suicidal behavior (SBQ-R) or emotional regulation (DERS-SF). We further found a significant difference between the conditions with regard to app usability, with the control app being the most usable (meanBeautiful Mood 72.9, SD 16.7; meanCOVID Coach 71.2, SD 15.4; meanCalm 66.8, SD 17.3; mean7 Cups 65.2, SD 17.7). We found no significant differences for app acceptability or appropriateness. CONCLUSIONS Few studies have evaluated prospectively the utility and usability of commercial apps for mood. This study found that free, self-guided commercial mobile mental health apps are seen as usable, but no one app is superior to the other. Although we found that regular use is indicated for effects on depression and anxiety to occur in those who are more symptomatic, regression to the mean cannot be ruled out. TRIAL REGISTRATION ClinicalTrials.gov NCT04536935; https://tinyurl.com/mr36zx3s.
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Affiliation(s)
- Katherine Anne Comtois
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Felicia Mata-Greve
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Morgan Johnson
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Michael D Pullmann
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Brittany Mosser
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
- Conducting Research to Enhance Assessment and Treatment Through Innovation in Mental Health Lab, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Patricia Arean
- Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
- Conducting Research to Enhance Assessment and Treatment Through Innovation in Mental Health Lab, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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11
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Xin M, Petrovic J, Zhang L, Yang X. Relationships between negative life events and suicidal ideation among youth in China: The direct and moderating effects of offline and online social support from gender perspective. Front Psychol 2022; 13:998535. [PMID: 36275303 PMCID: PMC9583011 DOI: 10.3389/fpsyg.2022.998535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/21/2022] [Indexed: 12/02/2022] Open
Abstract
Background Suicidal ideation was proved to be a critical precondition leading to the occurrence of subsequent suicidal behavior. Studies have confirmed that negative life events and forms of social support that youth are experiencing in the current socio-cultural context might have unique impacts on their suicidal ideation. However, the specific mechanism is relatively underexplored. Objective We sought to investigate the impacts of offline and online social supports on Chinese students’ suicidal ideation under the pressure of various negative life events, as well as potential gender differences in these relationships. Methods Participants were 2,018 middle – high school and university students from Northwestern China, who completed a demographics questionnaire and self-report measures of negative life events, social support, and suicidal ideation. Results Offline social support had a significant direct effect on suicidal ideation across genders. Among male youth, offline social support only had a moderating effect on the relationship between punitive negative life events and suicidal ideation. Among female youth, offline social support had a significant moderating effect on suicidal ideation under the pressure of all types of negative life events; Online social support only had a significant direct effect on female youth’s suicidal ideation, although it did significantly moderate the relationship between all types of negative life events and suicidal ideation, across genders. Conclusion Our findings revealed direct and moderating effects of offline and online social support on suicidal ideation among youth under the pressure of different types of negative life events, as well as gender-specific patterns in these relationships.
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Affiliation(s)
- Moye Xin
- School of Psychology, Shaanxi Normal University, Xi'an, China
- Shaanxi Provincial Key Laboratory for Behavioral and Cognitive Psychology, Shaanxi Normal University, Xi'an, China
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, Shaanxi, China
- *Correspondence: Moye Xin,
| | - Julia Petrovic
- Human Development, McGill University, Montreal, QC, Canada
| | - Lijin Zhang
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Xueyan Yang
- Institude for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi'an, China
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12
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Trail K, Baptiste PJ, Hunt T, Brooks A. Conducting Research in Crisis Helpline Settings. CRISIS 2022; 43:263-269. [PMID: 35438001 DOI: 10.1027/0227-5910/a000858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Katherine Trail
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia
| | - Paris J Baptiste
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Tara Hunt
- Lifeline Research Foundation, Lifeline Australia, Sydney, NSW, Australia
| | - Anna Brooks
- Lifeline Research Foundation, Lifeline Australia, Sydney, NSW, Australia
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13
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Shi L, Li H, Huang L, Hou Y, Song L. Does Cyberostracism Reduce Prosocial Behaviors? The Protective Role of Psychological Resilience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074388. [PMID: 35410069 PMCID: PMC8998944 DOI: 10.3390/ijerph19074388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/25/2022] [Accepted: 04/03/2022] [Indexed: 01/07/2023]
Abstract
To reduce the negative consequences of cyberostracism on prosocial behaviors, we developed a coping strategy based on psychological resilience, and revealed its effectiveness in combating the adverse effects of cyberostracism on prosocial behavior through two studies. Study 1 demonstrated that psychological resilience could mitigate the negative impact of cyberostracism on prosocial behaviors through experimental manipulation. By targeting continuously ostracized people with low resilience for an online self-help resilience intervention program, Study 2 confirmed that psychological resilience was effective in alleviating the detrimental effects of cyberostracism. These studies not only help us to recognize the negative effects of cyberostracism, but also extend Williams’ temporal need–threat model of ostracism in the context of online ostracism. As emerging technologies represent a promising new approach to intervention delivery, the most valuable contribution of this study is that we developed an online self-help psychological resilience intervention program that showed encouraging therapeutic effects and advantages for assisting in caring for a larger population of people who are at elevated risk for being cyberostracized.
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Affiliation(s)
- Linyu Shi
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, China; (L.S.); (L.H.)
| | - Hao Li
- Plateau Brain Science Research Center, Tibet University, Lhasa 850000, China;
- Institute of Oxygen Supply, Tibet University, Lhasa 850000, China
- Institute of education, Tibet University, Lhasa 850000, China
- School of psychology, South China Normal University, Guangzhou 510000, China
| | - Lianqiong Huang
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, China; (L.S.); (L.H.)
| | - Yubo Hou
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, China; (L.S.); (L.H.)
- Correspondence: (Y.H.); (L.S.)
| | - Lili Song
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
- Correspondence: (Y.H.); (L.S.)
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14
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Balcombe L, De Leo D. The Potential Impact of Adjunct Digital Tools and Technology to Help Distressed and Suicidal Men: An Integrative Review. Front Psychol 2022; 12:796371. [PMID: 35058855 PMCID: PMC8765720 DOI: 10.3389/fpsyg.2021.796371] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/09/2021] [Indexed: 12/12/2022] Open
Abstract
Suicidal men feel the need to be self-reliant and that they cannot find another way out of relationship or socioeconomic issues. Suicide prevention is of crucial importance worldwide. The much higher rate of suicide in men engenders action. The prelude is a subjective experience that can be very isolating and severely distressing. Men may not realize a change in their thinking and behaviors, which makes it more difficult to seek and get help, thereby interrupting a "downward spiral". Stoicism often prevents men from admitting to their personal struggle. The lack of "quality" connections and "non-tailored" therapies has led to a high number of men "walking out" on traditional clinical approaches. But there are complicated relationships in motivations and formative behaviors of suicide with regards to emotional state, psychiatric disorders, interpersonal life events and suicidal behavior method selection. Middle-aged and older men have alternated as the most at-risk of suicide. There is no one solution that applies to all men, but digital tools may be of assistance (e.g., video conferences, social networks, telephone calls, and emails). Digital interventions require higher levels of effectiveness for distress and suicidality but self-guided approaches may be the most suitable for men especially where linked with an integrated online suicide prevention platform (e.g., quick response with online chats, phone calls, and emails). Furthermore, technology-enabled models of care offer promise to advance appropriate linking to mental health services through better and faster understanding of the specific needs of individuals (e.g., socio-cultural) and the type and level of suicidality experienced. Long-term evidence for suicidality and its evaluation may benefit from progressing human computer-interaction and providing impetus for an eminent integrated digital platform.
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Affiliation(s)
- Luke Balcombe
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
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15
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Hechinger M, Fringer A. Professional Care Experiences of Persons With Suicidal Ideation and Behavior: Model Development Based on a Qualitative Meta-Synthesis. JMIR Form Res 2021; 5:e27676. [PMID: 34709191 PMCID: PMC8587187 DOI: 10.2196/27676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/27/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health care professionals (HCPs) are challenged in caring for persons with suicidal ideation or behavior. For affected persons, professional care is essential, and being interviewed about their experiences can be stressful. The experiences of persons ideating or attempting suicide are essential to designing eHealth products to support them in crises and provide continuous care. OBJECTIVE This study aimed to synthesize published qualitative research about how persons with suicidal thoughts or behavior experience inpatient or outpatient care. A model will be derived from the meta-synthesis to guide HCPs in their work with affected persons and provide a thorough needs assessment for eHealth development. METHODS A qualitative meta-synthesis was conducted using an inductive approach, as proposed by Sandelowski and Barroso. The inclusion criteria were studies in English and German that dealt with persons who ideated or attempted suicide. Relevant articles were identified by searching the PubMed and Cinahl databases and by hand searching relevant journals and reference lists. The findings of each study were analyzed using initial and axial coding, followed by selective coding. Finally, a conceptual model was derived. RESULTS In total, 3170 articles were identified in the systematic literature search. Articles were screened independently by 2 researchers based on the eligibility criteria. Finally, 12 studies were included. The central phenomenon observed among persons ideating or attempting suicide is their process from feeling unanchored to feeling anchored in life again. During inpatient and outpatient care, they experience being dependent on the skills and attitudes of HCPs. While helpful skills and attitudes support persons ideating or attempting suicide to reach their feeling of being anchored in life again, adverse interactions are experienced negatively and might lead to prolonging or maintaining the feeling of being unanchored in life. CONCLUSIONS The study promotes a differentiated view of the experiences of persons ideating or attempting suicide. The derived conceptual model can guide HCPs in their work with affected persons to support affected persons during their recovery. Moreover, the conceptual model is useable as a springboard to develop eHealth solutions for crisis situations and long-term care.
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Affiliation(s)
- Mareike Hechinger
- Institute of Nursing, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - André Fringer
- Institute of Nursing, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
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16
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Bailey E, Teh Z, Bleeker C, Simmons M, Robinson J. Youth partnerships in suicide prevention research: A failed investigator survey. Early Interv Psychiatry 2021; 15:1429-1432. [PMID: 33181863 DOI: 10.1111/eip.13069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/30/2020] [Accepted: 11/03/2020] [Indexed: 12/28/2022]
Abstract
AIM Youth suicide research stands to benefit from involving young people with lived experience as research partners; however, there may be a number of barriers to doing this successfully. The aim of this study was to identify the extent to which international youth suicide prevention researchers actively partner with young people in intervention research design, and to explore the barriers, facilitators and benefits to such engagement. METHODS Ninety-seven eligible researchers were identified using a systematic literature search and invited via email to participate in an online questionnaire. RESULTS Only 17 participants (17.5%) at least partially completed the questionnaire, and minimal qualitative data were provided. CONCLUSIONS Analysis of the limited data together with the low response rate suggests that the rate of youth partnerships in suicide prevention intervention research is very low. Guidelines regarding how to safely and effectively partner with young people in this sensitive research area may help to address this gap.
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Affiliation(s)
- Eleanor Bailey
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Zoe Teh
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Caitlin Bleeker
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Magenta Simmons
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Jo Robinson
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
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17
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Yu T, Hu D, Teng F, Mao J, Xu K, Han Y, Liu Y, Wu M. Effectiveness of internet-based cognitive behavioral therapy for suicide: a systematic review and meta-analysis of RCTs. PSYCHOL HEALTH MED 2021; 27:2186-2203. [PMID: 34074167 DOI: 10.1080/13548506.2021.1930073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Suicidal individuals rarely seek help and receive professional psychological intervention on their initiative. Internet-based cognitive behavioral therapy(iCBT) can increase availability and reduce stigma compared to face-to-face interventions for suicide.However, conclusions about the effectiveness of iCBT on suicide are controversial. The review aimed to determine the effectiveness of iCBT on reducing suicidal ideation (primary outcomes) and other outcomes related to suicide like suicide attempts(secondary outcomes). PubMed, the Cochrane Library, EMBASEwere searched up to March 2020 for RCTs of iCBT which aimed to reduce suicide.The potential bias was assessed by the Cochrane risk of bias tool. Data analyses wereperformed by RevMan5.3.Four studies meeting the eligibility criteria were included which reported data on a total of 1225 participants. We found iCBT was associated with reducing an individual's suicidal ideation, and first indications suggest that the treatment effect might be even more pronounced in the short term and in adults.Additionally, there was insufficient evidence to prove its effectiveness in reducing suicide attempts and suicide death.Overall, iCBT can overcome the disadvantages of traditional interventions and show promise on suicidal ideation. While ensuring safety and ethics, further studies are warranted, focusing on suicide specific behavior like suicide attempts.
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Affiliation(s)
- Ting Yu
- School of Nursing, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Deying Hu
- Department of Nursing, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fen Teng
- Department of Nursing, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Mao
- School of Nursing, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ke Xu
- School of Public Health, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanhong Han
- Department of Nursing, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yilan Liu
- Department of Nursing, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Minge Wu
- School of Nursing, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
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18
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Bailey E, Robinson J, Alvarez-Jimenez M, Nedeljkovic M, Valentine L, Bendall S, D'Alfonso S, Gilbertson T, McKechnie B, Rice S. Moderated Online Social Therapy for Young People With Active Suicidal Ideation: Qualitative Study. J Med Internet Res 2021; 23:e24260. [PMID: 33818392 PMCID: PMC8056298 DOI: 10.2196/24260] [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] [Received: 09/11/2020] [Revised: 11/26/2020] [Accepted: 02/08/2021] [Indexed: 01/23/2023] Open
Abstract
Background Web-based interventions are a promising approach to support youth at risk of suicide, and those incorporating peer-to-peer social networking may have the added potential to target interpersonal states of perceived burdensomeness and thwarted belongingness. Owing to feasibility and safety concerns, including fear of contagion, this had not been tested until recently. In 2018, we conducted a pilot evaluation to test the feasibility, safety, and acceptability of a Moderated Online Social Therapy intervention, called Affinity, with a sample of young people with active suicidal ideation. Objective The aim of this study is to report qualitative data collected from study participants regarding their experience of the web-based social network and the consequent safety features. Methods Affinity is a closed website incorporating 3 key components: therapeutic content delivered via comics, peer-to-peer social networking, and moderation by peers and clinicians. Semistructured interviews were conducted with 17 young people who participated in the pilot study after 8 weeks of exposure to the intervention. Interview data from 2 young people who did not use Affinity were excluded from the analysis. The interviews were analyzed using thematic analysis, with the frequency of responses characterized using the consensual qualitative research method. The results are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Results A total of 4 overarching themes were identified: a safe and supportive environment, the importance of mutual experiences, difficulty engaging and connecting, and the pros and cons of banning discussions about suicide. Interestingly, although Affinity was perceived to be safe and free of judgment, concerns about negative evaluation and triggering others were significant barriers to posting on the social network. Participants generally supported the banning of conversations about suicide, although for some this was perceived to reinforce stigma or was associated with frustration and distress. Conclusions The results not only support the safety and potential therapeutic benefit of the social networking aspect of Affinity but also highlight several implementation challenges. There is a need to carefully balance the need for stringent safety and design features while ensuring that the potential for therapeutic benefit is maximized.
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Affiliation(s)
- Eleanor Bailey
- Orygen, Parkville, Australia.,Swinburne University of Technology, Hawthorn, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Jo Robinson
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | | | - Lee Valentine
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Sarah Bendall
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Simon D'Alfonso
- Orygen, Parkville, Australia.,School of Computing and Information Systems, University of Melbourne, Parkville, Australia
| | - Tamsyn Gilbertson
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | | | - Simon Rice
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
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19
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Carrotte ER, Webb M, Flego A, Vincent B, Heath J, Blanchard M. Acceptability, Safety, and Resonance of the Pilot Digital Suicide Prevention Campaign "Better Off With You": Qualitative Study. JMIR Form Res 2021; 5:e23892. [PMID: 33656441 PMCID: PMC7970163 DOI: 10.2196/23892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/14/2020] [Accepted: 01/17/2021] [Indexed: 01/26/2023] Open
Abstract
Background The Interpersonal Theory of Suicide posits that there are three key elements of suicidal behavior: perceived burdensomeness, thwarted belongingness, and the acquired capability for suicide. The digital campaign Better Off With You was developed to directly challenge the idea of perceived burdensomeness among people who are contemplating suicide in 2 communities within Australia. Objective The aim of this study is to explore the needs and preferences of people with lived experience of suicidal thoughts and actions to inform the development of Better Off With You. Methods This study involved a series of focus groups that aimed to discuss campaign messaging, scope, and approach. People with lived experience of suicidal thoughts and actions attended the focus groups. After the completion of initial focus groups, the results informed the creation of campaign collateral by creative agencies. Early versions of the campaign collateral were then presented in the user testing sessions. Transcriptions were analyzed via thematic analysis. Results In total, 13 participants attended the focus groups and 14 attended the user testing sessions. The following three overarching themes were presented: acceptability, safety, and resonance. Participants believed that suicide is a serious and ongoing issue in their communities and welcomed a localized suicide prevention focus via peer-to-peer storytelling. The idea of perceived burdensomeness required clarification but was perceived as acceptable and relevant. Participants seemed drawn toward peer narratives that they perceived to be authentic, genuine, and believable as given by real people with lived experience. Campaign messaging needs to be clear and empathetic while directly talking about suicide. Participants did not anticipate any significant negative or harmful impact from any campaign videos and highlighted the importance of providing appropriate help-seeking information. Conclusions This iterative study provided important insights and knowledge about peer-to-peer storytelling in suicide prevention campaigns. Future campaigns should involve simple messaging, be validating and empathetic, and consider including a lived experience perspective.
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Affiliation(s)
| | - Marianne Webb
- Anne Deveson Research Centre, SANE Australia, South Melbourne, Australia
| | - Anna Flego
- Anne Deveson Research Centre, SANE Australia, South Melbourne, Australia
| | - Bonnie Vincent
- Anne Deveson Research Centre, SANE Australia, South Melbourne, Australia
| | - Jack Heath
- Anne Deveson Research Centre, SANE Australia, South Melbourne, Australia
| | - Michelle Blanchard
- Anne Deveson Research Centre, SANE Australia, South Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
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