Clinical trial NCT07001202: Acceptability and Feasibility of Reframe-IT+U for Suicidality in University Students.
Official title: Acceptability and Feasibility of a Preventive Indicated Intervention for Suicidality in University Students: Reframe-IT+U
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Suicidal Ideation
Depression Disorders
Anxiety
Keywords: Suicidal ideation prevention
Indicated prevention
Depression prevention
Anxiety prevention
University students
College students
Lead sponsor: Universidad de los Andes, Chile
Sponsor class: OTHER
First posted: 2025-06-03
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Quasi-experimental study pre and post.
Primary purpose: PREVENTION

Brief summary: Mental health in university students is a growing concern worldwide. In Chile, previous studies have shown high rates of depressive symptoms, anxiety, and suicidal risk in this population. This study seeks to evaluate the acceptability and feasibility of a Cognitive Behavioral Therapy (CBT)-based intervention for the indicated prevention of suicidality in undergraduate students, and also to explore its impact on reducing suicidal ideation. A quasi-experimental before-and-after design will be used with a sample of students from the Universidad de los Andes who present mild to moderate suicidal risk. As this is a pilot study, a sample size calculation is not required, but we expect to recruit 20 subjects, which will allow us to conduct acceptability and feasibility assessments and collect data for a larger-scale study. A follow-up will consist of repeating the initial assessment questionnaire, which will be completed two and four months after the intervention. The methodology includes an initial interview to assess inclusion and exclusion criteria, signing informed consent, and developing a safety plan with the students. Following this, six weekly sessions (three in-person and three with digital components) of 60 minutes each will be held, focusing on emotional regulation, cognitive restructuring, and problem-solving. The intervention will be facilitated by trained psychologists, under the supervision of a trained psychologist or psychiatrist. To assess acceptability, the Client Satisfaction Questionnaire (CSQ-8) will be primarily used.

To assess outcomes, validated instruments will be applied, such as the Columbia Suicide Risk Scale (C-SSRS), the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, the Generalized Anxiety Disorder 7 (GAD-7) for anxiety symptoms, the Short Form-12 Health Survey (SF-12) for quality of life, the Distress Tolerance Scale (DTS) for stress tolerance, the Community Assessment of Psychic Experiences-Positive (CAPE-P15) for psychotic symptoms, the Difficulties in Emotion Regulation Scale (DERS-E) for emotional regulation, the Social Problem-Solving Inventory-Revised (SPSI-R) for problem-solving, and the Cognitive-behavioural Therapy Skills Questionnaire (CBTSQ) for cognitive-behavioral skills. Reduction in suicidal ideation, satisfaction with the intervention, and program adherence will be measured.

The study hopes that the prevention program, along with the proposed assessments and procedures, will be appropriate and feasible in a university setting. This will allow progress toward a larger randomized controlled trial. Furthermore, it is expected that students in the intervention group will experience a reduction in suicidal ideation.

Detailed description: Mental health among university students has become, in recent years, a common and serious issue within higher education institutions worldwide, and Chile is no exception.

A systematic review and meta-analysis published in 2022 found a global prevalence of depressive symptoms among university students of 33.6% and anxiety symptoms of 39%. In Latin America, a study conducted in Brazil (2017) among medical students showed a prevalence of depression of 30.6%, anxiety disorders of 32.9%, and stress of 49.9%.

In Chile, there are few studies addressing the prevalence of mental health disorders among university students. In the "First National University Mental Health Survey," conducted in 2018 among 600 students from the Catholic University of Temuco, the University of Concepción, and the University of Tarapacá, 46% of students showed depressive symptoms, 46% anxiety symptoms, and 53.5% stress symptoms. Additionally, 29.7% presented all three symptoms simultaneously, and 5.1% of students had suicidal thoughts.

Data from the first Mental Health Survey at Universidad de los Andes, conducted in 2020 with 5,037 undergraduate students, showed a prevalence of depressive symptoms of 37.1% and anxiety symptoms of 37.9%. The prevalence of suicide risk was 20.0%. In the second survey at this institution in 2022, with 1,682 students participating, the prevalence of depression was 27.84%, anxiety 36.12%, and stress 2.91%. Suicidal ideation risk was found to be 18.7%.

The prevalence of suicidal ideation is alarming. However, it aligns with information from the World Health Organization (WHO), which states that suicide is the second leading cause of death among youth aged 15 to 29 worldwide.

Recent literature regarding suicide among university students is concerning. In the updated study of the Ten Great Schools, published by the National Academies of Sciences, Engineering, and Medicine, researchers found a suicide mortality rate of 5.6 per 100,000 students between 2009 and 2018.

A meta-analysis including 634,662 university students found high proportions of students experiencing suicidal thoughts, plans, and behaviors. The pooled lifetime prevalence estimates of suicidal ideation, plans, and attempts were 22.3%, 6.1%, and 3.2%, respectively. For the past 12-month prevalence, these figures were 10.6%, 3.0%, and 1.2%, respectively.

A cross-sectional study conducted in 2023 with 12,245 university students in Brazil found a prevalence of suicidal ideation of 5.9%. Variables most associated with suicidal ideation included a history of psychopathology, sexual abuse, dissatisfaction with course choice, and low academic performance.

The above was presented as background for suicide risk, but suicidal behavior has also been shown to have significant consequences in university students' lives. Suicide attempts are the most significant risk factor for completed suicide. Suicidal ideation is also strongly associated with a greater risk of future suicide. Moreover, experiencing mental health problems is associated with poor academic performance and increased dropout rates, with a 210% increase in the number of students who dropped out of their studies due to mental health problems in the past four years.

A meta-analytic synthesis published in 2021 evaluated risk factors related to suicide among university students. Adverse childhood experiences, underlying mental health problems, and financial difficulties predicted a higher risk of suicidal ideation and behavior. Regarding sexual minorities, the American College Health Association (ACHA) reported that 5.4% of transgender and gender non-conforming university students had attempted suicide in the past year, compared to 2.9% of cisgender men and 1.9% of cisgender women.

Considering all of the above, mental health disorders among university students remain a public health issue that should be addressed preventively through the implementation of evidence-based programs.

Following a public health model, suicide prevention strategies can be implemented at three levels: universal, selective, and indicated. Universal interventions target the general population. Selective interventions focus on subpopulations at higher risk, which can be identified based on sociodemographic characteristics, geographic distribution, or prevalence of mental disorders and substance use. Finally, indicated interventions are aimed at individuals known to be vulnerable to suicide or who have previously attempted suicide. In the university population, indicated prevention targets students showing warning signs or identified with potential suicide risk. A comprehensive suicide prevention program typically employs a combination of universal, selective, and indicated interventions.

In the United Kingdom, there is a national suicide prevention strategy for university students called the Suicide Safer University Strategy. It is based on pre-training members of the university community to enable them to carry out prevention and intervention with students. As training programs, they recommend interactive one- or two-day workshops such as the Applied Suicide Intervention Skills Training (ASIST). In the United States, there is a student suicide prevention guide developed by the Suicide Prevention Center of New York State. The indicated prevention model focuses on assessment and triage using semi-structured interviews, risk level determination using instruments such as the Columbia scale, collaborative safety planning such as the Stanley-Brown Safety Plan, notifying the primary support network, and timely referral to community health providers.

In 2019, Chile published its first set of recommendations for suicide prevention in educational institutions, which consists of six pillars: creating and maintaining a protective climate, preventing mental health problems and disorders, educating and raising awareness about suicide, detecting students at risk, acting protocols in case of an attempt or suicide, and postvention actions, as well as coordination and access to the health network.

On the other hand, a successful mental health prevention program for university students should include strategies that promote emotion regulation, a crucial component of well-being and social adaptation. One of the psychological theories that has most contributed to the development of preventive and therapeutic interventions in emotion management is cognitive-behavioral theory. Likewise, the literature highlights the importance of developing skills to cope with academic stress, such as effective appraisal of stressful situations and the use of problem-solving strategies.

A systematic review of suicide prevention in schools and universities included 35 studies, with a total of 24,270 participants. Of those 35 studies, 15 correspond to indicated prevention, and only 6 interventions are for indicated prevention in university populations, with the rest conducted in school populations.

Among the included studies, Fitzpatrick et al. (2005) conducted a randomized controlled trial using a brief audiovisual intervention focused on problem-solving and coping strategies. They found a decrease in suicidal ideation and depression in the intervention group, although the difference was not significant compared to the control group (26% vs. 22% improvement; p \> .10).

In a randomized controlled trial by Lin et al. (2019), a group of Taiwanese university students diagnosed with borderline personality disorder participated in a group cognitive-behavioral therapy (CBT) intervention aimed at reducing depression and suicide attempts. Another group participated in a skills training intervention based on dialectical behavior therapy (DBT). For the CBT group, a significant reduction in suicidal ideation was observed at 4, 8, 20, and 32 weeks of follow-up, with a large effect size (d = 5.24). For the DBT skills training group, a significant reduction in suicide attempts was found at 4, 8, 20, and 32 weeks of follow-up, with a small effect size (d = 0.32).

Instruments used to measure suicidal ideation and behavior included validated scales such as the Columbia Suicide Severity Rating Scale, the Beck Scale for Suicidal Ideation, and the Suicidal Behaviors Questionnaire-Revised (SBQ-R).

Eligibility criteria: Inclusion Criteria:

* Age 18 or older.
* Undergraduate students at Universidad de los Andes.
* Able to read and speak Spanish.
* Mild to moderate suicide risk in the past month, defined as having answered "Yes" to items 1, 2, 3, and/or 4 on the Columbia Suicide Severity Rating Scale (C-SSRS).

Exclusion Criteria:

* Severe suicide risk, defined as having answered "Yes" to item 5 (past month) or item 6 (past 3 months) on the Columbia Suicide Severity Rating Scale (C-SSRS).
* Presence of a severe, untreated psychiatric condition during the past year or history of psychiatric hospitalization in the last two years.
* Determination by the University Wellness Team that the participant is not in a suitable condition to participate due to a severe psychiatric condition or need for hospitalization.
* High severity of psychotic symptoms (score equal to or greater than 2 on any of items 13, 14, and/or 15 of the Community Assessment of Psychic Experiences - Positive Scale (CAPE, P15)).

Primary outcomes:
measure: Client Satisfaction Questionnaire (CSQ-8)
timeFrame: End of intervention at 6 weeks
measure: Feasibility Assessment: Number of participants recruited
timeFrame: through study completion, an average of 1 year
measure: Feasibility Assessment: Recruitment time for completion
timeFrame: through study completion, an average of 1 year
measure: Feasibility Assessment: Evaluation of data collection and results.
timeFrame: through study completion, an average of 1 year
measure: Feasibility Assessment: Level of progress of the participants in the sessions.
timeFrame: through study completion, an average of 1 yea
Secondary outcomes:
measure: Columbia-Suicide Severity Rating Scale (C-SSRS)
timeFrame: Through study completion, an average of 1 year
measure: Patient Health Questionnaire-9 (PHQ-9)
timeFrame: Through study completion, an average of 1 year
measure: Generalized Anxiety Disorder (GAD-7)
timeFrame: Through study completion, an average of 1 year
measure: Distress Tolerance Scale (DTS)
timeFrame: Through study completion, an average of 1 year
measure: The Cognitive-behavioral Therapy Skills Questionnaire (CBTSQ)
timeFrame: Through study completion, an average of 1 year
measure: Community Assessment of Psychotic Experiences Scale (CAPE-P15)
timeFrame: Through study completion, an average of 1 year
measure: Brief Problem Solving Inventory (SPSI-R)
timeFrame: Through study completion, an average of 1 year
measure: Difficulties in Emotion Regulation Scale - Spanish Version (DERS-E)
timeFrame: Through study completion, an average of 1 year
measure: 12-item Short-Form Health Survey
timeFrame: Through study completion, an average of 1 year
Other outcomes:
Locations:
Study officials:
References:
citation: Ramirez S., Romo V., Gaete J. Prevalencia de Problemas de Salud Mental en los Estudiantes de Pregrado de la Universidad de los Andes. Santiago, Chile.: Centro de Investigación en Salud Mental Estudiantil. Universidad de los Andes; 2023.)
citation: Martínez, P., Jiménez-Molina, Á., Mac-Ginty, S., Martínez, V., & Rojas, G. (2021). Salud mental en estudiantes de educación superior en Chile: Una revisión de alcance con meta-análisis. Terapia Psicológica, 39(3), 405-423. http://dx.doi.org/10.4067/S0718-48082021000300405
citation: Valdes JM, Diaz FJ, Christiansen PM, Lorca GA, Solorza FJ, Alvear M, Ramirez S, Nunez D, Araya R, Gaete J. Mental Health and Related Factors Among Undergraduate Students During SARS-CoV-2 Pandemic: A Cross-Sectional Study. Front Psychiatry. 2022 May 31;13:833263. doi: 10.3389/fpsyt.2022.833263. eCollection 2022.
citation: Li W, Zhao Z, Chen D, Peng Y, Lu Z. Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta-analysis. J Child Psychol Psychiatry. 2022 Nov;63(11):1222-1230. doi: 10.1111/jcpp.13606. Epub 2022 Mar 16.
citation: Pacheco JP, Giacomin HT, Tam WW, Ribeiro TB, Arab C, Bezerra IM, Pinasco GC. Mental health problems among medical students in Brazil: a systematic review and meta-analysis. Braz J Psychiatry. 2017 Oct-Dec;39(4):369-378. doi: 10.1590/1516-4446-2017-2223. Epub 2017 Aug 31.
citation: Mortier P, Cuijpers P, Kiekens G, Auerbach RP, Demyttenaere K, Green JG, Kessler RC, Nock MK, Bruffaerts R. The prevalence of suicidal thoughts and behaviours among college students: a meta-analysis. Psychol Med. 2018 Mar;48(4):554-565. doi: 10.1017/S0033291717002215. Epub 2017 Aug 14.
citation: Altavini CS, Asciutti APR, Santana GL, Solis ACO, Andrade LH, Oliveira LG, Andrade AG, Gorenstein C, Wang YP. Suicide ideation among Brazilian college students: Relationship with academic factors, mental health, and sexual abuse. J Affect Disord. 2023 May 15;329:324-334. doi: 10.1016/j.jad.2023.02.112. Epub 2023 Feb 26.
citation: Brown GK, Beck AT, Steer RA, Grisham JR. Risk factors for suicide in psychiatric outpatients: a 20-year prospective study. J Consult Clin Psychol. 2000 Jun;68(3):371-7.
citation: Joiner TE Jr, Brown JS, Wingate LR. The psychology and neurobiology of suicidal behavior. Annu Rev Psychol. 2005;56:287-314. doi: 10.1146/annurev.psych.56.091103.070320.
citation: Hysenbegasi A, Hass SL, Rowland CR. The impact of depression on the academic productivity of university students. J Ment Health Policy Econ. 2005 Sep;8(3):145-51.
citation: Megivern D, Pellerito S, Mowbray C. Barriers to higher education for individuals with psychiatric disabilities. Psychiatr Rehabil J. 2003 Winter;26(3):217-31. doi: 10.2975/26.2003.217.231.
citation: Sheldon E, Simmonds-Buckley M, Bone C, Mascarenhas T, Chan N, Wincott M, Gleeson H, Sow K, Hind D, Barkham M. Prevalence and risk factors for mental health problems in university undergraduate students: A systematic review with meta-analysis. J Affect Disord. 2021 May 15;287:282-292. doi: 10.1016/j.jad.2021.03.054. Epub 2021 Mar 26.
citation: Gould MS, Cross W, Pisani AR, Munfakh JL, Kleinman M. Impact of Applied Suicide Intervention Skills Training on the National Suicide Prevention Lifeline. Suicide Life Threat Behav. 2013 Dec;43(6):676-91. doi: 10.1111/sltb.12049. Epub 2013 Jul 25.
citation: Haeuser E, Serfes AL, Cork MA, Yang M, Abbastabar H, Abhilash ES, Adabi M, Adebayo OM, Adekanmbi V, Adeyinka DA, Afzal S, Ahinkorah BO, Ahmadi K, Ahmed MB, Akalu Y, Akinyemi RO, Akunna CJ, Alahdab F, Alanezi FM, Alanzi TM, Alene KA, Alhassan RK, Alipour V, Almasi-Hashiani A, Alvis-Guzman N, Ameyaw EK, Amini S, Amugsi DA, Ancuceanu R, Anvari D, Appiah SCY, Arabloo J, Aremu O, Asemahagn MA, Jafarabadi MA, Awedew AF, Quintanilla BPA, Ayanore MA, Aynalem YA, Azari S, Azene ZN, Darshan BB, Babalola TK, Baig AA, Banach M, Barnighausen TW, Bell AW, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bijani A, Bitew ZW, Bohlouli S, Bolarinwa OA, Boloor A, Bozicevic I, Butt ZA, Cardenas R, Carvalho F, Charan J, Chattu VK, Chowdhury MAK, Chu DT, Cowden RG, Dahlawi SMA, Damiani G, Darteh EKM, Darwesh AM, das Neves J, Weaver ND, De Leo D, De Neve JW, Deribe K, Deuba K, Dharmaratne S, Dianatinasab M, Diaz D, Didarloo A, Djalalinia S, Dorostkar F, Dubljanin E, Duko B, El Tantawi M, El-Jaafary SI, Eshrati B, Eskandarieh S, Eyawo O, Ezeonwumelu IJ, Ezzikouri S, Farzadfar F, Fattahi N, Fauk NK, Fernandes E, Filip I, Fischer F, Foigt NA, Foroutan M, Fukumoto T, Gad MM, Gaidhane AM, Gebregiorgis BG, Gebremedhin KB, Getacher L, Ghadiri K, Ghashghaee A, Golechha M, Gubari MIM, Gugnani HC, Guimaraes RA, Haider MR, Haj-Mirzaian A, Hamidi S, Hashi A, Hassanipour S, Hassankhani H, Hayat K, Herteliu C, Ho HC, Holla R, Hosseini M, Hosseinzadeh M, Hwang BF, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Islam RM, Iwu CCD, Jakovljevic M, Jha RP, Ji JS, Johnson KB, Joseph N, Joshua V, Joukar F, Jozwiak JJ, Kalankesh LR, Kalhor R, Kamyari N, Kanchan T, Matin BK, Karimi SE, Kayode GA, Karyani AK, Keramati M, Khan EA, Khan G, Khan MN, Khatab K, Khubchandani J, Kim YJ, Kisa A, Kisa S, Kopec JA, Kosen S, Laxminarayana SLK, Koyanagi A, Krishan K, Defo BK, Kugbey N, Kulkarni V, Kumar M, Kumar N, Kusuma D, La Vecchia C, Lal DK, Landires I, Larson HJ, Lasrado S, Lee PH, Li S, Liu X, Maleki A, Malik P, Mansournia MA, Martins-Melo FR, Mendoza W, Menezes RG, Mengesha EW, Meretoja TJ, Mestrovic T, Mirica A, Moazen B, Mohamad O, Mohammad Y, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed S, Mohammed S, Mokdad AH, Moradi M, Moraga P, Mubarik S, Mulu GBB, Mwanri L, Nagarajan AJ, Naimzada MD, Naveed M, Nazari J, Ndejjo R, Negoi I, Ngalesoni FN, Nguefack-Tsague G, Ngunjiri JW, Nguyen CT, Nguyen HLT, Nnaji CA, Noubiap JJ, Nunez-Samudio V, Nwatah VE, Oancea B, Odukoya OO, Olagunju AT, Olakunde BO, Olusanya BO, Olusanya JO, Bali AO, Onwujekwe OE, Orisakwe OE, Otstavnov N, Otstavnov SS, Owolabi MO, Mahesh PA, Padubidri JR, Pana A, Pandey A, Pandi-Perumal SR, Kan FP, Patton GC, Pawar S, Peprah EK, Postma MJ, Preotescu L, Syed ZQ, Rabiee N, Radfar A, Rafiei A, Rahim F, Rahimi-Movaghar V, Rahmani AM, Ramezanzadeh K, Rana J, Ranabhat CL, Rao SJ, Rawaf DL, Rawaf S, Rawassizadeh R, Regassa LD, Rezaei N, Rezapour A, Riaz MA, Ribeiro AI, Ross JM, Rubagotti E, Rumisha SF, Rwegerera GM, Moghaddam SS, Sagar R, Sahiledengle B, Sahu M, Salem MR, Kafil HS, Samy AM, Sartorius B, Sathian B, Seidu AA, Shaheen AA, Shaikh MA, Shamsizadeh M, Shiferaw WS, Shin JI, Shrestha R, Singh JA, Skryabin VY, Skryabina AA, Soltani S, Sufiyan MB, Tabuchi T, Tadesse EG, Taveira N, Tesfay FH, Thapar R, Tovani-Palone MR, Tsegaye GW, Umeokonkwo CD, Unnikrishnan B, Villafane JH, Violante FS, Vo B, Vu GT, Wado YD, Waheed Y, Wamai RG, Wang Y, Ward P, Wickramasinghe ND, Wilson K, Yaya S, Yip P, Yonemoto N, Yu C, Zastrozhin MS, Zhang Y, Zhang ZJ, Hay SI, Dwyer-Lindgren L; Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators. Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000-2018. BMC Med. 2022 Dec 19;20(1):488. doi: 10.1186/s12916-022-02639-z.
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.
citation: Stanley B, Brown GK, Brenner LA, Galfalvy HC, Currier GW, Knox KL, Chaudhury SR, Bush AL, Green KL. Comparison of the Safety Planning Intervention With Follow-up vs Usual Care of Suicidal Patients Treated in the Emergency Department. JAMA Psychiatry. 2018 Sep 1;75(9):894-900. doi: 10.1001/jamapsychiatry.2018.1776.
citation: Murphy MJ, Newby JM, Butow P, Loughnan SA, Joubert AE, Kirsten L, Allison K, Shaw J, Shepherd HL, Smith J, Andrews G. Randomised controlled trial of internet-delivered cognitive behaviour therapy for clinical depression and/or anxiety in cancer survivors (iCanADAPT Early). Psychooncology. 2020 Jan;29(1):76-85. doi: 10.1002/pon.5267. Epub 2019 Nov 12.
citation: Breet E, Matooane M, Tomlinson M, Bantjes J. Systematic review and narrative synthesis of suicide prevention in high-schools and universities: a research agenda for evidence-based practice. BMC Public Health. 2021 Jun 10;21(1):1116. doi: 10.1186/s12889-021-11124-w.
citation: Lin TJ, Ko HC, Wu JY, Oei TP, Lane HY, Chen CH. The Effectiveness of Dialectical Behavior Therapy Skills Training Group vs. Cognitive Therapy Group on Reducing Depression and Suicide Attempts for Borderline Personality Disorder in Taiwan. Arch Suicide Res. 2019 Jan-Mar;23(1):82-99. doi: 10.1080/13811118.2018.1436104. Epub 2018 May 10.
citation: Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the Scale for Suicide Ideation. J Consult Clin Psychol. 1979 Apr;47(2):343-52. doi: 10.1037//0022-006x.47.2.343. No abstract available.
citation: McMain SF, Guimond T, Barnhart R, Habinski L, Streiner DL. A randomized trial of brief dialectical behaviour therapy skills training in suicidal patients suffering from borderline disorder. Acta Psychiatr Scand. 2017 Feb;135(2):138-148. doi: 10.1111/acps.12664. Epub 2016 Nov 13.
citation: Nunez D, Meza D, Andaur J, Robinson J, Gaete J. Reframe-IT+, an indicated preventive school-based intervention, reduces suicidal ideation among adolescents in vulnerable contexts in Chile. BMC Psychol. 2024 Dec 24;12(1):780. doi: 10.1186/s40359-024-02300-9.
citation: Browne RH. On the use of a pilot sample for sample size determination. Stat Med. 1995 Sep 15;14(17):1933-40. doi: 10.1002/sim.4780141709.
citation: Crockett MA, Martinez V, Ordonez-Carrasco JL. [Psychometric properties of the Generalized Anxiety Disorder 7-item (GAD-7) scale in Chilean adolescents]. Rev Med Chil. 2022 Apr;150(4):458-464. doi: 10.4067/S0034-98872022000400458. Spanish.
citation: Garcia-Campayo J, Zamorano E, Ruiz MA, Pardo A, Perez-Paramo M, Lopez-Gomez V, Freire O, Rejas J. Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool. Health Qual Life Outcomes. 2010 Jan 20;8:8. doi: 10.1186/1477-7525-8-8.
citation: Argyropoulos SV, Ploubidis GB, Wright TS, Palm ME, Hood SD, Nash JR, Taylor AC, Forshall SW, Anderson IM, Nutt DJ, Potokar JP. Development and validation of the Generalized Anxiety Disorder Inventory (GADI). J Psychopharmacol. 2007 Mar;21(2):145-52. doi: 10.1177/0269881107069944.
citation: Andrews G. A brief integer scorer for the SF-12: validity of the brief scorer in Australian community and clinic settings. Aust N Z J Public Health. 2002 Dec;26(6):508-10. doi: 10.1111/j.1467-842x.2002.tb00357.x.
citation: Lera L, Marquez C, Saguez R, Moya MO, Angel B, Albala C. [Quality of life of older people with depression and dependence: validity of the SF-12 (short form health survey) questionnaire]. Rev Med Chil. 2021 Sep;149(9):1292-1301. doi: 10.4067/S0034-98872021000901292. Spanish.
citation: Sandin B, Simons JS, Valiente RM, Simons RM, Chorot P. Psychometric properties of the spanish version of The Distress Tolerance Scale and its relationship with personality and psychopathological symptoms. Psicothema. 2017 Aug;29(3):421-428. doi: 10.7334/psicothema2016.239.
citation: Capra C, Kavanagh DJ, Hides L, Scott JG. Current CAPE-15: a measure of recent psychotic-like experiences and associated distress. Early Interv Psychiatry. 2017 Oct;11(5):411-417. doi: 10.1111/eip.12245. Epub 2015 May 12.
citation: Nunez D, Arias V, Vogel E, Gomez L. Internal structure of the Community Assessment of Psychic Experiences-Positive (CAPE-P15) scale: Evidence for a general factor. Schizophr Res. 2015 Jul;165(2-3):236-42. doi: 10.1016/j.schres.2015.04.018. Epub 2015 Apr 30.
citation: D'Zurilla TJ, Chang EC, Nottingham EJ 4th, Faccini L. Social problem-solving deficits and hopelessness, depression, and suicidal risk in college students and psychiatric inpatients. J Clin Psychol. 1998 Dec;54(8):1091-107. doi: 10.1002/(sici)1097-4679(199812)54:83.0.co;2-j.
citation: De La Torre MT, Morera OF, Wood JM. Measuring social problem solving using the Spanish version for Hispanics of the Social Problem Solving Inventory-Revised. Cultur Divers Ethnic Minor Psychol. 2010 Oct;16(4):501-6. doi: 10.1037/a0021372.
citation: Crockett MA, Martinez V, Jimenez-Molina A. Subthreshold depression in adolescence: Gender differences in prevalence, clinical features, and associated factors. J Affect Disord. 2020 Jul 1;272:269-276. doi: 10.1016/j.jad.2020.03.111. Epub 2020 Apr 29.
citation: Jacob KL, Christopher MS, Neuhaus EC. Development and validation of the cognitive-behavioral therapy skills questionnaire. Behav Modif. 2011 Nov;35(6):595-618. doi: 10.1177/0145445511419254. Epub 2011 Sep 5.
citation: Attkisson CC, Zwick R. The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome. Eval Program Plann. 1982;5(3):233-7. doi: 10.1016/0149-7189(82)90074-x.
citation: Roberts RE, Attkisson CC. Assessing client satisfaction among Hispanics. Eval Program Plann. 1983;6(3-4):401-13. doi: 10.1016/0149-7189(83)90019-8.