NCT04707066

Brief Summary

Suicide is the 2nd leading cause of death among college students and suicidal ideation and suicide-related behaviors are a frequent presenting problem at college counseling centers (CCCs), which are overburdened. Studies show that some students respond rapidly to treatment, whereas others require considerably more resources. Evidence-based adaptive treatment strategies (ATSs) are needed to address this heterogeneity in responsivity and complexity. ATSs individualize treatment via decision rules specifying how the type and intensity of an intervention can be sequenced based on risk factors, response, or compliance. The purpose of this multisite study is to investigate the effectiveness of four adaptive treatment strategies (ATSs) to treat college students who report suicidal ideation when first seeking services at their college counseling center This multisite study will enroll moderately to severely suicidal college students in the "emerging adulthood" phase (ages 18-25) seeking services at CCCs. This Sequential Multi-Assignment Randomized Trial (SMART) will have two stages of intervention. In Stage 1, 700 participants from four CCCs will be randomized to 4-8 weeks of: 1) a suicide-focused treatment - Collaborative Assessment and Management of Suicidality (CAMS) or 2) Treatment as Usual (TAU). Sufficient responders to either intervention will discontinue services/be stepped down. Non-responders will be re-randomized to one of two Stage 2 higher intensity/dosage intervention options for an additional 4-16 weeks: 1) CAMS (either continued or administered for the first time) or 2) Comprehensive Dialectical Behavior Therapy (DBT), which includes individual therapy, skills group, and phone/text coaching for the clients and peer consultation for the counselors.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
227

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Oct 2022

Typical duration for not_applicable

Geographic Reach
1 country

4 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 11, 2021

Completed
2 days until next milestone

First Posted

Study publicly available on registry

January 13, 2021

Completed
1.8 years until next milestone

Study Start

First participant enrolled

October 25, 2022

Completed
2.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 19, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 19, 2024

Completed
Last Updated

November 22, 2024

Status Verified

November 1, 2024

Enrollment Period

2.1 years

First QC Date

January 11, 2021

Last Update Submit

November 20, 2024

Conditions

Keywords

Dialectical Behavior Therapy (DBT)Collaborative Assessment and Management of Suicide (CAMS)Sequential, multiple assignment, randomized trials (SMART)University Students

Outcome Measures

Primary Outcomes (9)

  • Suicide Ideation - Stage 1

    Change in score of CAMS Scale for Suicidal Ideation (SSI). This is a 19 question measure, each rated from 0-2. Total score is from 0-38, with a higher score indicating greater suicidality concern.

    Baseline to the end of Stage 1 treatment (up to 8 weeks)

  • Suicide Ideation - Stage 2

    Change in score of CAMS Scale for Suicidal Ideation (SSI). This is a 19 question measure, each rated from 0-2. Total score is from 0-38, with a higher score indicating greater suicidality concern.

    Baseline to the end of Stage 2 treatment (up to 20 weeks)

  • Suicide Ideation - 6 month follow-up

    Change in score of CAMS Scale for Suicidal Ideation (SSI). This is a 19 question measure, each rated from 0-2. Total score is from 0-38, with a higher score indicating greater suicidality concern.

    Baseline to 6 month follow-up

  • Non-Suicidal Self Injury - Stage 1

    Total Occurrences of Non-Suicidal Self Injury

    To the end of Stage 1 treatment (up to 8 weeks)

  • Non-Suicidal Self Injury - Stage 2

    Total Occurrences of Non-Suicidal Self Injury

    To the end of Stage 2 treatment (up to 20 weeks)

  • Non-Suicidal Self Injury - 6 month follow-up

    Total Occurrences of Non-Suicidal Self Injury

    To 6 month follow-up

  • Suicide Attempts - Stage 1

    Total Occurrences of Suicide Attempts

    To the end of Stage 1 treatment (up to 8 weeks)

  • Suicide Attempts - Stage 2

    Total Occurrences of Suicide Attempts

    To the end of Stage 2 treatment (up to 20 weeks)

  • Suicide Attempts - 6 month follow-up

    Total Occurrences of Suicide Attempts

    To 6 month follow-up

Study Arms (6)

1

EXPERIMENTAL

Subject assigned to CAMS for Phase 1. Subject is a Phase 1 CAMS Responder, thus placed into ongoing Maintenance/Monitoring.

Behavioral: Treatment As Usual (TAU)Behavioral: Collaborative Assessment and Management of Suicidality (CAMS) - Phase 2

2

EXPERIMENTAL

Subject assigned to CAMS for Phase 1. Subject is a Phase 1 CAMS Insufficient Responder, then assigned to Phase 2 CAMS.

Behavioral: Treatment As Usual (TAU)Behavioral: Dialectical Behavior Therapy (DBT) - Phase 2

3

EXPERIMENTAL

Subject assigned to CAMS for Phase 1. Subject is a Phase 1 CAMS Insufficient Responder, then assigned to Phase 2 DBT.

Behavioral: Treatment As Usual (TAU)Behavioral: Maintenance/Monitoring - Phase 2

4

EXPERIMENTAL

Subject assigned to TAU for Phase 1. Subject is a Phase 1 TAU Responder, thus placed into ongoing Maintenance/Monitoring.

Behavioral: Collaborative Assessment and Management of Suicidality (CAMS) - Phase 1Behavioral: Dialectical Behavior Therapy (DBT) - Phase 2

5

EXPERIMENTAL

Subject assigned to TAU for Phase 1. Subject is a Phase 1 TAU Insufficient Responder, then assigned to Phase 2 CAMS.

Behavioral: Collaborative Assessment and Management of Suicidality (CAMS) - Phase 1Behavioral: Maintenance/Monitoring - Phase 2

6

EXPERIMENTAL

Subject assigned to TAU for Phase 1. Subject is a Phase 1 TAU Insufficient Responder, then assigned to Phase 2 DBT.

Behavioral: Collaborative Assessment and Management of Suicidality (CAMS) - Phase 1Behavioral: Collaborative Assessment and Management of Suicidality (CAMS) - Phase 2

Interventions

Treatment As Usual

Also known as: TAU - Phase 1
123

Collaborative Assessment and Management of Suicidality

Also known as: CAMS
456

Dialectical Behavior Therapy

24

Maintenance/Monitoring

35

Collaborative Assessment and Management of Suicidality (CAMS) - Phase 2

16

Eligibility Criteria

Age18 Years - 25 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Enrolled at the university;
  • to 25 years of age;
  • Moderate to severe SI over the last two weeks indicated by a score of ³2 on the Counseling Center Assessment of Psychological Symptoms (CCAPS-34) question, "I have thoughts of ending my life" (range is 0 "not at all like me" to 4 "extremely like me"); and
  • Agree to video recording of all therapy and assessment sessions.

You may not qualify if:

  • Students who are deemed clinically inappropriate to receive services at the CCC by an intake counselor because of imminent risk, severe psychosis, or inability to remain enrolled in school (e.g., academic failure);
  • Students being unable to remain on campus long enough to go through the minimum number of sessions for Stage 1 (4 sessions);
  • Students who have received services at the CCC within the last three months (i.e., ATSs must be based on a new treatment episode).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

University of Nevada - Reno

Reno, Nevada, 89557, United States

Location

Rutgers University

New Brunswick, New Jersey, 08901, United States

Location

Duke University

Durham, North Carolina, 27705, United States

Location

University of Oregon

Eugene, Oregon, 97403, United States

Location

Related Publications (1)

  • Blalock K, Pistorello J, Rizvi SL, Seeley JR, Kassing F, Sinclair J, Oshin LA, Gallop RJ, Fry CM, Snyderman T, Jobes DA, Crumlish J, Krall HR, Stadelman S, Gozenman-Sapin F, Davies K, Steele D, Goldston DB, Compton SN. The Comprehensive Adaptive Multisite Prevention of University Student Suicide Trial: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2025 Apr 22;14:e68441. doi: 10.2196/68441.

MeSH Terms

Conditions

Suicide

Interventions

TherapeuticsCell Adhesion MoleculesClinical Trials, Phase I as TopicDialectical Behavior TherapyClinical Trials, Phase II as TopicMaintenance

Condition Hierarchy (Ancestors)

Self-Injurious BehaviorBehavioral SymptomsBehavior

Intervention Hierarchy (Ancestors)

Membrane GlycoproteinsGlycoproteinsGlycoconjugatesCarbohydratesProteinsAmino Acids, Peptides, and ProteinsMembrane ProteinsAntigens, SurfaceAntigensBiological FactorsClinical Trials as TopicClinical Studies as TopicEpidemiologic Study CharacteristicsEpidemiologic MethodsInvestigative TechniquesHealth Care Evaluation MechanismsQuality of Health CareHealth Care Quality, Access, and EvaluationPublic HealthEnvironment and Public HealthBehavior TherapyPsychotherapyBehavioral Disciplines and ActivitiesHealth Care Facilities Workforce and Services

Study Officials

  • Scott Compton, PhD

    Duke University

    PRINCIPAL INVESTIGATOR
  • Jacqueline Pistorello, PhD

    University of Nevada at Reno (UNR)

    PRINCIPAL INVESTIGATOR
  • Shireen Rizvi, PhD

    Rutgers University

    PRINCIPAL INVESTIGATOR
  • John Seeley, PhD

    University of Oregon

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
SEQUENTIAL
Model Details: Sequential, multiple assignment, randomized trials (SMART) design
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 11, 2021

First Posted

January 13, 2021

Study Start

October 25, 2022

Primary Completion

November 19, 2024

Study Completion

November 19, 2024

Last Updated

November 22, 2024

Record last verified: 2024-11

Data Sharing

IPD Sharing
Will share

We will participant de-identified data (linked only by GUID) with the National Institute of Mental Health Data Archive (NDA). The NDA is an informatics system and research data repository developed by the National Institutes of Health (NIH) to share research data. The NDA provides the infrastructure to store, search across, and analyze various types of data. In addition, The NDA provides longitudinal storage of a research participant's information generated by one or more research studies. In other words, the NDA is able to associate a single research participant's genomic, imaging, clinical assessment and other information even if the data were collected at different locations or through different studies. By doing so, the NDA gives researchers access to more data than they can collect on their own, making it easier and faster for researchers to gather, evaluate, and share research information from a variety of sources.

Shared Documents
STUDY PROTOCOL, SAP
Time Frame
All subject data will be submitted for inclusion in the NDA, through the conclusion of data collection activities. Data is to be submitted cumulatively, every 6 months.
Access Criteria
The NIH will provide access to scientific investigators for research purposes. Qualified researchers who have completed a Data Use Certification and received approval from the NDA Data Access Committee (DAC) may be approved to access broadly shared data. A separate request process exists for access to data in federated sources. Additionally, the DAC and support staff at NIH have access to NDA shared data.
More information

Locations