Differences Between Suicide Attempters and Suicide Ideators. Influence of the Brief Therapy Attempted Suicide Short Intervention Program (ASSIP) on Neuropsychological Correlates and Psychological Process Factors - Project 3
NCT ID: NCT06322199
Last Updated: 2026-01-23
Study Results
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Basic Information
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ACTIVE_NOT_RECRUITING
119 participants
OBSERVATIONAL
2022-09-23
2026-12-31
Brief Summary
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The overall aim of Project 3 is to evaluate the feasibility and cost-effectiveness of ASSIP flex over a 12-month follow-up period in terms of suicide reattempts and suicide correlates in a cohort who is attending ASSIP flex after a suicide attempt.
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Detailed Description
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In project 3, the feasibility and cost-effectiveness of ASSIP flex setting over a 12-month follow-up period will be investigated. To investigate that, the present study examines the newly implemented ASSIP flex service developed and implemented at the University Hospital of Psychiatry and Psychotherapy Bern (Switzerland).
Background:
In Switzerland, approximately three people die by suicide every day, and suicide attempts exceed this number by far. As a previous suicide attempt is one of the strongest predictors of a completed suicide, it is of utmost importance to identify the people at risk. However, research has shown that traditional risk factors (e.g., depression, psychiatric disorder, etc.) reliably predict suicide ideation but poorly predict suicidal behavior. Furthermore, while effective suicide-specific interventions exist, up to 50% of the suicide attempters reject the recommended treatment, and around 60% discontinue treatment after one session. Hence, a different approach is required. In this study, three projects will be conducted. Project 3 evaluates the feasibility and cost-effectiveness of ASSIP flex.
Study design of Project 3:
The present study examines longitudinally and observationally the newly implemented ASSIP flex at the University Hospital of Psychiatry and Psychotherapy Bern (Switzerland) and four additional recruitment centers. Patients after a suicide attempt who are immobile and/or not able to participate in the regular ASSIP due to other reasons (e.g., shame or fear of stigmatization) are asked to participate in the ASSIP flex project. Moreover, the ASSIP flex will be implemented and investigated in four additional recruitment centers in Switzerland: 1) Sanatorium Kilchberg in Zurich; 2) Psychiatric Hospital, University of Zurich (PUKZH); 3) Centre Hospitalier Universitaire Vaudois (CHUV); 4) Center Neuchâtelois de Psychiatrie (CNP).
All ASSIP flex patients who have agreed to participate in Project 3 (ASSIP flex) are asked to complete a baseline assessment (filling out questionnaires) before the first ASSIP flex session. This baseline assessment is conducted in the patient's environment (i.e., where the ASSIP flex sessions are carried out).
After the baseline assessment, the participants receive ASSIP flex in their personal environment, and after each ASSIP Flex session, process measurements (therapeutic alliance) are completed. Moreover, repeated measurements are conducted after four-six weeks and 12 months follow-up to assess long-term effects.
In project 3 of this study, no randomization took place, and all participants in this group received ASSIP flex.
To investigate the feasibility and effects of ASSIP flex, therapists will also be asked to complete some questionnaires. After the last flex session of each case, they are asked to fill out a brief questionnaire to rate their experiences with this ASSIP flex case. Finally, therapists are asked one year and two years after their ASSIP training to fill out a short questionnaire about their experiences with the ASSIP flex.
Conditions
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Study Design
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CASE_ONLY
PROSPECTIVE
Interventions
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ASSIP (Attempted Suicide Short Intervention Program) flex
ASSIP is a specific therapy for patients after a suicide attempt. The brief therapy ASSIP consists of 3-4 sessions of approximately 50 min. each. ASSIP flex delivers ASSIP in the patient's personal environment as an outreach home treatment. The structure of the ASSIP is the same as in the regular ASSIP, but the program is delivered in the patient's environment.
Session 1: A narrative interview is conducted, in which the patient is asked to tell her personal story, which led to the suicidal crisis. The narrative is video-recorded.
Session 2: Using video playback of the recorded narrative, patient and therapist explore further details of the suicidal process.
Session 3: A case conceptualization focusing on the patient's vulnerability and the trigger of the suicidal crisis is formulated in writing. A list of safety strategies for the prevention of future suicidal behavior is developed jointly with the patient.
Regular letters are sent to patients over a period of 2 years.
Eligibility Criteria
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Inclusion Criteria
* Age ≥ 18 years
* At least one previous suicide attempt
* Willingness to attend the ASSIP Flex
Exclusion Criteria
* Any psychotic disorder
* Inability to follow the procedures of the study (e.g., insufficient mastery of the German language, previous enrolment into the current study)
18 Years
ALL
No
Sponsors
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University of Bern
OTHER
Responsible Party
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Principal Investigators
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Anja C. Gysin-Maillart, PD
Role: PRINCIPAL_INVESTIGATOR
Univerisity of Bern, University Hospital of Psychiatry, Translational Research Center
Adriana O. Frei, MSc
Role: STUDY_CHAIR
University of Bern, University Hospital of Psychiatry, Translational Research Center
Locations
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Centre Hospitalier universitaire vaudois (CHUV)
Lausanne, , Switzerland
Center Neuchâtelois de Psychiatrie
Neuchâtel, , Switzerland
Psychiatric Hospital, University of Zurich (PUKZH)
Zurich, , Switzerland
Sanatorium Kilchberg
Zurich, , Switzerland
Countries
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References
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Peter, C. and A. Tuch, Suizidgedanken und Suizidversuche in der Schweizer Bevölkerung. Obsan Bulletin. Vol. 7. 2019, Nêuchatel. 2019.
Bostwick JM, Pabbati C, Geske JR, McKean AJ. Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew. Am J Psychiatry. 2016 Nov 1;173(11):1094-1100. doi: 10.1176/appi.ajp.2016.15070854. Epub 2016 Aug 13.
Ystgaard M, Arensman E, Hawton K, Madge N, van Heeringen K, Hewitt A, de Wilde EJ, De Leo D, Fekete S. Deliberate self-harm in adolescents: comparison between those who receive help following self-harm and those who do not. J Adolesc. 2009 Aug;32(4):875-91. doi: 10.1016/j.adolescence.2008.10.010. Epub 2008 Nov 22.
Klonsky ED, May A. Rethinking impulsivity in suicide. Suicide Life Threat Behav. 2010 Dec;40(6):612-9. doi: 10.1521/suli.2010.40.6.612.
Klonsky, E.D. and A.M. May, The three-step theory (3ST): A new theory of suicide rooted in the "ideation-to-action" framework. International Journal of Cognitive Therapy, 2015. 8(2): p. 114-129.
May, A.M. and E.D. Klonsky, What distinguishes suicide attempters from suicide ideators? A meta-analysis of potential factors. Clinical Psychology: Science and Practice, 2016. 23(1): p. 5.
Lizardi D, Stanley B. Treatment engagement: a neglected aspect in the psychiatric care of suicidal patients. Psychiatr Serv. 2010 Dec;61(12):1183-91. doi: 10.1176/ps.2010.61.12.1183.
Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57.
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Gysin-Maillart, Michel, Conner, Westrin and Ehnvall (in progress).
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Russell D, Peplau LA, Cutrona CE. The revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. J Pers Soc Psychol. 1980 Sep;39(3):472-80. doi: 10.1037//0022-3514.39.3.472.
Teismann T, et al., Skala Suizidales Erleben und Verhalten (SSEV). Diagnostica. 2021; 67(3): 115-125.
Wehmeier PM, Fox T, Doerr JM, Schnierer N, Bender M, Nater UM. Development and Validation of a Brief Measure of Self-Management Competence: The Self-Management Self-Test (SMST). Ther Innov Regul Sci. 2019 Jul 14:2168479019849879. doi: 10.1177/2168479019849879. Online ahead of print.
Beck AT, Steer RA, Ranieri WF. Scale for Suicide Ideation: psychometric properties of a self-report version. J Clin Psychol. 1988 Jul;44(4):499-505. doi: 10.1002/1097-4679(198807)44:43.0.co;2-6.
Lean M, Fornells-Ambrojo M, Milton A, Lloyd-Evans B, Harrison-Stewart B, Yesufu-Udechuku A, Kendall T, Johnson S. Self-management interventions for people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry. 2019 May;214(5):260-268. doi: 10.1192/bjp.2019.54. Epub 2019 Mar 22.
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Other Identifiers
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2021-02504 (Project 3)
Identifier Type: -
Identifier Source: org_study_id
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