(PS9-C52) Examining the Impact of Sleep Disturbances on Emotion Regulation Skills Among Suicidal Persons in a Randomized Clinical Trial

In 2020, approximately one suicide death occurred every 11 minutes (CDC, 2022). To curb this alarming trend, there has been recent focus on the development of suicide focused cognitive behavioral treatments. One such treatment, Brief Cognitive Behavioral Therapy (BCBT; Bryan & Rudd, 2018) has shown efficacy in reducing suicide attempts by as much as 60% in military populations (Rudd et al., 2015). In the first phase of BCBT, patients work on developing skills specific to emotion regulation, an identified construct associated with effective suicide interventions (Rudd, 2012). To better understand BCBT’s effectiveness in improving emotion regulation skills, this study aims to examine BCBT compared to Present-Centered Therapy (PCT), another evidence-based treatment for suicide reduction. We hypothesize that those randomized to BCBT will experience a significant improvement in emotion regulation compared to those randomized to PCT. Because sleep disturbances have been related to emotion regulation skills (Mauss, et al. 2013), we will look at self-ratings of sleep disturbances as they relate to emotion regulation. We hypothesize that elevated baseline sleep disturbance ratings will be related to reduced emotion regulation skills at follow-up.

This pilot study is a randomized controlled trial which aims to compare the efficacy of BCBT for telehealth (BCBT-T) and Present Centered Therapy for Telehealth (PCT-T) for individuals that have recently experienced suicidal ideations and/or suicidal behaviors. A total of 80 participants referred by local mental health providers will be randomized to receive 12 sessions of BCBT-T or PCT-T via an online telehealth platform. Participants will complete self-report measures during weekly sessions and at 3-month intervals for one year. This study is currently open to enrollment and has a total of 63 participants enrolled, 36 of whom have completed treatment. Currently, 53 participants have completed 3-month follow-up, 39 completed 6-month, 39 completed 9-month, and 38 completed 12-month follow-up.

Data collection is currently ongoing. The primary outcome of this presentation will be emotion regulation as measured by the Difficulties in Emotion Regulation Scale Short Form (DERS-SF; Kaufman, et al., 2016). The DERS-SF is an 18-item self-report measure that assesses six components of emotion regulation deficits: nonacceptance of emotional responses, difficulties engaging in goal-directed actions, impulse-control difficulties, lack of emotional awareness, limited access to emotion regulation strategies, and lack of emotional clarity. Baseline sleep disturbances will be assessed using the sleep disturbance domain from the PROMIS-43, a multi-dimensional measure of general health (Cella, et al. 2010). A series of two-way repeated measures analyses of covariance (ANCOVA), controlling for baseline suicidal ideation severity, history of suicide attempts, and relevant demographic covariates will be used to compare effects of treatment on emotion dysregulation from baseline to 3,6,9, and 12 months post-treatment.

Examining the long-term impact of BCBT on emotion regulation is essential to refining suicide specific intervention components focusing on emotion regulation skills.