OBJECTIVE To evaluate the efficacy of attachment-based family therapy (ABFT) compared with a family-enhanced nondirective supportive therapy (FE-NST) for decreasing adolescents' suicide ideation and depressive symptoms. METHOD A randomized controlled trial of 129 adolescents who are suicidal ages 12- to 18-years-old (49% were African American) were randomized to ABFT (n = 66) or FE-NST (n = 63) for 16 weeks of treatment. Assessments occurred at baseline and 4, 8, 12, and 16 weeks. Trajectory of change and clinical recovery were calculated for suicidal ideation and depressive symptoms. RESULTS There was no significant between-group difference in the rate of change in self-reported ideation (Suicidal Ideation Questionnaire-Jr; F1,127 = 181, p = .18). Similar results were found for depressive symptoms. However, adolescents receiving ABFT showed a significant decrease in suicide ideation (t127 = 12.61, p < .0001; effect size, d = 2.24). Adolescents receiving FE-NST showed a similar significant decrease (t127 = 10.88, p < .0001; effect size, d = 1.93). Response rates (ie, ≥50% decrease in suicide ideation symptoms from baseline) at post-treatment were 69.1% for ABFT versus 62.3% for FE-NST. CONCLUSION Contrary to expectations, ABFT did not perform better than FE-NST. The 2 treatments produced substantial decreases in suicidal ideation and depressive symptoms that were comparable to or better than those reported in other more intensive, multicomponent treatments. The equivalent outcomes could be attributed to common treatment elements, different active mechanisms, or regression to the mean. Future studies will explore long-term follow up, secondary outcomes, and potential moderators and mediators. CLINICAL TRIAL REGISTRATION INFORMATION Attachment-Based Family Therapy for Suicidal Adolescents; http://clinicaltrials.gov; NCT01537419.

中文翻译：

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一项随机对照试验：自杀青少年基于依恋的家庭和非定向支持治疗。

目的评估依恋家庭疗法（ABFT）与家庭增强型非定向支持疗法（FE-NST）相比，在减少青少年自杀意念和抑郁症状方面的疗效。方法129名自杀年龄为12至18岁（49％为非裔美国人）的青少年的随机对照试验被随机分配至ABFT（n = 66）或FE-NST（n = 63）治疗16周。在基线，第4、8、12和16周进行评估。计算了自杀意念和抑郁症状的变化轨迹和临床康复情况。结果自我报告观念的变化率在两组之间没有显着差异（自杀观念调查问卷，Jr； F1,127 = 181，p = .18）。对于抑郁症状也发现了相似的结果。然而，接受ABFT的青少年自杀意念显着减少（t127 = 12.61，p <.0001；效应量，d = 2.24）。接受FE-NST的青少年表现出相似的显着下降（t127 = 10.88，p <.0001；效应量，d = 1.93）。治疗后的反应率（即自杀意念症状较基线降低≥50％）对于ABFT为69.1％，而对于FE-NST为62.3％。结论与预期相反，ABFT的表现并不比FE-NST好。这两种治疗方法的自杀意念和抑郁症状显着降低，与其他更深入的多成分治疗方法所报告的结果相当或更好。等效结果可归因于常见的治疗要素，不同的积极机制或均值回归。未来的研究将探索长期随访，次要结果，以及潜在的主持人和调解人。临床试验注册信息：自杀青少年基于依恋的家庭疗法；http://clinicaltrials.gov; NCT01537419。