Project Summary/Abstract Suicidal ideation is prevalent and impairing in youth, with approximately 15% of high school studentsreporting seriously considering a suicide attempt and making a specific plan for suicide in the past 12 monthsSubstantial evidence documents perceived burdensomeness towards others, or the belief that one is a burdenor drain on others, as a risk factor for suicidal ideation in youth. This evidence highlights the potential promiseof perceived burdensomeness as a novel intervention target to reduce suicidal ideation in youth. However, onlyone pilot study, conducted by the sponsor, has examined an intervention targeting perceived burdensomenessin youth, and that study used a brief online intervention administered to a relatively low risk community sample.The current proposal seeks to leverage the sponsor’s clinical trial to enable the applicant to assist in thedevelopment and preliminary evaluation of a novel, brief psychosocial treatment module targeting perceivedburdensomeness in youth that can be embedded within existing psychosocial treatments. Outpatient youthclinical services represent a critical window of opportunity for selective prevention of perceivedburdensomeness in at-risk youth. The current proposal thus extends ongoing outpatient cognitive behavioraltreatment (CBT) for anxiety or depression to implement a brief, minimally disruptive, parent-involved moduletargeting perceived burdensomeness. The first aim of this proposal is to assist the sponsor in developing anovel, brief psychosocial intervention module (the GIVE module) targeting perceived burdensomeness towardsothers that can be embedded within existing CBT protocols for youth internalizing problems. The second aim isto collect qualitative and quantitative data relevant to cultural adaptation, acceptability, and satisfaction, as wellas preliminary data on the timing of reductions in perceived burdensomeness. Participants will be N=30 clinic-referred youth ages 10 to 17 with anxiety and depression-related difficulties and their parents who are part ofthe sponsor’s open trial of the GIVE module in a large university-based clinic, who display high levels ofperceived burdensomeness. The GIVE module will be administered during CBT session 6 and then brieflyreviewed in CBT session 7. It is hypothesized that perceived burdensomeness will be significantly lower afterthe GIVE module. The proposed research is expected to provide additional, rich quantitative and qualitativedata on the sponsor’s GIVE module trial. This data will further spur the refinement of this novel moduletargeting an identified risk factor for suicidal ideation that can be efficiently implemented within the context ofongoing psychosocial treatments for at-risk youths with anxiety and/or depression. With these researchfindings in hand, the applicant and his sponsor will be positioned to refine and evaluate the module in arandomized controlled trial.
