Abstract
Suicidal thoughts and behaviors (STBs) in youth are prevalent and impairing, but available psychosocial treatments are difficult to access and show limited efficacy. Prevention strategies are interventions intended to be implemented during relative well-periods before impairment or other adverse outcomes set in and therefore help avoid undue distress or psychological sequelae. However, prevention strategies have not always been clearly distinguished from treatment strategies in prior reviews. Additionally, increasing prevention efficacy by identifying what works how and for whom to allow for personalization of interventions could be impactful, but has not been sufficiently probed. To help address these knowledge gaps, a scoping review of all suicide prevention randomized controlled trials was performed on PubMed, PsycInfo, and GoogleScholar through February 2024. Secondary papers of included studies were also screened to identify moderators and mediators of suicide prevention programs. Overall, 23 trials testing prevention programs were identified, with only seven examining moderators and three mediators. Results showed that outcomes in suicide prevention programs are mixed, study heterogeneity is high, and more targeted trials often underpowered. Nonetheless, CBT emerged as efficacious in more than one study in indicated samples, identifying this approach as promising for suicide attempts especially. Most individual moderators and mediators were not studied frequently enough to draw strong conclusions. However, youth with a history of STBs appeared to benefit from prevention efforts more than those without, indicating that more targeted approaches may be more efficient than universal approaches. Overall, additional work is sorely needed both in broadly testing prevention programs and identifying potential moderators and mediators of intervention.
Key Take Away Points
- Youth prevention intervention outcomes are mixed, studies are heterogeneous, and more targeted trials often underpowered.
- CBT emerged as efficacious in more than one study in indicated samples.
- Studies of prevention moderators and mediators are scarce and lack quality.
- Youth with a history of STBs appeared to benefit from prevention efforts more than those without.
Recommended Citation
P Goger, R Nam, N Lowry, et al. (2023) "50 years of child and adolescent suicide prevention interventions: A review of randomized controlled trials and their moderators and mediators," Journal of Applied Research on Children: Informing Policy for Children at Risk: Vol. 14: Iss. 1, Article 5.DOI: https://doi.org/10.58464/2155-5834.1543
Available at: https://digitalcommons.library.tmc.edu/childrenatrisk/vol14/iss1/5
