Preventing Youth Suicide in Primary Care: A Family Model

NCT ID: NCT00604097

Last Updated: 2012-12-17

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE3
• Total Enrollment: 66 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2004-09-30
• Study Completion Date: 2008-08-31

Brief Summary

The purpose of the study is to test the efficacy of a brief family therapy (Attachment-Based Family Therapy) for youth presenting in primary care with suicidal ideation and depressed mood.

Detailed Description

Youth suicide is a serious public health problem and clinical challenge for medical and behavioral health providers, yet few preventive interventions have been tested for this population. This project addresses this deficit by testing the efficacy of a brief family therapy for adolescents presenting with serious risk for suicide in a primary care setting. Several innovations characterize the study. First, patients will be identified and treated directly in the primary care setting. Integrating behavioral health services into primary care may a) reduce burden on physicians by promoting parents as safety monitors, b) increase behavioral health treatment adherence, and c) address many underlying family problems associated with suicide. Second, to identify seriously at risk adolescents, we will assess for severe and persistent suicidal ideation and co-occurring depression. Patients will need to score above clinical cutoffs on both ideation (SIQ-JR > 31) and depression (BDI-II >20) at two consecutive appointments (generally within 3 days of each other). Third, treatment will target two of the most critical suicide risk factors: depression and family conflict. Depression is the most consistently associated risk factor for suicide and family conflict is the most common precipitant of completed suicide (20%) and non-fatal suicidal episodes (50%). Fourth, we will use Attachment Based Family Therapy (ABFT; Diamond et al., 2002) as the intervention approach, an efficacious and manualized family therapy model specifically designed for adolescent depression. ABFT has been successful in reducing suicidal ideation, hopelessness, depression, anxiety, and family conflict. Participants will be recruited from the primary care centers at The Children's Hospital of Philadelphia. Eighty-seven percent of patients are African American and 60% are girls. One hundred adolescents will be randomized to 6 to 10 weeks of either ABFT or Enhanced Usual Care (EUC). Patients will be evaluated at baseline 6, 12, 24, and 52 weeks.

Conditions

Suicide

Keywords

youth suicide; family therapy; primary care; intervention

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: FACTORIAL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

1

Attachment-Based Family Therapy

Group Type: EXPERIMENTAL

Attachment-Based Family Therapy

Intervention Type: BEHAVIORAL

12-16 week family-based therapy

2

Enhanced Usual Care

Group Type: ACTIVE_COMPARATOR

Enhanced Usual Care

Intervention Type: BEHAVIORAL

Rapid referral to community outpatient care with weekly monitoring of symptoms by study team

Interventions

Attachment-Based Family Therapy

12-16 week family-based therapy

Intervention Type: BEHAVIORAL

Enhanced Usual Care

Rapid referral to community outpatient care with weekly monitoring of symptoms by study team

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Suicidal ideation (SIQ-JR > 30)
• Moderate depressed mood (BDI-II > 19)
• At least one parent/caregiver willing to participate

Exclusion Criteria

• Psychosis
• Mental retardation or other significant cognitive impairment

• Minimum Eligible Age: 12 Years
• Maximum Eligible Age: 17 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Children's Hospital of Philadelphia

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Guy S Diamond, PhD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital of Philadelphia

Locations

CHOP Adolescent Care Center

Philadelphia, Pennsylvania, United States

CHOP University City Primary Care

Philadelphia, Pennsylvania, United States

CHOP Primary Care Center at Cobb's Creek

Philadelphia, Pennsylvania, United States

CHOP Primary Care Center in South Philadelphia

Philadelphia, Pennsylvania, United States

Countries

United States

References

Diamond G, Creed T, Gillham J, Gallop R, Hamilton JL. Sexual trauma history does not moderate treatment outcome in Attachment-Based Family Therapy (ABFT) for adolescents with suicide ideation. J Fam Psychol. 2012 Aug;26(4):595-605. doi: 10.1037/a0028414. Epub 2012 Jun 18.

Reference Type: RESULT

PMID: 22709259 (View on PubMed)

Diamond GS, Wintersteen MB, Brown GK, Diamond GM, Gallop R, Shelef K, Levy S. Attachment-based family therapy for adolescents with suicidal ideation: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2010 Feb;49(2):122-31. doi: 10.1097/00004583-201002000-00006.

Reference Type: RESULT

PMID: 20215934 (View on PubMed)

Other Identifiers

1R49CE000428

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2004-11-3995

Identifier Type: -

Identifier Source: org_study_id