A scoping review of psychosocial suicide prevention interventions among adults: Clinical trial factors, predictors, mediators, and moderators in randomized controlled trials

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review Pub Date : 2025-06-09 DOI:10.1016/j.cpr.2025.102614

Jaclyn C. Kearns , Craig P. Polizzi , Julia Naganuma-Carreras , Kyle J. Bourassa , Tate F. Halverson , Rokas Perskaudas , Nathan A. Kimbrel , Alejandro Interian , Robert M. Bossarte , Bryann B. DeBeer , Joseph I. Constans , Melissa E. Dichter , Steven K. Dobscha , Marianne Goodman , Mark Ilgen , Richard R. Owen , Brian P. Marx

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Abstract

Objective

There has been a proliferation of psychosocial interventions to prevent suicide over the past several decades with varying levels of benefit. We conducted a comprehensive scoping review to synthesize our knowledge of the effectiveness, strengths, and limitations of these interventions among adults. We focused on important aspects of randomized controlled trials (RCTs), including internal and external validity, outcome measurement, and exclusion criteria. We examined predictors, mediators, and moderators associated with suicide outcomes.

Methods

A systematic search was conducted for RCTs of psychosocial suicide prevention interventions with adults, following PRISMA-ScR guidelines.

Results

We identified 141 publications and 131 were unique RCTs. Publications had some concerns with risk of bias (internal validity); publications had moderate or high external validity. A quarter of RCTs excluded older adults (60 years or older) and individuals with psychotic symptoms/features and bipolar disorder/symptoms despite the fact that these groups are at elevated risk for suicide death. Forty-one publications (29.1 % of total publications) examined predictors, mediators, and moderators of suicide outcomes. Sixteen (11.3 % of total publications) publications included predictors, two (1.4 %) included mediators, 11 (7.8 %) included posttreatment mediators, and 16 (11.3 %) included moderators. Participant gender/sex, marital status, and race did not moderate treatment effects. Mixed results may be due to insufficient statistical power to test predictor, mediator, and moderator hypotheses.

Conclusion

This review highlighted RCT aspects (e.g., exclusion of older adults and individuals with serious mental illness, improving suicide outcome measurement) that may be beneficial to consider in future RCTs. Additional research on predictors, mediators, and moderators is needed.

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成人心理社会自杀预防干预的范围综述：随机对照试验中的临床试验因素、预测因子、中介因子和调节因子

在过去的几十年里，预防自杀的心理社会干预措施激增，并取得了不同程度的效果。我们进行了一项全面的范围综述，以综合我们对这些干预措施在成人中的有效性、优势和局限性的了解。我们关注随机对照试验（RCTs）的重要方面，包括内部和外部效度、结果测量和排除标准。我们检查了与自杀结果相关的预测因子、调节因子和调节因子。

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来源期刊

Clinical Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

23.10

自引率

1.60%

发文量

期刊介绍： Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.