Adolescent suicide attempt prevention: Predictors of response to a cognitive–behavioral family and youth centered intervention

Résumé

Objective Suicide is a leading cause of adolescent death. Recent data support the efficacy of cognitive–behavioral treatments with strong family components for reducing suicide risk; however, not all youth benefit from current interventions. Identifying predictors of treatment response can inform treatment selection and optimize benefits. Method This study examines predictors of response to a DBT-informed cognitive–behavioral family treatment (SAFETY), among 50 youth with recent suicide attempts/self-harm. Youth and parents were assessed at baseline and post-treatment. Results Results indicated medium-to-large effect sizes for SAFETY on youth suicidal behavior (SB; defined as suicide attempts, aborted attempts, and planning), depression, hopelessness, social adjustment, and parental depression. Classification tree analysis, with a correct classification rate of 93.3%, and follow-up logistic analyses indicated that 35% of youths reporting active SB at baseline reported active SB at post-treatment, whereas post-treatment SB was rare among youths whose active suicidality had resolved by the baseline assessment (5%). Among youths reporting baseline SB, those endorsing sleep problems were more likely to report post-treatment SB (53%) versus those without sleep problems (0%). Conclusions These findings highlight the potential value of personalized treatment approaches based on pretreatment characteristics and the significance of baseline SB and sleep problems for predicting treatment response. ADOLESCENT TENTATIVE INTERVENTION TRAITEMENT THÉRAPIE-FAMILLE THÉRAPIE-COMPORTEMENTALE-DIALECTIQUE DÉPRESSION DÉSESPOIR