Arch Suicide Res. 2020 Oct-Dec;24(4):589-608. doi: 10.1080/13811118.2019.1650143. Epub 2019 Sep 10.
In a randomized controlled trial, we found that suicidal patients who received Collaborative Assessment and Management of Suicidality (CAMS) reported greater improvements in suicidal ideation and mental health distress compared to participants who received treatment as usual (TAU). Here, we explored moderators and mediators of the effectiveness of CAMS. Compared to TAU, CAMS was more effective in reducing suicidal ideation when the working alliance, in particular its bond subcomponent, was low. In terms of reducing mental health distress, CAMS was superior to TAU only for participants who did not use illicit drugs and, more tentatively, only for patients without borderline personality traits. We suggest that CAMS may repair a difficult vantage point in terms of poor working alliance in patients with suicide ideation. To obtain superior benefits of CAMS upon more general mental health distress in patients with drug abuse or borderline traits, these problems may need to be more explicitly targeted in parallel.
在一项随机对照试验中，我们发现与接受常规治疗（TAU）的患者相比，接受协作评估和自杀管理（CAMS）的自杀患者在自杀意念和精神健康困扰方面的改善更为明显。在这里，我们探讨了 CAMS 有效性的调节因素和中介因素。与 TAU 相比，当工作联盟（特别是其联系子成分）较低时，CAMS 更能有效减少自杀意念。在减轻精神健康困扰方面，CAMS 仅对不使用非法药物的参与者，更试探性地，仅对没有边缘型人格特质的患者，优于 TAU。我们认为，CAMS 可能会修复有自杀意念的患者中工作联盟不佳这一困难的局面。为了在滥用药物或具有边缘特质的患者中获得 CAMS 在更广泛的精神健康困扰方面的优势，可能需要并行更明确地针对这些问题。
