Communications of the ACM
Computer-Based Approach to Treating Anxiety May Reduce Suicide Risk
Credit: dotmsr.com
A group of psychology researchers at Florida State University have developed a simple computer-based approach to treating anxiety sensitivity, something that could have major implications for veterans and other groups who are considered at risk for suicide.
"We have been using computer-delivered interventions for many years now in an effort to more efficiently deliver effective treatments," says psychology Professor Brad Schmidt, director of the Anxiety and Behavioral Health Clinic. "This study gives us evidence that a brief intervention may help to prevent suicide risk."
The study, "Randomized Clinical Trial Evaluating the Efficacy of a Brief Intervention Targeting Anxiety Sensitivity Cognitive Concerns," shows how Schmidt developed a treatment by focusing more on fears of losing control of one’s thoughts and sanity. It is published in the December issue of the Journal of Consulting and Clinical Psychology by the American Psychological Association.
The team established a fully computerized treatment that does not require a therapist or other mental health specialist, only access to a computer.
The new intervention, called the Cognitive Anxiety Sensitivity Treatment, or CAST, is a 45-minute treatment that contains videos, interactive features, and true-false questions designed to make sure the patient understands the topic.
The program explains that symptoms such as racing thoughts, the inability to concentrate, and others, are not dangerous and not an indication that something bad is about to happen. It also provides users with exercises that they can practice to improve responses to stress and anxiety.
To test the computer-based treatment, Schmidt and his colleagues recruited 108 subjects who had above-average anxiety sensitivity. Half were given the CAST program, while the other half spent 45 minutes going through a computer-based lesson on the importance of a healthy lifestyle. The volunteers were tested for anxiety sensitivity levels before and after the sessions, as well as one month later.
The volunteers who got the CAST training saw their anxiety sensitivity scores drop significantly and by much more than the volunteers who learned about healthy living. More importantly, the decrease in anxiety sensitivity brought about by the computer method was very similar to the decreases seen in many earlier trials done with therapists. The therapist-based trials, however, were very intensive, with much more time spent in the therapist’s office.
Schmidt and his colleagues say the new research can have huge implications in treating people who are at risk for suicide.
One group in particular who stands to benefit from the new treatment option is members of the military and veterans, who are at an increased risk for suicide but often avoid seeking help from psychologists or other clinicians because of the perceived stigma.
"Traditional psychotherapy is expensive, requires highly trained personnel and is unfortunately associated with a negative stigma for a lot of individuals," says Aaron Norr, a doctoral student working with Schmidt. "This means that a large number of people dealing with suicidal ideation won’t get the help they need for a variety of reasons. That is why this intervention has so much potential. Hopefully this delivery platform will allow us to reach these individuals in need who would otherwise fall through the cracks."
Although the study was not large enough or long enough to analyze completed suicides among the subjects, CAST training appears to be effective in lowering suicide risk. Psychologists know that people with heightened anxiety sensitivity are at a greater risk for suicide, and they suspect that the link is related to the increased depression that can result from heightened anxiety sensitivity, so decreasing anxiety sensitivity should help lower suicide risks.
Future work by the group will focus on testing the effectiveness of CAST training in a larger sample using neurophysiological measures to examine how the training affects brain systems. Furthermore, the group plans to improve CAST by adding components that address other suicide-related issues, such as feelings of isolation and being a burden on others.
Other authors on the paper include doctoral students Daniel Capron, Amanda Raines, and Nicholas Allan.
This work was in part supported by the Military Suicide Research Consortium, an effort supported by the Office of the U.S. Assistant Secretary of Defense for Health Affairs under Award No. (W81XWH-10-2-0181).
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