Suicide
Conditions
Keywords
Suicide, Suicide cognitions, Anger, Mobile intervention
Brief summary
Suicide cognitions are conceptualized as enduring, chronic vulnerability factors that predispose individuals to suicidal crises. Therefore, modification of these beliefs may reduce suicidal thoughts and behaviors. The goal of this research is to develop, refine, and pilot-test a mobile intervention to reduce cognitions that contribute to elevated suicide risk and to assess the impact of reductions in suicide cognitions and anger cognitions on suicide risk and functioning.
Detailed description
Suicide cognitions are conceptualized as enduring, chronic vulnerability factors that predispose individuals to suicidal crises. Therefore, modification of these beliefs may reduce suicidal thoughts and behaviors. In addition to suicide cognitions, another potentially modifiable risk factor for suicide is anger. The goal of this research is to develop, refine, and pilot-test a mobile interpretation bias modification intervention to reduce cognitions that contribute to elevated suicide risk and to assess the impact of reductions in suicide cognitions and hostile interpretation bias (a cognitive bias that is associated with anger) on suicide risk and functioning.
Interventions
This is an interpretation bias modification intervention that is designed to target hostile interpretation bias. Participants will be instructed to complete at least 5 treatment sessions per week for a period of 4 weeks. Each session takes approximately 10 minutes.
BEHAVIORALMobile Intervention for Suicidal Thoughts (MIST)
This is an interpretation bias modification intervention that is designed to target cognitive factors that contribute to suicide risk. Participants will be instructed to complete at least 5 treatment sessions per week for a period of 4 weeks. Each session takes approximately 10 minutes.
Sponsors
VA Office of Research and Development
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Participants will use the Mobile Intervention for Suicidal Thoughts (MIST) intervention for 4 weeks, followed by the Mobile Intervention for Reducing Anger (MIRA) for another 4 weeks.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Veterans 18 years or older * Diagnosed with PTSD, established via the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) * Report a score of 12 on the 5-item Dimensions of Anger Reactions Scale * Can read at least 6th grade level material * Report a score of 1-3 (indicating ideation without intent) on the Columbia-Suicide Severity Rating Scale (C-SSRS) * Have attended a mental health appointment within the past month, with another scheduled in the following month (i.e., be engaged in treatment with a mental health provider)
Exclusion criteria
* Diagnosed with bipolar or psychotic disorder. * Current substance use disorder. * Current imminent suicide risk or homicidal ideation requiring immediate intervention.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants Recruited | Through study completion (approximately 10 months) | Participant feasibility expectation will be met if recruitment is 75% (i.e., N = 8) or greater of recruitment expectation (N = 10). |
| Number of Enrolled Participants Who Complete the MIST Intervention | Post-MIST assessment visit (approximately one month after enrollment) | Treatment retention feasibility goal will be met if attrition from the MIST intervention is no more than 25% (i.e., not more than 3). |
| Number of Participants Reporting Satisfaction With MIST App: Client Satisfaction Questionnaire | Post-MIST assessment visit (approximately one month after enrollment) | Patient satisfaction will be assessed with item #7 from the Client Satisfaction Questionnaire. This item is scored on a scale of 1 to 4, with one indicating lower satisfaction and 4 indicating greater satisfaction. The patient satisfaction goal will be met if 80% or greater of participants indicate score a 3 or 4 on this item (i.e., at least 8 participants score a 3 or 4). |
| MIST App Utilization | Post-MIST assessment visit (approximately one month after enrollment) | MIST app utilization goal will be met if MIST app utilization rates are greater than 50% of expected use (i.e., mean # of sessions completed is greater than 10). |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| MIST Intervention Followed by MIRA Intervention These are both mobile interventions that use interpretation bias modification (IBM) techniques to reduce cognitive biases. The MIST app targets suicidal cognitions and the MIRA app targets hostile interpretation bias (which contributes to anger). The MIRA application has already been developed, but the MIST application is newly developed based on the same procedures. All participants will complete the MIST intervention and provide feedback so that we can refine it. We will also be collecting EMA data on to examine how changes to suicide cognitions and hostile interpretation bias (by use of the two apps) affects suicidal ideation and functioning.
Mobile Intervention for Suicidal Thoughts (MIST): This is an interpretation bias modification intervention that is designed to target cognitive factors that contribute to suicide risk. Participants will be instructed to complete at least 5 treatment sessions per week for a period of 4 weeks. Each session takes approximately 10 minutes.
Mobile Intervention for Reducing Anger (MIRA): This is an interpretation bias modification intervention that is designed to target hostile interpretation bias. Participants will be instructed to complete at least 5 treatment sessions per week for a period of 4 weeks. Each session takes approximately 10 minutes. | 10 |
| Total | 10 |
Baseline characteristics
| Characteristic | MIST Intervention Followed by MIRA Intervention |
|---|---|
| Age, Continuous | 47.1 years STANDARD_DEVIATION 12.25 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 1 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 9 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 4 Participants |
| Race (NIH/OMB) More than one race | 1 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants |
| Race (NIH/OMB) White | 4 Participants |
| Region of Enrollment United States | 10 Participants |
| Sex: Female, Male Female | 3 Participants |
| Sex: Female, Male Male | 7 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 10 | 0 / 10 | 0 / 10 |
| other Total, other adverse events | 0 / 10 | 0 / 10 | 4 / 10 |
| serious Total, serious adverse events | 0 / 10 | 0 / 10 | 0 / 10 |
Outcome results
Primary
MIST App Utilization
MIST app utilization goal will be met if MIST app utilization rates are greater than 50% of expected use (i.e., mean # of sessions completed is greater than 10).
Time frame: Post-MIST assessment visit (approximately one month after enrollment)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MIST Intervention Followed by MIRA Intervention | MIST App Utilization | 15.30 treatment sessions completed | Standard Deviation 4.35 |
Primary
Number of Enrolled Participants Who Complete the MIST Intervention
Treatment retention feasibility goal will be met if attrition from the MIST intervention is no more than 25% (i.e., not more than 3).
Time frame: Post-MIST assessment visit (approximately one month after enrollment)
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| MIST Intervention Followed by MIRA Intervention | Number of Enrolled Participants Who Complete the MIST Intervention | 10 Participants |
Primary
Number of Participants Recruited
Participant feasibility expectation will be met if recruitment is 75% (i.e., N = 8) or greater of recruitment expectation (N = 10).
Time frame: Through study completion (approximately 10 months)
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| MIST Intervention Followed by MIRA Intervention | Number of Participants Recruited | 10 Participants |
Primary
Number of Participants Reporting Satisfaction With MIST App: Client Satisfaction Questionnaire
Patient satisfaction will be assessed with item #7 from the Client Satisfaction Questionnaire. This item is scored on a scale of 1 to 4, with one indicating lower satisfaction and 4 indicating greater satisfaction. The patient satisfaction goal will be met if 80% or greater of participants indicate score a 3 or 4 on this item (i.e., at least 8 participants score a 3 or 4).
Time frame: Post-MIST assessment visit (approximately one month after enrollment)
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| MIST Intervention Followed by MIRA Intervention | Number of Participants Reporting Satisfaction With MIST App: Client Satisfaction Questionnaire | 8 Participants |