Comprehensive Adaptive Multisite Prevention of University Student Suicide

Summary

Suicide is the 2nd leading cause of death among college students and suicidal ideation and suicide-related behaviors are a frequent presenting problem at college counseling centers (CCCs), which are overburdened. Studies show that some students respond rapidly to treatment, whereas others require considerably more resources. Evidence-based adaptive treatment strategies (ATSs) are needed to address this heterogeneity in responsivity and complexity. ATSs individualize treatment via decision rules specifying how the type and intensity of an intervention can be sequenced based on risk factors, response, or compliance.

The purpose of this multisite study is to investigate the effectiveness of four adaptive treatment strategies (ATSs) to treat college students who report suicidal ideation when first seeking services at their college counseling center

This multisite study will enroll moderately to severely suicidal college students in the "emerging adulthood" phase (ages 18-25) seeking services at CCCs. This Sequential Multi-Assignment Randomized Trial (SMART) will have two stages of intervention. In Stage 1, 700 participants from four CCCs will be randomized to 4-8 weeks of: 1) a suicide-focused treatment - Collaborative Assessment and Management of Suicidality (CAMS) or 2) Treatment as Usual (TAU). Sufficient responders to either intervention will discontinue services/be stepped down. Non-responders will be re-randomized to one of two Stage 2 higher intensity/dosage intervention options for an additional 4-16 weeks: 1) CAMS (either continued or administered for the first time) or 2) Comprehensive Dialectical Behavior Therapy (DBT), which includes individual therapy, skills group, and phone/text coaching for the clients and peer consultation for the counselors.

Conditions

• Suicide

Interventions

BEHAVIORAL

Treatment As Usual (TAU)

Treatment As Usual

BEHAVIORAL

Collaborative Assessment and Management of Suicidality (CAMS) - Phase 1

Collaborative Assessment and Management of Suicidality

BEHAVIORAL

Dialectical Behavior Therapy (DBT) - Phase 2

Dialectical Behavior Therapy

BEHAVIORAL

Maintenance/Monitoring - Phase 2

Maintenance/Monitoring

BEHAVIORAL

Collaborative Assessment and Management of Suicidality (CAMS) - Phase 2

Collaborative Assessment and Management of Suicidality (CAMS) - Phase 2

Sponsors & Collaborators

• National Institute of Mental Health (NIMH)

  collaborator NIH

• Duke University

  lead OTHER

Principal Investigators

• Scott Compton, PhD · Duke University

• Jacqueline Pistorello, PhD · University of Nevada at Reno (UNR)

• Shireen Rizvi, PhD · Rutgers University

• John Seeley, PhD · University of Oregon

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Max Age

25 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-10-25

Primary Completion

2024-11-19

Completion

2024-11-19

Countries

• United States

Study Locations