Suicidal Ideation

Young adults aged 18 to 25 who experience frequent thoughts about killing themselves are the focus of this study, which evaluates the (cost-)effectiveness of Attachment Based Family Therapy (ABFT) compared to Treatment As Usual (TAU). Suicide is a leading cause of death among young adults, and current treatments have limited success. This trial aims to determine if involving family through ABFT can better reduce suicidality and improve outcomes, informing clinical guidelines and care practices in Belgium and the Netherlands. Participants are randomly assigned to one of two groups: the experimental group receives ABFT as an add-on to TAU, which includes treatments like antidepressants, CBT, or DBT, with weekly ABFT sessions lasting about 16 weeks. The control group receives TAU alone, allowing up to four sessions of systemic family therapy. ABFT focuses on strengthening parent-child attachment bonds to provide a supportive base for young adults, involving parents or caregivers actively in therapy. Throughout the study, suicidality is measured at baseline, immediately after intervention, and at follow-ups 3, 6, and 12 months post-intervention using tools like the Suicidal Ideation Questionnaire Junior. Researchers also assess depressive symptoms, family functioning, attachment, quality of life, and healthcare costs. The trial includes 138 participants across multiple sites, with double-blind randomized allocation. Safety, adherence, and cost-effectiveness are closely monitored during and after the treatment period.

Suicide is the second leading cause of death among youth, and rates in the US are rising despite prevention efforts. Researchers are evaluating a digital platform called Vira to improve how care is delivered to adolescents at high risk for suicide. This platform aims to use smartphone data and secure communication tools to better understand and manage risk factors like psychological distress, anhedonia, behavioral withdrawal, and sleep problems in young people receiving intensive outpatient treatment. The study compares two groups of adolescent patients aged 13 to 18 years old who are in an intensive outpatient Dialectical Behavior Therapy (DBT) program. One group uses the Vira platform, which collects data passively from smartphone sensors about activity, sleep, mobility, and mood-related language. Vira also prompts daily check-ins and supports practitioners with reminders to encourage behavior changes. The other group receives the usual treatment with the addition of a passive monitoring app called EARS. Participants will use their assigned app during their intensive outpatient treatment. Researchers will assess outcomes using tools like the Columbia Suicide Severity Rating Scale and Scale for Suicidal Ideation over six months. Other measures include anxiety, risky behaviors, sleep quality, mood, and pleasure scales at three and six months. The study monitors clinical outcomes to determine if the digital platform enhances care for youth at risk of suicide.

Researchers are evaluating the effectiveness and feasibility of Narrative Enhancement and Cognitive Therapy (NECT), a group-based treatment designed to reduce self-stigma in people with mental disorders. Self-stigma involves internalizing negative stereotypes which can harm treatment adherence, self-esteem, quality of life, and increase despair or suicide risk. This pragmatic, multicenter, randomized controlled trial includes 416 patients from 26 mental health centers in Northeast Italy, aiming to improve psychological outcomes like self-esteem, hope, empowerment, recovery perception, and mental well-being. Participants in the intervention group will attend 20 one-hour NECT group sessions divided into five parts: orientation, psychoeducation, cognitive restructuring, narrative enhancement, and conclusion. The therapy helps challenge stigmatizing beliefs and fosters a positive self-narrative. This group therapy is provided alongside participants' usual care, which may include medication and psychosocial treatments. The control group will continue their standard care without NECT. The study lasts about 12 months, with a 2-month recruitment phase, 5 months of intervention, and 5 months for data analysis and publication. Participants will undergo assessments at enrollment and after the 20-week intervention to measure changes in self-stigma, self-esteem, hope, empowerment, recovery perception, mental well-being, and stigma-related stress. Treatment fidelity will be monitored through session recordings. The study also tracks feasibility by evaluating participation rates and feedback. All participants remain under their usual care throughout the study, and data collection includes monitoring care received during the trial.

Veterans face a heightened risk of suicide during the first year after leaving military service, especially those not connected to VA healthcare. This research aims to improve reintegration and reduce suicide risk for recently transitioned Veterans by evaluating STEP-Home-SP, a skills-based, video telehealth workshop. It is designed to provide suicide prevention education, support for accessing VA care, and tools to manage the transition effectively during this critical period. The study compares two groups: one participating in the STEP-Home-SP workshop and the other receiving Enhanced Usual Care (EUC), which includes standard care plus an educational packet on suicide risk and VA care connection. STEP-Home-SP involves weekly 1.5-hour group sessions over 12 weeks, focusing on emotional regulation, problem solving, and attention training, with up to six additional 30-minute individual sessions tailored to each Veteran's needs. EUC involves existing transition support programs such as the Transition Assistance Program and VA Solid Start outreach. Participants will be assessed at multiple points over a year, including baseline, 12 weeks, and 24 weeks. Researchers will measure feasibility factors like recruitment and adherence, satisfaction with the program, and changes in reintegration status using the Military-to-Civilian Questionnaire. They will also monitor engagement with VA care and collect qualitative feedback. The study will help inform future larger trials and aims to address social isolation and suicide risk during Veterans' transition to civilian life.

Researchers are investigating the effects of a multidomain lifestyle intervention to slow cognitive decline and dementia risk in elderly residents aged 60 to 80 in Zhejiang Province, China. The study builds on findings from Finland, where a similar approach combining physical activity, nutrition, cognitive training, social activities, and vascular risk management showed promise in healthy older adults at risk of cognitive decline. This trial aims to explore how such an intervention may change brain structure and function as well as cognitive abilities in an Asian population. Participants are randomly assigned to either a structured multidomain intervention group or a self-guided control group. The intervention group receives tailored nutritional guidance, cognitive training, physical exercises, and vascular risk monitoring, all adapted to Chinese cultural norms. The control group receives regular health education campaigns and basic health monitoring every 6 to 12 months. This trial runs for two years with ongoing assessments to evaluate the impact of these lifestyle changes. During the study, participants undergo various evaluations including cognitive tests measuring global and domain-specific cognition, neuroimaging scans like MRI and fMRI, laboratory blood tests, and physical performance measures such as grip strength and gait speed. Questionnaires assess quality of life, depression, sleep quality, and daily activities. Researchers also monitor cardiovascular health, dementia onset, and falls. This comprehensive monitoring will help determine the intervention's effects on brain health and daily functioning over the 24-month period.

Researchers are evaluating the effects of a smartphone-based Healthy Lifestyle (HLS) intervention on the mental and physical health of firefighters in Tainan, Taiwan. This cluster randomized controlled trial aims to determine if the Traditional Chinese version of the HLS mobile app can improve firefighters' health compared to usual care. The study also seeks to find out whether the intervention can promote a healthier lifestyle and reduce the risk of chronic non-communicable diseases among firefighters. Participants will be randomly assigned to either the intervention group, which uses the Traditional Chinese HLS mobile app designed specifically for firefighters, or the control group, which receives usual care. The intervention period lasts from 3 to 6 months, during which firefighters in the intervention group will use the app to support healthier behaviors. The control group will continue with their standard practices without the app. Throughout the study, firefighters will undergo health and fitness assessments at the start and again 3 to 6 months after the intervention begins. Measurements include blood pressure, depressive symptoms, PTSD symptoms, body mass index, smoking habits, diet patterns, physical activity levels, sitting time, sleep duration and napping frequency, glycated hemoglobin, lipid profiles, C-reactive protein, and physical performance. The study will monitor these outcomes to assess changes in mental and physical health. Safety and progress will be observed through these regular evaluations during the study period.

Researchers are evaluating a new clinical approach to support Latinx/Hispanic youth aged 12 to 18 who experience suicidal thoughts and behaviors, along with their caregivers. The study aims to test a culturally relevant treatment called Socio-Cognitive Behavioral Therapy for Suicidal Behavior (SCBT-SB), which is tailored to address the unique cultural and developmental needs of these youth. The study compares the standard SCBT-SB treatment to a new model that includes additional support from community health workers (CHWs), trusted community members who help families access resources and reduce stigma. Participants will receive the SCBT-SB treatment, which includes individual, caregiver, and family sessions conducted in English or Spanish. The therapy has two phases: an initial crisis module with nine core sessions, followed by flexible coping skills sessions. Half of the families will also receive support from a CHW who will assess social needs, provide referrals, psychoeducation, and ongoing follow-up at least once a month. The clinician and CHW coordinate care to enhance family engagement. Youth and their families will be followed for nine months, with assessments of suicidal thoughts, suicide attempts, and depressive symptoms at baseline, six months, and nine months. Data will be collected through self-reports and clinical interviews to measure changes in these symptoms. The study uses a randomized, double-blind design to evaluate the impact of adding CHWs to standard therapy. Participation involves regular treatment sessions and monitoring of mental health outcomes over the study period.

Researchers are evaluating a peer-delivered recovery program called SUPPORT designed for Veterans with serious mental illness (such as psychotic and bipolar disorders) who are at increased risk of suicide. The study aims to improve functional and social recovery and reduce suicide risk by tailoring recovery planning to each Veteran's suicidal experiences. This intervention is an adaptation of the Wellness Recovery Action Plan (WRAP) and uses cognitive learning strategies to help Veterans recall their safety plans and improve functioning. The 5-year study has two phases: Phase 1 focuses on refining SUPPORT using input from Veterans and experts and training Peer Specialists. Phase 2 is a pilot randomized controlled trial comparing SUPPORT to enhanced standard care (ESC), which includes usual suicide prevention measures plus additional research contacts. SUPPORT is delivered weekly in 50-minute sessions by Peer Specialists who work closely with each Veteran to create a personalized recovery plan. The ESC group receives standard suicide risk assessments, safety planning, mental health referrals, and follow-up contacts. Participants are assessed quantitatively at baseline, mid-treatment, post-treatment, and 3 months post-treatment, with additional qualitative interviews after treatment. Peer Specialists are also interviewed after delivering the intervention. Researchers measure the feasibility of recruitment and retention, participant satisfaction, and changes in suicidal thoughts and recovery. The study is sponsored by the VA Office of Research and Development and involves ongoing monitoring over about four years.

Researchers are evaluating a smartphone-delivered behavioral intervention called Therapeutic Evaluative Conditioning for Suicide (TEC-S) aimed at adults with recent and frequent suicidal thoughts and behaviors. This one-arm open trial focuses on assessing the safety, acceptability, and preliminary effectiveness of TEC-S in reducing suicidal thoughts and behaviors among 20 adults aged 18 and older living near Boston, MA. Participants will have optional access to the TEC-S treatment on their smartphones for 30 days. TEC-S involves a computerized task where participants repeatedly pair images and words related to suicidal behavior with negative stimuli, and self-related stimuli with positive stimuli, aiming to change attitudes toward suicide. During the study, participants will receive three daily ecological momentary assessments (EMAs) to monitor their suicidal thoughts, safety, and acceptability of the intervention. Weekly self-report and behavioral measures will also assess treatment mechanisms. Throughout the 30-day treatment phase, researchers will collect data on treatment completion, safety, and various measures of suicidal thoughts and behaviors using Likert scales and behavioral tasks. Participants will be monitored closely to ensure safety and acceptability of TEC-S. The study will help understand if this smartphone intervention is a feasible and safe approach to reduce suicidal thoughts and behaviors in adults.

Researchers are evaluating a new digital peer support intervention called Supporting Wellbeing with Everyday Experiences of Peers (SWEEP) aimed at ethnically diverse youth aged 14 to 18 at risk for suicide in underserved communities. The study focuses on adolescents who have experienced suicidal thoughts and depression, particularly those in The Bronx, New York, where mental healthcare access is limited. The purpose is to assess whether brief, culturally responsive suicide recovery narratives delivered via smartphone can reduce suicidal thoughts in this group. Participants will receive one suicide recovery narrative each day for 14 days through a smartphone app, available in both audio and text formats. During the study, participants will also complete ecological momentary assessments (EMA) up to five times daily to monitor suicidal thoughts and related outcomes. The study includes several phases: initially collecting narratives, then a small group of adolescents receiving the intervention with post-intervention interviews, and finally a phase with a treatment group receiving the narratives plus EMA and a control group with EMA only. Throughout the 14-day trial, participants will engage with the app daily, providing self-reports on suicidal thoughts, urge resistance, social connectedness, optimism, and social support. Researchers will evaluate if the narratives help reduce suicidal thoughts over this period. Acceptability of the intervention will be measured at the end. The total participation involves daily interaction with the app and completion of multiple brief surveys each day to track changes and responses to the intervention.