Group Interventions for Suicidal African Americans
| Status: | Withdrawn |
|---|---|
| Conditions: | Depression, Depression, Psychiatric, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 64 |
| Updated: | 12/17/2017 |
| Start Date: | May 2016 |
| End Date: | May 2017 |
The investigator is conducting a hybrid efficacy-effectiveness randomized controlled trial
with low-income African American suicide attempters. Guided by the Theory of Triadic
Influence (TTI), this pilot randomized controlled trial aims:
1. to determine if psychosocial group intervention (PGI) is more effective than enhanced
treatment as usual (ETAU) in reducing suicidal behavior (ideation, attempts; primary
outcome) and improving its correlates (depressive symptoms, hopelessness, quality of
life) (secondary outcomes) in low-income African Americans with a recent attempt.
2. to determine if PGI is more effective than ETAU at bolstering intrapersonal (I),
social/situational (SS), and cultural/environmental (CE) risk and protective factors
that mediate the condition-suicidal behavior and correlates link and thus serve as
mechanisms of change.
3. to determine I, SS, and CE variables that moderate the condition-suicidal behavior link
and thus serve as predictors of intervention outcome.
Hypothesis for Aim 1: At post-intervention and follow-up, PGI participants will evidence
greater improvements in suicidal behavior and its correlates than those in ETAU.
Hypothesis for Aim 2: Changes in these risk and protective factors will account for condition
effects on outcomes: (1) psychological distress, aggression, impulsivity, substance abuse,
low self-esteem, and suicide acceptability (I-risk); (2) perceived burdensomeness and
thwarted belongingness, relationship discord, intimate partner violence perpetration and
victimization (SS-risk); (3) access to a weapon and barriers to service utilization
(CE-risk); (4) reasons for living, optimism, positive ethnic identity, effective coping, and
spiritual well-being (I-protective); (5) overall family health and social support from family
and friends (SS-protective); and (6) religious involvement and effectiveness of obtaining
resources (CE-protective).
Hypothesis for Aim 3: Individuals (1) having fewer Diagnostic and Statistical Manual of
Mental Disorders (DSM) disorders and attachment styles characterized by positivity toward the
self and others (I); (2) children and more limited trauma histories (SS); and (3) more daily
hassles and less exposure to community disorder (CE) will evidence greater reductions in
suicidal behavior and its correlates and greater enhancements in quality of life at
post-intervention and follow-up.
with low-income African American suicide attempters. Guided by the Theory of Triadic
Influence (TTI), this pilot randomized controlled trial aims:
1. to determine if psychosocial group intervention (PGI) is more effective than enhanced
treatment as usual (ETAU) in reducing suicidal behavior (ideation, attempts; primary
outcome) and improving its correlates (depressive symptoms, hopelessness, quality of
life) (secondary outcomes) in low-income African Americans with a recent attempt.
2. to determine if PGI is more effective than ETAU at bolstering intrapersonal (I),
social/situational (SS), and cultural/environmental (CE) risk and protective factors
that mediate the condition-suicidal behavior and correlates link and thus serve as
mechanisms of change.
3. to determine I, SS, and CE variables that moderate the condition-suicidal behavior link
and thus serve as predictors of intervention outcome.
Hypothesis for Aim 1: At post-intervention and follow-up, PGI participants will evidence
greater improvements in suicidal behavior and its correlates than those in ETAU.
Hypothesis for Aim 2: Changes in these risk and protective factors will account for condition
effects on outcomes: (1) psychological distress, aggression, impulsivity, substance abuse,
low self-esteem, and suicide acceptability (I-risk); (2) perceived burdensomeness and
thwarted belongingness, relationship discord, intimate partner violence perpetration and
victimization (SS-risk); (3) access to a weapon and barriers to service utilization
(CE-risk); (4) reasons for living, optimism, positive ethnic identity, effective coping, and
spiritual well-being (I-protective); (5) overall family health and social support from family
and friends (SS-protective); and (6) religious involvement and effectiveness of obtaining
resources (CE-protective).
Hypothesis for Aim 3: Individuals (1) having fewer Diagnostic and Statistical Manual of
Mental Disorders (DSM) disorders and attachment styles characterized by positivity toward the
self and others (I); (2) children and more limited trauma histories (SS); and (3) more daily
hassles and less exposure to community disorder (CE) will evidence greater reductions in
suicidal behavior and its correlates and greater enhancements in quality of life at
post-intervention and follow-up.
Attention will be paid to Theory of Triadic Influence intrapersonal, social/ situational, and
cultural/ environmental risk and protective factors that impact outcomes. The central
hypothesis is that compared to enhanced treatment as usual, through targeting Theory of
Triadic Influence-risk and protective factors the culturally-informed, Theory of Triadic
Influence-driven, empowerment based psychosocial group intervention will more positively
alter trajectories in suicidal behaviors and its correlates. The rationale is that upon study
completion, if data support the psychosocial group intervention value, they will facilitate
our long-term goal of disseminating evidence-based culturally-relevant interventions.
In order to test the hypothesis that at post-intervention and 6 and 12-month follow-up,
compared to individuals in ETAU, those in the PGI will endorse less I, SS, and CE risk
factors, reduced suicidal ideation, depressive symptoms, and hopelessness, and greater levels
of I, SS, and CE protective factors as well as increased quality of life, the study
procedures will be as follows: Male and female participants between the ages of 18-64 will be
recruited in the medical and psychiatric emergency rooms at GHS. Once the individual has been
medically cleared and has provided informed consent, he/she will be screened for study
appropriateness by trained project team members (10-20 minutes). If he/she meets inclusion
criteria, study participation will include a 3-hour interview. All study measures will be
read to each participant. Measures will assess background variables, suicidal behavior,
depressive symptoms, hopelessness, quality of life, and I, SS, and CE risk and protective
factors. All measures are psychometrically sound and appropriate for use with an African
American population. Once the interview is over, the participant will be randomly assigned to
either the PGI (10 group therapy sessions) or the ETAU condition (participation in a support
group focused on suicidal behaviors plus suicidal behavior monitoring and help with accessing
resources). The PGI, conducted in accord with the culturally informed, TTI-guided, and
empowerment based group protocol, and the support group will be unstructured; both groups
will last 120 minutes. Following the completion of the PGI or ETAU condition, the individuals
will be assessed at post-intervention (3 hours), and at 6 month and 12 month follow-ups (3
hours each). To increase retention and reduce suicide risk, reminder phone calls will be made
and texts sent on Relieflink, a suicide prevention app that received 1st prize in an App
Challenge sponsored by Substance Abuse and Mental Health Services Administration.
cultural/ environmental risk and protective factors that impact outcomes. The central
hypothesis is that compared to enhanced treatment as usual, through targeting Theory of
Triadic Influence-risk and protective factors the culturally-informed, Theory of Triadic
Influence-driven, empowerment based psychosocial group intervention will more positively
alter trajectories in suicidal behaviors and its correlates. The rationale is that upon study
completion, if data support the psychosocial group intervention value, they will facilitate
our long-term goal of disseminating evidence-based culturally-relevant interventions.
In order to test the hypothesis that at post-intervention and 6 and 12-month follow-up,
compared to individuals in ETAU, those in the PGI will endorse less I, SS, and CE risk
factors, reduced suicidal ideation, depressive symptoms, and hopelessness, and greater levels
of I, SS, and CE protective factors as well as increased quality of life, the study
procedures will be as follows: Male and female participants between the ages of 18-64 will be
recruited in the medical and psychiatric emergency rooms at GHS. Once the individual has been
medically cleared and has provided informed consent, he/she will be screened for study
appropriateness by trained project team members (10-20 minutes). If he/she meets inclusion
criteria, study participation will include a 3-hour interview. All study measures will be
read to each participant. Measures will assess background variables, suicidal behavior,
depressive symptoms, hopelessness, quality of life, and I, SS, and CE risk and protective
factors. All measures are psychometrically sound and appropriate for use with an African
American population. Once the interview is over, the participant will be randomly assigned to
either the PGI (10 group therapy sessions) or the ETAU condition (participation in a support
group focused on suicidal behaviors plus suicidal behavior monitoring and help with accessing
resources). The PGI, conducted in accord with the culturally informed, TTI-guided, and
empowerment based group protocol, and the support group will be unstructured; both groups
will last 120 minutes. Following the completion of the PGI or ETAU condition, the individuals
will be assessed at post-intervention (3 hours), and at 6 month and 12 month follow-ups (3
hours each). To increase retention and reduce suicide risk, reminder phone calls will be made
and texts sent on Relieflink, a suicide prevention app that received 1st prize in an App
Challenge sponsored by Substance Abuse and Mental Health Services Administration.
Inclusion Criteria:
- 18 - 64 yrs old
- patients who seek treatment at Grady Health System (GHS) after a suicide attempt
- African American
- speak English
Exclusion Criteria:
- cognitive impairments
- medical instability
We found this trial at
1
site
80 Jesse Hill Jr Dr SE
Atlanta, Georgia 30303
Atlanta, Georgia 30303
(404) 616-1000
Principal Investigator: Nadine Kaslow, PhD
Grady Memorial Hospital Grady is an internationally recognized teaching hospital staffed exclusively by doctors from...
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