Clinical trial NCT06921226: Exploratory Analysis of Interpersonal and Intrapersonal Psychological Processes Implied in Risk-taking and Suicidal Behaviors, in Adult and Adolescent At-risk
Official title: Intra-personal and Interpersonal Psychological Processes Involved in Risk-taking and Suicidal Behaviors Among Vulnerable Adolescents and Adults
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Suicidal Ideas
Suicidal Ideation
Risk-taking
Keywords: Risk-taking behaviors
Impulsivity
Interpersonal needs
Suicidal ruminations
Suicidal behaviors
BART
Lead sponsor: Centre Hospitalier Metropole Savoie
Sponsor class: OTHER
Collaborators: name: Centre Hospitalier Spécialisé de la Savoie (Chambéry)
name: Université Savoie Mont Blanc
First posted: 2025-04-10
Enrollment: 1400
Sex: ALL
Minimum age (years): 12
Maximum age (years): 65
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: PREVENTION

Brief summary: In a recent report, Santé Publique France (2023), reported that 4.2% of 18-85 year-olds had thought about suicide in the last 12 months, and 6.8% had attempted suicide in their lifetime and 0.5% in the last year. Even more recently, the DREES (Direction de la recherche, des études, de l'évaluation et des statistiques auprès des Ministères Sociaux) published a report on May 16, 2024, showing a sharp rise in hospitalization rates for self-inflicted acts among female patients aged between 10 and 24, with a peak around age 15. Two-thirds of these hospitalizations for self-inflicted injuries are related to deliberate drug intoxication. Depression, bipolar disorders and schizophrenia spectrum disorders (among other psychological disorders) are known risk factors for suicide, which is the leading cause of death in this clinical context. In addition to these formalized psychopathological elements, risk behaviors underpinned by psychological processes common to suicide attempts are suspected and need to be studied in depth.

Research into psychiatry and the psychopathology of suicide has identified a number of risk and protective factors. These psychological determinants - or processes - act alongside other key factors such as the environment and social ties. Life contexts can have an impact on health, and more specifically on the psychopathology of individuals, through disturbances of a biological, psychological and social nature. It is important to be able to describe what processes are at work and how they explain the development and maintenance of behaviours that put one's life and health at risk. This is part of a preventive approach to mental health. We suggest that the study of psychological processes such as suicidal ruminations, impulsivity and interpersonal needs (e.g. the interpersonal theory of suicide) is necessary to understand their involvement in risk-taking and suicidal behavior. To our knowledge, few studies of this type are underway in France, particularly with vulnerable clinical populations (adolescents/adults). The inclusion of a process-centered approach (Kinderman, 2015), in a transdiagnostic and preventive way, constitutes an innovative approach.

Detailed description: The aim of this study is to describe psychological processes that contribute to risk-taking and suicidal behaviors.

The primary objective of this study is: To examine the fit of an Structural Equation Model (SEM) of risk-taking and suicidal behaviors and ideation, and explain those self-destructive behavior can possibly affected by Perceived Burdensomeness (PB) and Thwarted Belongingness (TB), Impulsivity and Suicidal Ruminations (SR) among with suicidal ideations.

This study will address the following secondary objectives:

1. To explore the mediating effect of risk-taking, as a behavioral variable, on the relationship between suicidal ideation and behavior and impulsivity.
2. To explore the mediating effect of risk-taking, as a self-reported variable, on the relationship between suicidal ideation and behavior and impulsivity.
3. To explore the mediating effect of risk-taking, as a cognitive variable, on the relationship between suicidal ideation and behavior and impulsivity.
4. To explore the mediating effect of PB on the relationship between SR and suicidal ideation and behavior.
5. To explore the mediating effect of TW, on the relationship between SR and suicidal ideation and behavior.
6. To explore the mediating effect of SR on the relationship between suicidal ideation and behavior and impulsivity.

The effect of developmental status (adult versus adolescent), will be considerated as a co-variate.

Eligibility criteria: Inclusion Criteria:

* Age 12-65 years
* Adolescent population considered as at risk in mental health : admitted to the peadiatric department (CHMS).

or - Adult population : user of the Espoir73 association (an association for adults with a mental health problem) or users of SM@RT (CHS, a psycho-social rehabilitation center for adults with a mental illness).

Exclusion Criteria:

- No suicidal ideation or behaviors (none " Yes " response at the 6 questions of the C-SSRS screen version).

Primary outcomes:
measure: Suicidal ideation and behaviors
timeFrame: At inclusion
Secondary outcomes:
Other outcomes:
Locations:
city: Chambery
country: France
facility: CH Métropole Savoie
state: Savoie
city: Bassens
country: France
facility: Centre Hospitalier Spécialisé de la Savoie (CHS)
city: Francin
country: France
facility: ESPOIR73
Study officials:
References:
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citation: Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, Currier GW, Melvin GA, Greenhill L, Shen S, Mann JJ. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011 Dec;168(12):1266-77. doi: 10.1176/appi.ajp.2011.10111704.