A Novel Cognitive Reappraisal Intervention for Suicide Prevention

Last updated: January 17, 2025
Sponsor: Weill Medical College of Cornell University
Overall Status: Completed

Phase

N/A

Condition

Suicide

Treatment

Supportive Therapy

Cognitive Reappraisal Intervention for Suicide Prevention

Clinical Study ID

NCT03026127
1603017115
1R61MH110542
5R33MH110542
  • Ages 50-90
  • All Genders

Study Summary

The goal of this trial is to refine and test a novel emotion-regulation based psychosocial intervention designed to reduce suicide risk in middle-aged and older adults (50-90 years old) who have been discharged after a suicide-related hospitalization (i.e. for suicidal ideation or suicide attempt).

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • 50 years and older

  • Diagnosis (based on SCID-5 Clinical Trials Version to assess DSM-5 diagnoses): AnyDSM-5 depression or anxiety diagnosis, including major depressive disorder, bipolardepression, depressive disorder Not Elsewhere Classified, anxiety disorder NotElsewhere Classified, adjustment disorder with anxiety and depressed mood (butwithout any of the diagnoses shown under Exclusion Criteria)

  • Recent hospitalization for suicidal ideation or suicide attempt. At hospitaladmission, Columbia Suicide Severity Rating Scale greater or equal to 3, "ActiveSuicidal Ideation with any methods or a suicide attempt."

  • Patients with any degree of suicidal ideation at discharge (Columbia SuicideSeverity Rating greater or equal to 0) will be included.

  • Patients who are on psychotropics and on after-care community psychotherapy willalso be included.

Exclusion

Exclusion Criteria:

  • History or current diagnosis of Psychotic Disorders; Current Diagnosis of Bipolar Ior Bipolar II, with current episode hypomanic, manic or mixed; Diagnosis ofDementia.

  • Cognitive Impairment: Mini Mental State Exam (MMSE) < 24.

  • Acute or severe medical illness (i.e. delirium; decompensated cardiac, liver, orkidney failure; major surgery; stroke or myocardial infarction during the threemonths prior to entry.

  • Aphasia, sensory problems, and/or inability to speak English.

Study Design

Total Participants: 72
Treatment Group(s): 2
Primary Treatment: Supportive Therapy
Phase:
Study Start date:
March 28, 2017
Estimated Completion Date:
October 03, 2024

Study Description

The Investigators developed a novel psychosocial intervention called "Cognitive Reappraisal Intervention for Suicide Prevention (CRISP)," which aims to improve cognitive reappraisal ability (i.e. the ability to modify the appraisal of a situation to alter its emotional significance) (target), and reduce suicide risk (outcome). The conceptual framework views suicidal ideation and behavior as failed attempts to regulate negative emotions and by improving cognitive reappraisal, an effective emotion regulation strategy, the investigators expect to reduce suicide risk. This theory is supported by studies showing that unsuccessful attempts to regulate negative emotions and decreased cognitive reappraisal are associated with increased suicidal ideation and behavior.

The R61 phase is a proof-of-principle phase and its goals are to optimize CRISP and test its engagement with cognitive reappraisal. Certified social workers will administer 12 weekly sessions of CRISP to 40 middle-aged and older adults (50-90 years old) after a suicide-related hospitalization. Research assistants, unaware of the study aims, will conduct assessments at study entry (hospital admission), discharge, 6 and 12 weeks post-discharge. Target engagement will be assessed with EEG assessments during a standard pictured-based stimuli and our novel cognitive reappraisal paradigm.

The R33 phase aims to provide further evidence of target engagement of the optimized CRISP in a larger sample, evaluate the relationship of cognitive reappraisal with suicide risk as measured with Columbia Suicide Severity Rating Scale (C-SSRS) and estimate implementation parameters for a large-scale clinical trial. A different sample of 90 middle-aged and older adults (using the same inclusion/exclusion criteria as for the R61 phase) will be randomized to CRISP or to Supportive Therapy (ST, a control treatment not designed to improve emotion regulation). Assessments will be conducted on admission, at discharge, and at 6, 12 and 24 weeks post-discharge. Primary aims are: 1) CRISP participants will show improvement in cognitive reappraisal ability from discharge to end of treatment; and 2) improvement in cognitive reappraisal ability will be associated with suicide risk over 24 weeks.

Connect with a study center

  • Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine

    White Plains, New York 10605
    United States

    Site Not Available

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