Interoception-Focused Therapy for Suicidal Thoughts

(RISE Trial)

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Auburn University

Disqualifiers: Under 18

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

200 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores two approaches to managing suicidal thoughts and feelings. The first approach, Reconnecting to Internal Sensations and Experiences (RISE), focuses on interoception, which involves awareness of internal body signals like emotions and sensations. The second approach emphasizes general healthy habits, such as good hygiene and nutrition. The trial seeks college students who have experienced suicidal thoughts or have difficulty sensing their internal body signals.

As an unphased trial, it offers participants the chance to contribute to innovative research that could enhance mental health strategies for others.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this therapy is safe for college students with suicidality or low interoception?

Research has shown that the interoceptive awareness treatment is generally safe for participants. A small initial study examined this method, which helps individuals become more aware of their body's signals and emotions. The study found positive effects without major negative side effects.

While these early results are promising, the safety of this treatment continues to be researched. Since the treatment doesn't involve medication, it usually results in fewer physical side effects. However, as with any new therapy, monitoring participants' reactions is important. Participants in similar studies have generally handled the treatment well, with no major problems reported.

The "Healthy Habits" part of the study focuses on learning better daily routines, such as healthy eating and stretching. This approach is common and is generally considered very safe. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores a novel approach to addressing suicidal thoughts through interoception-focused therapy. Unlike traditional treatments that might rely on medication or cognitive behavioral therapy, this method emphasizes reconnecting individuals with their internal sensations and experiences. By enhancing body awareness and emotional understanding, it could offer a more holistic way to manage distress and improve well-being. The trial also considers "Healthy Habits," which bolsters daily routines like financial planning and healthy eating, providing a comprehensive look at lifestyle factors that might influence mental health. This dual approach could unveil new insights into how these elements contribute to reducing suicidal thoughts.

What evidence suggests that this trial's treatments could be effective for suicidal thoughts?

Research has shown that increased awareness of bodily signals can help reduce suicidal thoughts. In this trial, participants may receive the "Reconnecting to Internal Sensations and Experiences" program, which has shown promising results in early studies. This program helps individuals become more aware of their bodies, understand their emotions, and practice self-care. Initial findings suggest it can strengthen a person's connection to their inner feelings, potentially reducing thoughts of self-harm. While more research is needed, these results offer hope for those dealing with suicidal thoughts. ^{1 2 4 6 7}

Are You a Good Fit for This Trial?

This trial is for college students aged 18 or older who have experienced suicidal thoughts or have a history of low body awareness, which can relate to eating disorders. It's not open to anyone under the age of 18.

Inclusion Criteria

Low interoceptive awareness

I have had thoughts of or attempted suicide in the past.

Exclusion Criteria

I am under 18 years old.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants undergo four modules focusing on interoception, including body awareness, body sensations/movement, eating, health and self-care, emotional awareness, and understanding the self in relation to others.

4 weeks

Comparator

Participants complete modules related to healthy habits such as financial planning, hygiene, stretching, and healthy eating.

4 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment, including measures of interoception, eating pathology, and suicidality.

1 week

What Are the Treatments Tested in This Trial?

Interventions

• Healthy Habits
• Reconnecting to Internal Sensations and Experiences

Trial Overview Project RISE tests a program focusing on improving body awareness and understanding emotions versus 'Healthy Habits' modules covering financial planning and hygiene. Participants are randomly assigned to one of these two approaches.

How Is the Trial Designed?

Group I: Interoceptive Awareness Experimental Treatment 1 Intervention

The intervention consists of four modules that focus on multiple aspects of interoception including: body awareness, body sensations/movement, eating, health and self-care, emotional awareness, and understanding the self in relation to others.

Group II: Healthy Habits Active Control 1 Intervention

The comparator condition is called "Health Habits" and is matched for time and attention; participants complete modules related to healthy habits such as financial planning, hygiene, stretching, and healthy eating.

Who Is Running the Clinical Trial?

Auburn University

Lead Sponsor

Trials

81

Recruited

14,600+

Published Research Related to This Trial

The systematic review of 22 studies involving 14,988 participants found preliminary evidence that individuals with a history of suicide attempts may have impaired interoceptive accuracy, suggesting a link between difficulties in sensing bodily states and suicidal behavior.

Interoceptive disturbances, particularly in cognitive and emotional evaluations of bodily sensations, were notably more pronounced in those who attempted suicide compared to those who only had suicidal thoughts or plans, indicating that these abnormalities could be important indicators of suicidal risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interoceptive Abnormalities and Suicidality: A Systematic Review. Hielscher, E., Zopf, R.[2021]

A study involving 276 participants in India found that interoceptive dysfunction, or difficulty recognizing internal body sensations, is linked to suicidal thoughts, highlighting a significant risk factor for suicidality in the region.

A small pilot intervention called RISE, tested on 40 participants, showed promise in improving interoceptive awareness and reducing suicidal ideation, suggesting that mindfulness-based approaches could be effective in suicide prevention efforts in India.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Pilot Feasibility Study of Reconnecting to Internal Sensations and Experiences (RISE), a Mindfulness-Informed Intervention to Reduce Interoceptive Dysfunction and Suicidal Ideation, among University Students in India. Smith, AR., Kinkel-Ram, S., Grunwald, W., et al.[2022]

An intervention aimed at improving interoception, such as progressive muscle relaxation exercises, was found to reduce implicit identification with suicide among 136 undergraduate participants, suggesting a potential method to lower suicide risk.

A pilot study with 22 clinical participants showed that an online interoceptive awareness training program was well-received and linked to improvements in interoception, reductions in suicidal ideation, and other psychological symptoms, indicating its potential efficacy for clinical outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reconnecting to Internal Sensation and Experiences: A Pilot Feasibility Study of an Online Intervention to Improve Interoception and Reduce Suicidal Ideation. Smith, AR., Forrest, LN., Perkins, NM., et al.[2021]

The RISE intervention, which focuses on interoceptive awareness, was well-received and had a high completion rate of 85% among the 195 participants, indicating its feasibility for use among active duty service members and veterans.

While RISE significantly improved various aspects of interoceptive sensibility, such as emotional awareness and self-regulation, it did not show a measurable impact on suicidal ideation, likely due to the low baseline levels of ideation reported by participants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reconnecting to Internal Sensations and Experiences (RISE): An online, multi-session intervention improves interoceptive sensibility for military personnel. Smith, AR., Witte, TK., Troop-Gordon, W., et al.[2023]

Mindfulness-Based Cognitive Therapy to Prevent Suicide (MBCT-S) significantly improved attentional control in high suicide risk Veterans, as shown by better performance on E-Stroop tasks over a 6-month follow-up involving 135 participants.

Veterans receiving MBCT-S experienced improved processing of combat-related and negative emotional words, while those receiving only enhanced treatment as usual (eTAU) showed worsening attentional control, highlighting the potential efficacy of MBCT-S in reducing suicide risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attentional control may be modifiable with Mindfulness-Based Cognitive Therapy to Prevent Suicide. Chesin, MS., Keilp, JG., Kline, A., et al.[2022]

Individuals with suicidality, including those who have thought about, planned, or attempted suicide, exhibit significantly poorer interoceptive abilities compared to controls, with the most severe deficits observed in those who have attempted suicide.

Recent suicide attempts are more closely linked to interoceptive deficits than past attempts, suggesting that improving interoceptive awareness may be a crucial strategy in preventing suicidal behavior.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

(Dis)connected: An examination of interoception in individuals with suicidality. Forrest, LN., Smith, AR., White, RD., et al.[2016]

In a study of 537 adults, those with lifetime suicidal ideation were more likely to worry about their bodily sensations, indicating a potential link between interoception and suicidal thoughts.

Individuals with a history of suicide attempts tended to distract themselves from bodily sensations and had less self-regulation, suggesting that impaired interoception may be a factor in suicidal behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Examination of interoception along the suicidality continuum. Rogers, ML., Hagan, CR., Joiner, TE.[2019]

Citations

1. sciencedirect.com sciencedirect.com/science/article/abs/pii/S000578942100023X

Reconnecting to Internal Sensation and Experiences Improving interoception could reduce suicide-related outcomes. •. Pilot data for an online interoception intervention are presented. •. The intervention was ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8870213/

A Pilot Feasibility Study of Reconnecting to Internal ... A mindfulness-informed intervention designed to reduce interoceptive dysfunction, and thereby suicidality, has yielded promising initial effects in pilot ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT05285111

Pilot of Reconnecting to Internal Sensations and ... The intervention consists of four modules that focus on multiple aspects of interoception including: body awareness, body sensations/movement, eating, health ...

4. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/abs/10.1111/sltb.12994

Reconnecting to Internal Sensations and Experiences ... This preregistered randomized controlled trial tested the effects of a four-session, online interoceptive awareness intervention relative to ...

5. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37655866/

Reconnecting to Internal Sensations and Experiences (RISE) Conclusions: RISE is a disseminable, cost-effective, and transdiagnostic intervention that improves interoceptive sensibility up to 3 months.

6. sciencedirect.com sciencedirect.com/science/article/am/pii/S000578942100023X

Reconnecting to Internal Sensation and Experiences A growing body of research supports this supposition and suggests that impaired interoception differentiates those who think about suicide from those who engage ...

7. mdpi.com mdpi.com/2076-328X/13/11/945

Exploring the Link between Interoceptive Body Awareness ... This study aimed to examine the association between interoceptive body awareness variables and suicidal orientation in a sample of 169 undergraduate students ...