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Awarded Research Grant to Prevent Violence and Violence-Related Injury

Preventing Youth Suicide in Primary Care: A Family Model

FOA Number: CE04-045 - Grants for Violence-Related Injury Prevention Research
Project Period: 8/1/04–7/31/07
Application/Grant Number: 1-R49-CE000428-01
Principal Investigator: Guy Diamond, PhD
Children’s Hospital of Philadelphia
Joseph Stokes Jr. Research Institute
3615 Civic Center Boulevard
Philadelphia, PA 19104-4318
Phone: 215-590-7550
Fax: 215-590-7410
E-mail: Gdiamond@psych.upenn.edu

Description

Suicide among adolescents is a serious public health problem and clinical challenge for medical and behavioral health providers. Yet few preventive interventions have been tested for this population. This project addresses this deficit by testing the efficacy of brief family therapy for adolescents presenting with serious risk for suicide in a primary care setting.

Several innovations characterize this study:

  1. Patients will be identified and treated directly in the primary care setting. Integrating behavioral health services into primary care may—

    a. reduce burden on physicians by promoting parents as safety monitors,
    b. increase behavioral health treatment adherence, and
    c. address many underlying family problems associated with suicide.

  2. To identify high-risk adolescents, the study will assess severe and persistent suicidal ideation and co-occurring depression. Patients who take part in the study must score above clinical cutoffs on both ideation (SIQ > 31) and depression (BDI-II >20) at two consecutive appointments (generally within 3 days of each other).
  3. Treatment will target two of the most critical suicide risk factors: depression and family conflict. Depression is the most consistently associated risk factor for suicide and family conflict is the most common precipitant of completed suicide (20%) and non-fatal suicidal episodes (50%).
  4. The intervention approach will be Attachment-based Family Therapy (ABFT), an efficacious and manualized family therapy model designed specifically for adolescent depression. ABFT has been successful in reducing suicidal ideation, hopelessness, depression, anxiety, and family conflict.

The Children's Hospital of Philadelphia's Adolescent Care Center will be the performance site, where typically one to three adolescents a week present with severe and current ideation. Eighty-seven percent of patients are African American and 60% are females. One hundred and twenty adolescents will be randomized to 6 to 10 weeks of either ABFT or enhanced usual care. Patients will be evaluated at baseline and 6, 12, 24, and 52 weeks.

 

 
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