Reducing short term suicide risk after hospitalization: A randomized controlled trial of the Collaborative Assessment and Management of Suicidality

Comtois, Katherine Anne; Hendricks, Karin E.; DeCou, Christopher R.; Chalker, Samantha A.; Kerbrat, Amanda H.; Crumlish, Jennifer; Huppert, Tierney K; Jobes, David A.

doi:10.1016/j.jad.2022.09.042

Cited by 7 publications

(5 citation statements)

References 37 publications

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“…Only rumination and negative affect displayed significant same-day within-person associations with SI intensity, suggesting these two ACCs may be involved in proximal risk for SI more than positive affect, distress intolerance and emotion dysregulation. Thus, interventions aimed at reducing SI during the post-discharge period (e.g., Comtois et al 2023) may benefit from detecting and intervening on short-term intraindividual upswings in negative affect and ruminative negative thinking. Interestingly, only the same-day associations between ACCs and SI intensity varied randomly across individuals.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, interventions aimed at reducing SI during the post‐discharge period (e.g., Comtois et al. 2023) may benefit from detecting and intervening on short‐term intraindividual upswings in negative affect and ruminative negative thinking. Interestingly, only the same‐day associations between ACCs and SI intensity varied randomly across individuals.…”

Section: Discussionmentioning

confidence: 99%

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Daily Levels and Dynamic Metrics of Affective–Cognitive Constructs Associate With Suicidal Thoughts and Behaviours in Adults After Psychiatric Hospitalization

Wallace,

Brick,

Provost

et al. 2024

Clin Psychology and Psychoth

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The period after psychiatric hospitalization is an extraordinarily high‐risk period for suicidal thoughts and behaviours (STBs). Affective–cognitive constructs (ACCs) are salient risk factors for STBs, and intensive longitudinal metrics of these constructs may improve personalized risk detection and intervention. However, limited research has examined how within‐person daily levels and between‐person dynamic metrics of ACCs relate to STBs after hospital discharge. Adult psychiatric inpatients (N = 95) completed a 65‐day ecological momentary assessment protocol after discharge as part of a 6‐month follow‐up period. Using dynamic structural equation models, we examined both within‐person daily levels and between‐person dynamic metrics (intensity, variability and inertia) of positive and negative affect, rumination, distress intolerance and emotion dysregulation as risk factors for STBs. Within‐person lower daily levels of positive affect and higher daily levels of negative affect, rumination, distress intolerance and emotion dysregulation were risk factors for next‐day suicidal ideation (SI). Same‐day within‐person higher rumination and negative affect were also risk factors for same‐day SI. At the between‐person level, higher overall positive affect was protective against active SI and suicidal behaviour over the 6‐month follow‐up, while greater variability of rumination and distress intolerance increased risk for active SI, suicidal behaviour and suicide attempt. The present study provides the most comprehensive examination to date of intensive longitudinal metrics of ACCs as risk factors for STBs. Results support the continued use of intensive longitudinal methods to improve STB risk detection. Interventions focusing on rumination and distress intolerance may specifically help to prevent suicidal crises during critical transitions in care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Daily Levels and Dynamic Metrics of Affective–Cognitive Constructs Associate With Suicidal Thoughts and Behaviours in Adults After Psychiatric Hospitalization

Wallace,

Brick,

Provost

et al. 2024

Clin Psychology and Psychoth

View full text Add to dashboard Cite

show abstract

“…Verschiedene Behandlungsprogramme zur stationären Behandlung suizidaler Patienten [14][15][16] -inklusive einer App [17] -werden derzeit evaluiert; als unverzichtbare suizidfokussierte Behandlungsbausteine gelten die Risikoexploration, die Zugangsbeschränkung zu letalen Mitteln, die Erstellung eines Notfallplans und die Vermittlung von Fertigkeiten zum Umgang mit suizidalen Eskalationen [18]. In allen Fällen -insbesondere aber in "schwierigen" Fällen, wie den dargestellten -geht es darüber hinaus darum, frühzeitig ein individuelles Fallkonzept zu entwickeln, aus dem heraus suizidales Erleben und Verhalten verstanden werden kann.…”

Section: Entwicklung Eines Fallverständnissesunclassified

Suiziddrohungen bei Entlassung aus stationär-psychiatrischer Behandlung

Koban,

Teismann

2024

Nervenheilkunde

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ZUSAMMENFASSUNGSuiziddrohungen vor einer geplanten Entlassung stellen Behandler im stationären Setting vor erhebliche Schwierigkeiten; insbesondere, da sich nicht sicher differenzieren lässt zwischen sogenannten Suizidgesten und genuiner Suizidalität. Es empfiehlt sich, frühzeitig während eines stationären Aufenthalts suizidales Erleben und Verhalten explizit zum Thema zu machen. Die therapeutische Auseinandersetzung sollte dabei auf einem fundierten Fallkonzept aufbauen und muss die motivationale Ausgangslage von Patienten berücksichtigen. Motivations- und beziehungsfördernde Therapiestrategien sind veränderungsorientierten Therapieinterventionen dabei immer voranzustellen. Strukturierte Therapieprogramme während und nach dem stationären Aufenthalt können für die weitergehende Aufarbeitung genutzt werden.

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“…A sixth RCT of CAMS had mixed results. The “Aftercare Focus Study” was designed to intentionally recruit extremely high-risk people—namely, patients who had made suicide attempts and were recently discharged from inpatient psychiatric care ( 24 ). In the study, 150 patients were randomly assigned to CAMS or TAU.…”

Section: Empirical Support For Camsmentioning

confidence: 99%

The use of CAMS and DBT to effectively treat patients who are suicidal

Jobes,

Rizvi

2024

Front. Psychiatry

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Around the world, suicide ideation, attempts, and deaths pose a major public and mental health challenge for patients (and their loved ones). Accordingly, there is a clear need for effective clinical treatments that reliably reduce suicidal thoughts and behaviors. In this article, we review the Collaborative Assessment and Management of Suicidality (CAMS) and Dialectical Behavior Therapy (DBT), two clinical treatments that rise to the highest levels of empirical rigor. Both CAMS and DBT are now supported by randomized controlled trials (RCTs), with independent replications, and meta-analyses. There are also supportive data related to training clinical providers to use CAMS and DBT with adherence. RCTs that investigate the use of both interventions within clinical trial research designs and the increasing use of these complementary approaches within routine clinical practice are discussed. Future directions for research and clinical use of CAMS and DBT are explored as means to effectively treat suicidal risk.

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Reducing short term suicide risk after hospitalization: A randomized controlled trial of the Collaborative Assessment and Management of Suicidality

Cited by 7 publications

References 37 publications

Daily Levels and Dynamic Metrics of Affective–Cognitive Constructs Associate With Suicidal Thoughts and Behaviours in Adults After Psychiatric Hospitalization

Daily Levels and Dynamic Metrics of Affective–Cognitive Constructs Associate With Suicidal Thoughts and Behaviours in Adults After Psychiatric Hospitalization

Suiziddrohungen bei Entlassung aus stationär-psychiatrischer Behandlung

The use of CAMS and DBT to effectively treat patients who are suicidal

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