Kruzan Kaylee P, Biernesser Candice, Hoffmann Jennifer A, Meyerhoff Jonah
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 750 N. Lakeshore Drive, Chicago, IL 60611, USA.
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA.
Curr Treat Options Psychiatry. 2024 Jun;11(2):76-89. doi: 10.1007/s40501-024-00318-9. Epub 2024 Apr 24.
To summarize literature on digital mental health interventions (DMHIs) for self-injurious thoughts and behaviors (SITBs) among adolescents and young adults. This includes studies evaluating DMHI efficacy in reducing SITBs, exploring the quality of these interventions, and describing the features, functionality, and psychological strategies of these interventions.
Evidence for the efficacy of DMHIs for SITBs is limited but growing. The strongest support is for DMHIs with a cognitive-behavioral approach, those that target suicidality specifically, and those that target adults rather than adolescents. DMHIs vary in format and level of human support. Human support is commonly in the form of a clinician-peer support is infrequent. DMHIs facilitate safety planning, connect users with crisis support, teach users coping strategies, or encourage self-assessment. CBT-based approaches are the most frequent, but others include mindfulness and problem solving. While no DMHI for SITBs incorporate all evidence-based strategies for suicide prevention, many include several, with the most common being elements of safety planning.
DMHIs have promise to address high rates of SITBs among young people. We summarize the existing literature and offer suggestions for future research to improve trial methodology, optimize design of DMHIs, and translate DMHIs into practice.
总结关于青少年和青年中针对自我伤害性想法和行为(SITB)的数字心理健康干预(DMHI)的文献。这包括评估DMHI在减少SITB方面疗效的研究、探索这些干预措施的质量,以及描述这些干预措施的特征、功能和心理策略。
DMHI对SITB疗效的证据有限但在增加。最有力的支持是针对采用认知行为方法的DMHI、专门针对自杀倾向的DMHI,以及针对成年人而非青少年的DMHI。DMHI在形式和人力支持水平上各不相同。人力支持通常以临床医生的形式提供,同伴支持很少见。DMHI有助于安全规划,将用户与危机支持联系起来,教授用户应对策略,或鼓励自我评估。基于认知行为疗法(CBT)的方法最为常见,但其他方法包括正念和问题解决。虽然没有针对SITB的DMHI纳入所有基于证据的自杀预防策略,但许多DMHI包括几种,最常见的是安全规划要素。
DMHI有望解决年轻人中高比例的SITB问题。我们总结了现有文献,并为未来研究提出建议,以改进试验方法、优化DMHI设计,并将DMHI转化为实践。