Targeting Emotion Dysregulation to Reduce Suicide in People With Psychosis

Study Overview
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Brief Summary
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People with psychotic disorders are excluded from most suicide-focused clinical trials despite incredibly high rates of completed suicide, and interventions that have been tested for this population have shown limited impact on suicide. Emotion dysregulation is a significant suicidogenic factor that is understudied in people with psychotic disorders. The investigators propose to implement and evaluate an intervention targeting emotion dysregulation in people with psychotic disorders while employing rigorous statistical modeling and measurement techniques including Ecological Momentary Assessment, which will support future advanced research on suicide and suicide prevention for this high-risk group.

Official Title
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Targeting Emotion Dysregulation to Reduce Suicide in People With Psychosis

Conditions
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Psychosis, Suicide

Intervention / Treatment
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* Behavioral: Dialectical Behavior Therapy Skills Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: At least 18 years old Psychosis spectrum disorder as assessed by the Mini International Neuropsychiatric Interview (MINI) for Psychotic Disorder Studies Heightened suicide risk as determined by a score of 8+ on the Suicide Behaviors Questionnaire-Revised (SBQ-R). This cutoff may be revised downwards (toward lower suicide risk) if recruitment appears difficult, but will not be revised upwards. Enrollment and engagement in outpatient mental health services with at least one mental health service in the previous month 6+ grade equivalent reading level as assessed by the Wide Range Achievement Test 4 (WRAT-4) Exclusion Criteria: Chart diagnosis of intellectual disability (DSM5 317, 318), traumatic brain injury, or deafness.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dialectical Behavior Therapy - Skill Training<br> | Behavioral: Dialectical Behavior Therapy Skills Training<br>* Dialectical Behavior Therapy Skills Training (DBT-ST) is a group-based intervention focused on teaching skills for improving emotion regulation. The sessions will be offered in-person or via approved telehealth services.<br>* Other names: Dialectical Behavior Therapy Skills Group;|
| No Intervention: Treatment As Usual<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Suicidal Ideation | Beck Scale for Suicide Ideation. Minimum score: 0. Maximum score: 42. Higher scores are worse. | Four months | 
| Emotion Dysregulation | Difficulties in Emotion Regulation Scale (DERS-36). Minimum score: 36. Maximum score: 180. Higher scores are worse. | Four months |