BRAVA: A randomized controlled trial of a brief group intervention for youth with suicidal ideation and their caregivers
Bibliographic record
Abstract
OBJECTIVES: Suicide is the second leading cause of mortality among Canadian youth. As wait times for mental health (MH) support have increased, adolescents with mild-to-moderate suicidal ideation (SI) are waiting longer for support compared to those with more acute SI. Building Resilience and Attachment in Vulnerable Adolescents (BRAVA) is a 6-week virtual group intervention designed to provide support to adolescents with mild to moderate SI and their caregivers. We conducted a randomized controlled trial to assess the efficacy of BRAVA in reducing symptoms of SI, depression, and anxiety in adolescents, and improving life stress in caregivers. DESIGN/METHODS: Outcome measures were administered to both groups [BRAVA, Enhanced Treatment-as-Usual (ETU)] at intake and exit, and at 3-month follow-up (BRAVA only) for SI (primary outcome), anxiety and depression (adolescent), perceived stress (youth and caregiver), attachment and family functioning (caregiver). SI was measured using Suicidal Ideation Questionnaire Junior. Intention to treat (ITT) analysis was performed for youth and caregiver cohorts. RESULTS: Ninety-nine eligible youth presenting with mild-to-moderate SI and their caregivers were recruited from hospital and community MH services. Families were randomized to BRAVA (n = 50) or ETU (n = 49). Adolescents were on average 14.6 years old, mostly female (64%), and of European racial heritage (44%). In ITT analysis, both BRAVA and ETU groups improved in youth SI from intake to exit, with no statistically significant differences between groups at exit. Sensitivity analysis without multiple imputations demonstrated a significant difference in SI scores at exit between the groups, where improvements in the BRAVA group were maintained at 3-month follow-up. Significant differences between groups on youth perceived stress, and depression and anxiety scores were also observed in BRAVA participants at post-treatment compared to the ETU control group. No statistically significant differences were observed for any caregiver outcomes measured except a trend for improved perceived caregiver stress in the BRAVA group post-treatment. CONCLUSIONS: BRAVA was associated with significantly greater improvements in anxiety/depression and adolescent perceived stress compared to ETU. Although the intervention did not result in significant caregiver reported improvements, group cohesion and treatment satisfaction were high for both youth and caregivers. CLINICAL TRIAL REGISTRATION: BRAVA: Building Resilience and Attachment in Vulnerable Adolescents (BRAVA); https://clinicaltrials.gov/ : NCT04751968.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.014 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".