Family-focused cognitive behavioral treatment for depressed adolescents in suicidal crisis with co-occurring risk factors: a randomized trial / Christianne ESPOSITO-SMYTHERS in Journal of Child Psychology and Psychiatry, 60-10 (October 2019)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 60-10 (October 2019) . - p.1133-1141 Titre : Family-focused cognitive behavioral treatment for depressed adolescents in suicidal crisis with co-occurring risk factors: a randomized trial Type de document : texte imprimé Auteurs : Christianne ESPOSITO-SMYTHERS, Auteur ; Jennifer C. WOLFF, Auteur ; Richard T. LIU, Auteur ; Jeffrey I. HUNT, Auteur ; Leah ADAMS, Auteur ; Kerri L. KIM, Auteur ; Elizabeth A. FRAZIER, Auteur ; Shirley YEN, Auteur ; Daniel P. DICKSTEIN, Auteur ; Anthony SPIRITO, Auteur Article en page(s) : p.1133-1141 Langues : Anglais (eng) Mots-clés : Suicide  adolescent  clinical trial  cognitive behavioral therapy Index. décimale : PER Périodiques Résumé : BACKGROUND: Suicide is the second leading cause of death among adolescents. The purpose of this study was to test a family-focused outpatient cognitive behavioral treatment (F-CBT) protocol for depressed adolescents following psychiatric hospitalization for a suicide attempt or suicidal ideation, and who had a co-occurring risk factor (suicidal behavior prior to the index admission, nonsuicidal self-injury, and/or a substance use disorder), in a randomized Phase 2 efficacy trial. METHOD: One hundred forty-seven adolescents (mean age = 14.91 years; 76.2% female, 85.5% White) and their families, recruited primarily from an inpatient psychiatric hospitalization program, were randomly assigned to F-CBT or enhanced treatment-as-usual (E-TAU). A suicide attempt was the primary outcome variable. Depression, suicidal ideation, and nonsuicidal self-injury are also reported here. Assessments were completed at pretreatment as well as 6, 12, and 18-months postrandomization (Trial Registration ClinicalTrials.gov Identifier: NCT01732601). RESULTS: In the sample as a whole, rates of attempts decreased from 20% at 6 months to 9% at 12 months to 7% at 18 months. There was no evidence of a significant difference between treatment arms in rates of suicide attempts, major depressive disorder, suicidal ideation, or nonsuicidal self-injury at any of the postrandomization assessment points. CONCLUSIONS: Though F-CBT was associated with reductions in suicidality, depression, and nonsuicidal self-injury, E-TAU showed an equally strong effect. Greater frequency of F-CBT treatment sessions, particularly at the start of care, and alternative approaches to transitioning to care at 12 months, may be necessary when using F-CBT with this population. En ligne : http://dx.doi.org/10.1111/jcpp.13095 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=406 [article] Family-focused cognitive behavioral treatment for depressed adolescents in suicidal crisis with co-occurring risk factors: a randomized trial [texte imprimé] / Christianne ESPOSITO-SMYTHERS, Auteur ; Jennifer C. WOLFF, Auteur ; Richard T. LIU, Auteur ; Jeffrey I. HUNT, Auteur ; Leah ADAMS, Auteur ; Kerri L. KIM, Auteur ; Elizabeth A. FRAZIER, Auteur ; Shirley YEN, Auteur ; Daniel P. DICKSTEIN, Auteur ; Anthony SPIRITO, Auteur . - p.1133-1141. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 60-10 (October 2019) . - p.1133-1141 Mots-clés : Suicide  adolescent  clinical trial  cognitive behavioral therapy Index. décimale : PER Périodiques Résumé : BACKGROUND: Suicide is the second leading cause of death among adolescents. The purpose of this study was to test a family-focused outpatient cognitive behavioral treatment (F-CBT) protocol for depressed adolescents following psychiatric hospitalization for a suicide attempt or suicidal ideation, and who had a co-occurring risk factor (suicidal behavior prior to the index admission, nonsuicidal self-injury, and/or a substance use disorder), in a randomized Phase 2 efficacy trial. METHOD: One hundred forty-seven adolescents (mean age = 14.91 years; 76.2% female, 85.5% White) and their families, recruited primarily from an inpatient psychiatric hospitalization program, were randomly assigned to F-CBT or enhanced treatment-as-usual (E-TAU). A suicide attempt was the primary outcome variable. Depression, suicidal ideation, and nonsuicidal self-injury are also reported here. Assessments were completed at pretreatment as well as 6, 12, and 18-months postrandomization (Trial Registration ClinicalTrials.gov Identifier: NCT01732601). RESULTS: In the sample as a whole, rates of attempts decreased from 20% at 6 months to 9% at 12 months to 7% at 18 months. There was no evidence of a significant difference between treatment arms in rates of suicide attempts, major depressive disorder, suicidal ideation, or nonsuicidal self-injury at any of the postrandomization assessment points. CONCLUSIONS: Though F-CBT was associated with reductions in suicidality, depression, and nonsuicidal self-injury, E-TAU showed an equally strong effect. Greater frequency of F-CBT treatment sessions, particularly at the start of care, and alternative approaches to transitioning to care at 12 months, may be necessary when using F-CBT with this population. En ligne : http://dx.doi.org/10.1111/jcpp.13095 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=406

Self-injurious implicit attitudes among adolescent suicide attempters versus those engaged in nonsuicidal self-injury / Daniel P. DICKSTEIN in Journal of Child Psychology and Psychiatry, 56-10 (October 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-10 (October 2015) . - p.1127-1136 Titre : Self-injurious implicit attitudes among adolescent suicide attempters versus those engaged in nonsuicidal self-injury Type de document : texte imprimé Auteurs : Daniel P. DICKSTEIN, Auteur ; Megan E. PUZIA, Auteur ; Grace K. CUSHMAN, Auteur ; Alexandra B. WEISSMAN, Auteur ; Ezra WEGBREIT, Auteur ; Kerri L. KIM, Auteur ; Matthew K. NOCK, Auteur ; Anthony SPIRITO, Auteur Article en page(s) : p.1127-1136 Langues : Anglais (eng) Mots-clés : Suicide  nonsuicidal self-injury  adolescent  cognition Index. décimale : PER Périodiques Résumé : Background Suicide is among the most important mental health issues affecting adolescents today despite much research on its detection and prevention. Beyond suicide attempts (SAs), clinicians are increasingly confronted with another, potentially related problem: non-suicidal self-injury (NSSI)—defined as the deliberate destruction of body tissue without intent to die. NSSI may increase risk for making an SA by sevenfold, but many studies examining this link have involved youths engaging in both NSSI and SAs. Thus, there is a need to compare homogeneous groups of adolescents engaged in NSSI-only or SA-only, but not both, to advance what is known about each form of self-harm. The self-injurious implicit association task (SI-IAT) is a particularly important computerized behavioral task to study such adolescents because the SI-IAT provides objective behavioral data about problems for which people may lack insight or be motivated to conceal, such as SAs and NSSI. Methods We evaluated implicit associations with cutting and death/suicide using the computerized SI-IAT in three mutually exclusive groups: (1) adolescents who made an SA but had never engaged in NSSI (n = 47); (2) adolescents who engaged in NSSI but had never made an SA (n = 46); and (3) typically developing control (TDC) adolescents without history of psychiatric problems (n = 43). Results Nonsuicidal self-injury participants had stronger identification with cutting versus no cutting than either SA or TDC participants. Contrary to our hypothesis, NSSI participants had stronger identification with suicide/death versus life than either SA or TDC participants. Conclusions Strong implicit attitudes towards suicide/death among adolescents with NSSI without a prior SA suggest that clinicians should not dismiss NSSI as not serious. Further work is required to elucidate the mechanism by which youths engaged in NSSI acquire these stronger identifications and make a first-time SA to develop novel treatment and prevention strategies blocking this transformation, ultimately reducing youth suicide. En ligne : http://dx.doi.org/10.1111/jcpp.12385 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=269 [article] Self-injurious implicit attitudes among adolescent suicide attempters versus those engaged in nonsuicidal self-injury [texte imprimé] / Daniel P. DICKSTEIN, Auteur ; Megan E. PUZIA, Auteur ; Grace K. CUSHMAN, Auteur ; Alexandra B. WEISSMAN, Auteur ; Ezra WEGBREIT, Auteur ; Kerri L. KIM, Auteur ; Matthew K. NOCK, Auteur ; Anthony SPIRITO, Auteur . - p.1127-1136. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-10 (October 2015) . - p.1127-1136 Mots-clés : Suicide  nonsuicidal self-injury  adolescent  cognition Index. décimale : PER Périodiques Résumé : Background Suicide is among the most important mental health issues affecting adolescents today despite much research on its detection and prevention. Beyond suicide attempts (SAs), clinicians are increasingly confronted with another, potentially related problem: non-suicidal self-injury (NSSI)—defined as the deliberate destruction of body tissue without intent to die. NSSI may increase risk for making an SA by sevenfold, but many studies examining this link have involved youths engaging in both NSSI and SAs. Thus, there is a need to compare homogeneous groups of adolescents engaged in NSSI-only or SA-only, but not both, to advance what is known about each form of self-harm. The self-injurious implicit association task (SI-IAT) is a particularly important computerized behavioral task to study such adolescents because the SI-IAT provides objective behavioral data about problems for which people may lack insight or be motivated to conceal, such as SAs and NSSI. Methods We evaluated implicit associations with cutting and death/suicide using the computerized SI-IAT in three mutually exclusive groups: (1) adolescents who made an SA but had never engaged in NSSI (n = 47); (2) adolescents who engaged in NSSI but had never made an SA (n = 46); and (3) typically developing control (TDC) adolescents without history of psychiatric problems (n = 43). Results Nonsuicidal self-injury participants had stronger identification with cutting versus no cutting than either SA or TDC participants. Contrary to our hypothesis, NSSI participants had stronger identification with suicide/death versus life than either SA or TDC participants. Conclusions Strong implicit attitudes towards suicide/death among adolescents with NSSI without a prior SA suggest that clinicians should not dismiss NSSI as not serious. Further work is required to elucidate the mechanism by which youths engaged in NSSI acquire these stronger identifications and make a first-time SA to develop novel treatment and prevention strategies blocking this transformation, ultimately reducing youth suicide. En ligne : http://dx.doi.org/10.1111/jcpp.12385 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=269

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