TY  - JOUR
PY  - 2018//
TI  - As Safe as Possible (ASAP): a brief app-supported inpatient intervention to prevent postdischarge suicidal behavior in hospitalized, suicidal adolescents
JO  - American journal of psychiatry
A1  - Kennard, Betsy D.
A1  - Goldstein, Tina
A1  - Foxwell, Aleksandra A.
A1  - McMakin, Dana L.
A1  - Wolfe, Kristin
A1  - Biernesser, Candice
A1  - Moorehead, Alexandra
A1  - Douaihy, Antoine
A1  - Zullo, Lucas
A1  - Wentroble, Erin
A1  - Owen, Victoria
A1  - Zelazny, Jamie
A1  - Iyengar, Satish
A1  - Porta, Giovanna
A1  - Brent, David A.
SP  - 864
EP  - 872
VL  - 175
IS  - 9
N2  - OBJECTIVE: The authors report on a pilot study of an inpatient intervention for suicidal adolescents, As Safe as Possible (ASAP), supported by a smartphone app (BRITE) to reduce suicide attempts following hospital discharge. <br><br>METHOD: Across two sites, 66 adolescents hospitalized for suicidal ideation (N=26) or a recent suicide attempt (N=40) were randomly assigned to the ASAP intervention program plus treatment as usual or to treatment as usual alone. ASAP, which focuses on emotion regulation and safety planning, is a 3-hour intervention delivered on the inpatient unit. The BRITE app prompted participants to rate their level of emotional distress on a daily basis and provided personalized strategies for emotion regulation and safety planning. A blind, independent evaluator assessed suicide attempts following hospital discharge and suicidal ideation at 4, 12, and 24 weeks after discharge. <br><br>RESULTS: The ASAP intervention did not have a statistically significant effect on suicide attempt, although findings were in the hypothesized direction for occurrence of an attempt (16% compared with 31%; χ<sup>2</sup>=1.86, df=1, g=-0.36) and time to an attempt (hazard ratio=0.49, 95% CI=0.16, 1.47). Past history of a suicide attempt was a significant moderator of treatment outcome, with a stronger, albeit nonsignificant, effect of the ASAP intervention among participants with a history of suicide attempt (hazard ratio=0.23, 95% CI=0.05, 1.09). There were no treatment effects on suicidal ideation. The majority of participants (70%) used the BRITE app (median usage, 19 times). Participants reported high satisfaction with both the intervention and the app. <br><br>CONCLUSIONS: The ASAP intervention program shows promise in reducing the incidence of postdischarge suicide attempts among adolescents hospitalized for suicidality and merits further study.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-953X
UR  - http://dx.doi.org/10.1176/appi.ajp.2018.17101151
ID  - ref1
ER  -