Faculty of Psychology, Universidad de Talca, Talca 3460000, Chile.
Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago 8320000, Chile.
Int J Environ Res Public Health. 2022 Mar 26;19(7):3947. doi: 10.3390/ijerph19073947.
Suicidal ideation is prevalent in adolescents and is a marker for subsequent psychiatric vulnerability and symptom severity. Literature shows that blended care (integrating online and offline components in a treatment process) could improve the effectiveness and adherence of interventions targeting suicidal ideation in adolescents, but the evidence is inconclusive. Thus, we will test the effectiveness of a blended intervention to reduce suicidal ideation (primary outcome) in school settings using a single-blind two-armed cluster randomized controlled trial (cRCT). The internet-based component corresponds to the Reframe-IT, a program encompassing eight online sessions based on cognitive-behavioral therapy (CBT) principles. The face-to-face intervention will be delivered through four CBT sessions. Additionally, we will assess the effect of the intervention on the following secondary outcomes: suicidal attempts, depressive symptoms, hopelessness, emotional regulation, and problem-solving skills. Primary and secondary outcomes will be assessed at post-intervention, 3-month, 6-month, and 12-month follow-up. Finally, we will explore the mediation role of cognitive, emotional, and behavioral correlates of suicide on the effect of the intervention. Results will inform whether the intervention can reduce suicide among school adolescents and be implemented on a large scale in Chile.
自杀意念在青少年中很普遍，是随后出现精神脆弱和症状严重的标志。文献表明，混合式护理（在治疗过程中整合在线和离线组件）可以提高针对青少年自杀意念的干预措施的有效性和依从性，但证据尚无定论。因此，我们将使用单盲双臂群组随机对照试验（cRCT）在学校环境中测试混合干预措施减少自杀意念（主要结果）的效果。基于互联网的部分对应于 Reframe-IT，这是一个包含基于认知行为疗法（CBT）原则的八个在线课程的项目。面对面的干预将通过四个 CBT 课程进行。此外，我们将评估干预对以下次要结果的影响：自杀企图、抑郁症状、绝望、情绪调节和解决问题的能力。主要和次要结果将在干预后、3 个月、6 个月和 12 个月随访时进行评估。最后，我们将探讨自杀的认知、情感和行为相关因素对干预效果的中介作用。结果将表明该干预措施是否可以减少智利学校青少年的自杀行为，并在智利大规模实施。
