Ultra-Brief Crisis IPT-A Based Intervention for Suicidal Children and Adolescents (IPT-A-SCI) Pilot Study Results

Liat Haruvi Catalan, Mira Levis Frenk, Ella Adini Spigelman, Yair Engelberg, Shira Barzilay, Laura Mufson, Alan Apter, Noa Benaroya Milshtein, Silvana Fennig, Anat Brunstein Klomek, Liat Haruvi Catalan, Mira Levis Frenk, Ella Adini Spigelman, Yair Engelberg, Shira Barzilay, Laura Mufson, Alan Apter, Noa Benaroya Milshtein, Silvana Fennig, Anat Brunstein Klomek

Abstract

In recent years, suicidal behaviors have shown substantial increase worldwide. This trend is also prominent in Israel and has led to a dramatic increase in mental health treatment demand resulting in long wait times and low treatment acceptance rate. To address the critical need in crisis intervention for children and adolescents at suicidal risk we developed an ultra-brief acute crisis intervention, based on Interpersonal Psychotherapy (IPT). IPT is an evidence-based intervention for various psychopathologies among different age groups. The current adaptation of IPT-A is comprised of five weekly sessions, followed by monthly follow-up caring email contacts to the patients and their parents, over a period of 3 months. This paper aims to review the theoretical foundation of this intervention, describe the research design, and present preliminary results of a pilot study. Preliminary Results from our samples of 26 adolescents indicate meaningful trends for both the suicidal ideation (SIQ) and depression (MFQ) outcome measures. Significant interaction was found concerning suicidal ideation but not for depression. Main limitations include small sample size and stratified controls. The treatment appears to be safe, feasible and acceptable and initial results show promising trends to support further study of the approach.

Keywords: IPT; adolescents; crisis intervention; depression; suicide attemps; suicide behavior.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2020 Haruvi Catalan, Levis Frenk, Adini Spigelman, Engelberg, Barzilay, Mufson, Apter, Benaroya Milshtein, Fennig and Klomek.

Figures

Figure 1
Figure 1
Suicidal ideation by group and measurement.
Figure 2
Figure 2
Depressive symptomology by group and measurement.

References

    1. Hedegaard H, Curtin SC, Warner M. Suicide Rates in the United States Continue to Increase. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; (2018).
    1. Itzhaky L, Gratch I, Galfalvy H, Keilp JG, Burke AK, Oquendo MA, et al. . Psychosocial risk factors and outcomes associated with suicide attempts in childhood: a retrospective study. J Psychiatr Res. (2020) 125:129–35. 10.1016/j.jpsychires.2020.03.008
    1. Mehlum L, Tørmoen AJ, Ramberg M, Haga E, Diep LM, Laberg S, et al. . Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: a randomized trial. J Am Acad Child Adolesc Psychiatry. (2014) 53:1082–91. 10.1016/j.jaac.2014.07.003
    1. Miller AL, Rathus JH, Linehan MM. Dialectical Behavior Therapy With Suicidal Adolescents. New York, NY: Guilford Press; (2007).
    1. Mehlum L, Ramberg M, Tørmoen AJ, Haga E, Diep LM, Stanley BH, et al. . Dialectical behavior therapy compared with enhanced usual care for adolescents with repeated suicidal and self-harming behavior: outcomes over a one-year follow-up. J Am Acad Child Adoles Psychiatry. (2016) 55:295–300. 10.1016/j.jaac.2016.01.005
    1. Stanley B, Brown G, Brent DA, Wells K, Poling K, Curry J, et al. . Cognitive-behavioral therapy for suicide prevention (CBT-SP): treatment model, feasibility, and acceptability. J Am Acad Child Adoles Psychiatry. (2009) 48:1005–13. 10.1097/CHI.0b013e3181b5dbfe
    1. Rousseau D, Cook-Cottone C. Trauma-informed yoga training in Kenya: A qualitative pilot study on feasibility and acceptability. Complement Ther Med. (2018) 40:53–60. 10.1016/j.ctim.2018.07.010
    1. Diamond G, Russon J, Levy S. Attachment-based family therapy: a review of the empirical support. Family Process. (2016) 55:595–610. 10.1111/famp.12241
    1. Ashrafioun L, Bishop TM, Conner KR, Pigeon ER. Frequency of prescription opioid misuse and suicidal ideation, planning, and attempts. J Psychiatr Res. (2017) 92:1–7. 10.1016/j.jpsychires.2017.03.011
    1. Israely Ministry of Health Suicide in Israel. (2018). Available online at:
    1. Gysin-Maillart A, Schwab S, Soravia L, Megert M, Michel K. A novel brief therapy for patients who attempt suicide: a 24 months follow up randomuzes controlled study of the attempted suicide short intervention program (ASSIP). PLoS Med. (2016) 13:e1001968. 10.1371/journal.pmed.1001968
    1. Jacobson CM, Mufson L. Interpersonal psychotherapy for depressed adolescents adapted for self-injury (IPT-ASI): rationale, overview, and case summary. Am J Psychother. (2012) 66:349–74. 10.1176/appi.psychotherapy.2012.66.4.349
    1. Joiner T, Kalafat J, Draper J, Stokes H, Knudson M, Berman AL, et al. . Establishing standards for the assessment of suicide risk among callers to the national suicide prevention lifeline. Suicide Life Threat Behav. (2007) 37:353–65. 10.1521/suli.2007.37.3.353
    1. Falgares G, Marchetti D, De Santis S, Carrozzino D, Kopala-Sibley DC, Fulcheri M, et al. . Attachment styles and suicide-related behaviors in adolescence: the mediating role of self-criticism and dependency. Front Psychiatry. (2017) 8:36. 10.3389/fpsyt.2017.00036
    1. Levi Y, Horesh N, Fischel T, Treves I, Or E, Apter A. Mental pain and its communication in medically serious suicide attempts: an “impossible situation”. J Affect Dis. (2008) 111:244–50. 10.1016/j.jad.2008.02.022
    1. Horesh N, Levi Y, Apter A. Medically serious versus non – serious suicide attempts: relationshipso lethality and intent to clinical and interpersonal characteristics. J Affect Dis. (2012) 136:286–93. 10.1016/j.jad.2011.11.035
    1. Klerman GL, Weissman MM, Rounsaville BJ, Chevron E. Interpersonal Psychotherapy for Depression. New York, NY: Basic Books; (1984).
    1. Markowitz JC, Weissman MM. Casebook of Interpersonal Psychotherapy. Oxford: Oxford University Press; (2012).
    1. Mufson L, Dorta KP, Moreau D, Weissman MM. Interpersonal Psychotherapy for Depressed Adolescents. 2nd ed. New York, NY: Guildford Press; (2004).
    1. Brunstein Klomek A, Zalsman G, Mufson L. Interpersonal psychotherapy for depressed adolescents. Isr J Psychiatry Relat Sci. (2007) 44:40–6.
    1. Mahan RM, Swan SA, Macfie J. Interpersonal psychotherapy and mindfulness for treatment of major depression with anxious distress. Clin Case Stud. (2018) 17:104–19. 10.1177/1534650118756530
    1. Waldron HL, Tanofsky-Kraff M, Wilfley DE. Interpersonal psychotherapy for clients with eating disorders. In: Choate LH, editor. Eating Disorders and Obesity (2015).
    1. Mufson L, Weissman MM, Moreau D, Garfinkel R. Efficacy of interpersonal psychotherapy for depressed adolescents. Arch Gen Psychiatry. (1999) 56:573–9 10.1001/archpsyc.56.6.573
    1. Spence S, O'Shea G, Donovan C. Improvements in interpersonal functioning following interpersonal psychotherapy (IPT) with adolescents and their association with change in depression. Behav Cogn Psychother. (2016) 44:257–72. 10.1017/S1352465815000442
    1. Mufson L, et al. Presented at IOWA IPT Conference Preliminary Outcomes of IPT-A for Depressed Youth Engaging in Suicidal Behavior (IPT-A-SP). Iowa: (2015).
    1. Graham P, Irvine Fitzpatrick L, Bowyer DS, Taylor R, Tan L. Proof of concept: interpersonal psychotherapy acute crisis (ipt ac) for deliberate self-poisoning/self-harm. (2020). Available online at:
    1. Motto JA, Bostrom AG. A randomized controlled trial of postcrisis suicide prevention. Psychiatr Serv. (2001) 52:828–33. 10.1176/appi.ps.52.6.828
    1. Stanley B, Brown GK. Safety planning intervention: a brief intervention to mitigate suicide risk. Cogn Behav Pract. (2012) 19:256–64. 10.1016/j.cbpra.2011.01.001
    1. Reynolds W. Suicide Ideation Questionnaire. Odessa, FL: Psychological Assessment Resources; (1987).
    1. Posner K, Brown KG, Stanley B, Brent AD, Yershova VK, Oquendo M, et al. . The Columbia–suicide severity rating scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. (2011) 168:1266–77. 10.1176/appi.ajp.2011.10111704
    1. Weissman MM, Orvaschel H, Padian N. Children's symptom and social functioning self-report scales: comparison of mother's and children's reports. J Nerv Ment Dis. (1980) 168:736–40. 10.1097/00005053-198012000-00005
    1. Angold A, Costello EJ, Messer SC, Pickles A. Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. Int J Methods Psychiatr Res. (1995) 5:237–49.
    1. Birmaher B, Khetarpal S, Brent D, Gully M, Balach L, Kaufman J, et al. The screen for child anxiety related emotional disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry. (1997) 36:553–4. 10.1097/00004583-199704000-00018
    1. Lionetti F, Mastrotheodoros S, Palladino BE. Experiences in close relationships revised child version (ECR-RC): psychometric evidence in support of a security factor. Eur J Dev Psychol. (2018) 15:452–63. 10.1080/17405629.2017.1297228
    1. Rosenberg M. Conceiving the Self. New York, NY: Basic Books; (1979).
    1. Burns CD, Cortell R, Wagner BM. Treatment compliance in adolescents after attempted suicide: a 2-year follow-up study. J Am Acad Child Adolesc Psychiatry. (2008) 47:948–57. 10.1097/CHI.0b013e3181799e84
    1. Lipsitz JD, Markowitz JC. Mechanisms of change in interpersonal therapy (IPT). Clin Psychol Rev. (2013) 33:1134–47. 10.1016/j.cpr.2013.09.002

Source: PubMed

3
Předplatit