72 Participants Needed

Cognitive Reappraisal for Suicide Prevention

(CRISP Trial)

DK
LE
Overseen ByLaurie Evans, MS
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Weill Medical College of Cornell University
Must be taking: Psychotropics
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 1 JurisdictionThis treatment is already approved in other countries

Trial Summary

Do I have to stop taking my current medications for the trial?

The trial does not specify if you need to stop taking your current medications. However, patients who are on psychotropics and receiving community psychotherapy are included, so it seems you can continue your current medications.

What data supports the idea that Cognitive Reappraisal for Suicide Prevention is an effective treatment?

The available research shows that Cognitive Reappraisal for Suicide Prevention (CRISP) is effective for middle-aged and older adults who have been hospitalized for suicidal thoughts or attempts. CRISP helps by identifying personal triggers and teaching strategies to manage negative emotions, which can reduce suicidal thoughts. This approach is particularly important during the high-risk period after hospital discharge. Additionally, another study found that using cognitive reappraisal, as opposed to suppressing emotions, is linked to lower suicidal thoughts, suggesting that CRISP's focus on reappraisal is beneficial.12345

What safety data exists for Cognitive Reappraisal for Suicide Prevention?

The Cognitive Reappraisal Intervention for Suicide Prevention (CRISP) is a psychosocial intervention targeting cognitive reappraisal to reduce suicide risk in middle-aged and older adults recently hospitalized for suicidality. The intervention is based on identifying personalized triggers and negative emotions, providing strategies for adaptive responses. While the abstract does not provide specific safety data, it suggests that CRISP is designed to address a high-risk period post-discharge, indicating a focus on safety and prevention. Other studies mentioned, such as those on cognitive-based psychotherapy and dialectical behavior therapy, indicate that similar interventions are generally found to be feasible, acceptable, and potentially effective, though specific safety data for CRISP is not detailed in the provided abstracts.15678

Is the treatment Cognitive Reappraisal Intervention for Suicide Prevention (CRISP) a promising treatment?

Yes, CRISP is a promising treatment because it helps middle-aged and older adults who have been hospitalized for suicidal thoughts or attempts by teaching them to manage their emotions better. This approach can reduce suicidal thoughts and improve their ability to handle emotional crises.345910

What is the purpose of this trial?

The goal of this trial is to refine and test a novel emotion-regulation based psychosocial intervention designed to reduce suicide risk in middle-aged and older adults (50-90 years old) who have been discharged after a suicide-related hospitalization (i.e. for suicidal ideation or suicide attempt).

Research Team

DK

Dimitris Kiosses, PhD

Principal Investigator

Weill Medical College of Cornell University

Eligibility Criteria

This trial is for adults aged 50-90 who have recently been hospitalized for suicidal thoughts or attempts. Participants must have a diagnosis of depression or anxiety, be on psychotropics, and receiving community psychotherapy. Excluded are those with psychotic disorders, bipolar I/II in manic states, dementia, severe medical issues, or language/sensory barriers.

Inclusion Criteria

Recent hospitalization for suicidal ideation or suicide attempt with specific criteria
Patients with any degree of suicidal ideation at discharge
I am taking medication for my mental health and attending therapy.
See 2 more

Exclusion Criteria

I have not had a severe illness in the last 3 months.
History or current diagnosis of Psychotic Disorders
Cognitive Impairment with MMSE < 24
See 2 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

R61 Treatment

Certified social workers administer 12 weekly sessions of CRISP to participants after a suicide-related hospitalization

12 weeks
12 visits (in-person)

R61 Follow-up

Participants are assessed for target engagement with EEG assessments and cognitive reappraisal paradigm

12 weeks
Assessments at discharge, 6 and 12 weeks post-discharge

R33 Treatment

Participants are randomized to CRISP or Supportive Therapy to evaluate cognitive reappraisal and suicide risk

24 weeks
Assessments at admission, discharge, 6, 12, and 24 weeks post-discharge

R33 Follow-up

Participants are monitored for improvement in cognitive reappraisal ability and its association with suicide risk

24 weeks

Treatment Details

Interventions

  • Cognitive Reappraisal Intervention for Suicide Prevention
  • Supportive Therapy
Trial Overview The study tests a new emotion-regulation intervention aimed at reducing suicide risk against supportive therapy. It targets middle-aged and older adults post-suicide-related hospitalization to see if the novel approach can better prevent future crises.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: CRISPExperimental Treatment1 Intervention
Cognitive Reappraisal Intervention for Suicide Prevention (CRISP) is a psychosocial intervention aimed to reduce suicide risk in middle-aged and older adults who have been hospitalized for suicidal ideation or suicide attempt. CRISP offers a combination of emotion regulation techniques, including changing the subject's perspective or the way he/she thinks to improve emotion reactions. Additional strategies taught include the provision of environmental adaptation tools (notes, checklists, calendars, etc), phone calls, and a tablet application called WellPATH.
Group II: Supportive Therapy (ST)Active Control1 Intervention
Supportive Therapy focuses on: 1. facilitating expression of affect; 2. conveying to the patient that he or she is understood; 3. offering empathy; and 4. highlighting positive experiences. The ST manual aims to standardize nonspecific therapeutic factors.

Cognitive Reappraisal Intervention for Suicide Prevention is already approved in United States for the following indications:

🇺🇸
Approved in United States as CRISP for:
  • Suicide prevention in middle-aged and older adults

Find a Clinic Near You

Who Is Running the Clinical Trial?

Weill Medical College of Cornell University

Lead Sponsor

Trials
1,103
Recruited
1,157,000+

Stanford University

Collaborator

Trials
2,527
Recruited
17,430,000+

Florida State University

Collaborator

Trials
234
Recruited
41,100+

National Institute of Mental Health (NIMH)

Collaborator

Trials
3,007
Recruited
2,852,000+

Rutgers University

Collaborator

Trials
127
Recruited
2,814,000+

Findings from Research

The study involved 147 patients who had previously attempted suicide, and after a 6-session cognitive-based psychotherapy intervention over four months, there was a notable reduction in the odds of further suicide attempts and an increase in outpatient visits, although these results were not statistically significant.
While the intervention did not significantly lower the risk of subsequent suicide attempts or clinical severity at the 12-month mark, it did improve treatment adherence among patients who had made multiple attempts, suggesting that targeted approaches may be beneficial for specific subgroups.
Brief Cognitive-based Psychosocial Intervention and Case Management for Suicide Attempters Discharged from the Emergency Department in Taipei, Taiwan: A Randomized Controlled Study.Lin, YC., Liu, SI., Chen, SC., et al.[2021]
Outpatients with mood disorders who committed suicide attended significantly fewer cognitive therapy sessions and had a higher dropout rate (88% vs. 53%) compared to those who did not commit suicide, indicating that engagement in therapy is crucial.
Patients who committed suicide exhibited higher levels of hopelessness at the end of therapy, suggesting that inadequate response to treatment and premature termination are important risk factors for suicide.
Inadequate response to therapy as a predictor of suicide.Dahlsgaard, KK., Beck, AT., Brown, GK.[2007]
In a study of 120 individuals with recent suicide attempts, those receiving cognitive therapy showed a significantly faster improvement in their problem-solving skills, particularly in reducing negative views and impulsive behaviors, compared to a control group.
Cognitive therapy not only helps decrease the recurrence of suicide attempts but also leads to rapid changes in problem-solving appraisal within 6 months, which is crucial during the high-risk period following a suicide attempt.
Changes in problem-solving appraisal after cognitive therapy for the prevention of suicide.Ghahramanlou-Holloway, M., Bhar, SS., Brown, GK., et al.[2022]

References

Brief Cognitive-based Psychosocial Intervention and Case Management for Suicide Attempters Discharged from the Emergency Department in Taipei, Taiwan: A Randomized Controlled Study. [2021]
Inadequate response to therapy as a predictor of suicide. [2007]
Changes in problem-solving appraisal after cognitive therapy for the prevention of suicide. [2022]
The relation of cognitive reappraisal and expressive suppression to suicidal ideation and suicidal desire. [2015]
Cognitive Reappraisal Intervention for Suicide Prevention (CRISP) for Middle-Aged and Older Adults Hospitalized for Suicidality. [2022]
An open pilot feasibility study of a brief dialectical behavior therapy skills-based intervention for suicidal individuals. [2022]
Cognitive-Behavioral Family Treatment for Suicide Attempt Prevention: A Randomized Controlled Trial. [2023]
Cognitive-behavioral therapy for suicide prevention (CBT-SP): treatment model, feasibility, and acceptability. [2022]
A new understanding of the cognitive reappraisal technique: an extension based on the schema theory. [2023]
Differences in emotion modulation using cognitive reappraisal in individuals with and without suicidal ideation: An ERP study. [2017]
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