Skills to Enhance Positivity in Suicidal Youth

NCT ID: NCT04994873

Last Updated: 2025-10-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

216 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-04

Study Completion Date

2026-09-01

Brief Summary

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This is a Hybrid Type I Effectiveness-Implementation design. Specifically, this study proposes to test the effectiveness of STEP in reducing suicidal events and ideation in 216 adolescents, admitted to inpatient psychiatric care due to suicide risk. Participants will be randomized to either STEP or ETAU. STEP involves 4 in-person sessions (3 individual, 1 family) focused on psychoeducation regarding positive and negative affect, mindfulness meditation, gratitude, and savoring. Mood monitoring prompts and skill reminders will be sent daily for the first month post-discharge and three times a week for the following two months. The ETAU condition will receive reminders to log into a safety resource app, matched in frequency to the STEP group. Effectiveness aspects of the design include using clinical staff as interventionists and having very few exclusion criteria.

Detailed Description

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216 participants and their families (across two sites) will be randomized to either STEP or ETAU (as described in the research strategy). Aims and hypotheses are below:

Aim 1: Examine the effectiveness of STEP in reducing suicidal events (attempt or emergency intervention to intercede attempt), active SI (with intent or plan), and depression at 6-month f/u (primary) and suicidal events at 12-month follow-up (f/u). H1: It is hypothesized that those randomized to STEP, compared to ETAU, will have lower rates of suicide events (H1A), active SI (H1B), and depression (H1C) over the 6-month follow-up period; H1D: It is hypothesized that those randomized to STEP, compared to ETAU, will have lower rates of suicidal events at the 12-month, long term f/u.

Aim 2: Examine engagement of the hypothesized mechanisms at the 3- and 6-month f/u. It is hypothesized that those randomized to STEP, compared to ETAU, will have: H2A: higher attention to positive affect, assessed by implicit tasks; H2B: higher gratitude and satisfaction with life, assessed by self-report; H2C: lower negative affect, assessed by implicit tasks and self-report.

Aim 3: Examine whether hypothesized mechanisms mediate reduction of suicidal events and ideation. H3: Changes in attention to positive affect, gratitude, satisfaction with life, and negative affect at 3-month f/u will be related to improvements in suicidal ideation and suicidal events at the 6-month f/u.

Secondary Aim Examine elements supporting external validity. Acceptability, appropriateness, and feasibility of STEP to patients, parents, clinicians, and administrators will be assessed by: 1) a survey consisting of brief, standardized measures of these items, and 2) qualitative interviews to further explore these perceptions. These findings will be used to: 1) modify STEP to address potential barriers, and 2) develop implementation strategies designed to overcome these challenges, for testing in a future Hybrid Type III effectiveness-implementation trial.

Conditions

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Suicide, Attempted

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

2 condition randomized clinical trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The baseline assessment will occur prior to randomization and follow-up assessors will be blind to participant condition

Study Groups

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STEP: Positivity skill enhancement

This intervention includes the Enhanced TAU described below plus it entails 4 in-person sessions delivered during an inpatient psychiatric admission, followed by mood monitoring and skills messages delivered post-discharge via app, to promote the practice of increasing attention to positive affect and experiences as a means of reducing risk for suicidal behavior.

Group Type EXPERIMENTAL

STEP

Intervention Type BEHAVIORAL

Behavioral intervention to increase positive affect

Enhanced TAU

his comparison intervention involves regular programming of the inpatient psychiatric unit, followed by safety plan and resources loaded onto an app that the participant has access to post-discharge.

Group Type ACTIVE_COMPARATOR

Enhanced TAU

Intervention Type BEHAVIORAL

Standard care plus a phone app with a personalized safety plan

Interventions

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STEP

Behavioral intervention to increase positive affect

Intervention Type BEHAVIORAL

Enhanced TAU

Standard care plus a phone app with a personalized safety plan

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Ages 12- 60 years
* hospitalized on an inpatient psychiatric unit due to suicide risk
* past month suicide attempts or suicidal ideation
* proficient in English (parent either English or Spanish
* access to a smart phone.


Ages 22 - 60 years

* work with adolescents hospitalized on an inpatient psychiatric unit due to suicide risk
* proficient in English or Spanish

Exclusion Criteria

* active psychotic disorder
* significant cognitive impairment or deficits
* ward of the State
* discharge to residential facility.
Minimum Eligible Age

12 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Brown University

OTHER

Sponsor Role lead

Responsible Party

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Anthony Spirito

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Children's Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

Butler Hospital

Providence, Rhode Island, United States

Site Status RECRUITING

Bradley Hospital

Riverside, Rhode Island, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Anthony Spirito, PhD

Role: CONTACT

4013692435

Shirley Yen, PhD

Role: CONTACT

4013787315

Facility Contacts

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Shirley Yen, PhD

Role: primary

401-378-7315

Anthony Spirito

Role: primary

4013692435

Anthony Spirito, PhD

Role: primary

4013692435

Jennifer C Wolff, PhD

Role: backup

540-921-7574

References

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Yen S, Suazo N, Doerr J, Macrynikola N, Villarreal LS, Sodano S, O'Brien KHM, Wolff JC, Breault C, Gibb BE, Elwy R, Kahler CW, Ranney M, Jones R, Spirito A. Skills to Enhance Positivity in adolescents at risk for suicide: Protocol for a randomized controlled trial. PLoS One. 2023 Oct 20;18(10):e0287285. doi: 10.1371/journal.pone.0287285. eCollection 2023.

Reference Type DERIVED
PMID: 37862324 (View on PubMed)

Other Identifiers

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1023

Identifier Type: -

Identifier Source: org_study_id

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