Reduction in Suicidal Ideation from Prolonged Exposure Therapy for Adolescents
Open accessAbstract
Objective: Adolescents with posttraumatic stress disorder (PTSD) are at higher risk for suicide compared to adolescents without PTSD. This study aimed to explore whether PTSD treatment reduces suicidal ideation in adolescents and whether the degree of reduction in PTSD was associated with reduction in suicidal ideation. Methods: Adolescent females with PTSD from a sexual assault (55% Black, 15.3 years, SD = 1.5) were randomized to either prolonged exposure therapy for adolescents (PE-A, n= 31) or client-centered therapy (CCT, n = 30). They reported on suicidal ideation, depression and PTSD at pre- and post-treatment, every therapy session, and follow-up, and about 40% endorsed suicidal ideation at baseline. Results: There was a significant reduction in a single-item measure of suicidal ideation during treatment across all participants. The Time in Treatment × Condition interaction was significant (p < .05, d = 0.52), indicating a significantly steeper reduction in suicidal ideation in PE-A compared to in CCT. The degree of reduction in PTSD (ps < .05, d = 0.26–0.54) and depression symptoms (ps < .05, d= 0.54–0.81) in treatment and follow-up was associated with the speed of suicidal ideation reduction in treatment and follow-up. Conclusions: Adolescents randomized to PE-A had significantly faster reductions in suicidal ideation compared to those randomized to CCT. Greater reduction in PTSD and depression symptoms were associated with faster reduction in suicidal ideation. Clinically, this study demonstrates that adolescents who have suicidal ideation without current intent may benefit from PE-A.
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PE significantly reduces suicidal ideation in civilians, veterans, and active-duty military personnel.
“PE significantly reduces suicidal ideation in civilians (Brown, Belli, et al., 2020; Brown et al., 2018), veterans (Cox et al., 2016), and active-duty military personnel (Brown, McLean, et al., 2019).”
From An Open-Phase Pilot Trial of an Integration of Prolonged Exposure Therapy and the Coping Long-Term With Active Suicide Program (2026) · cites this paper as Brown, Belli, et al., 2020
The Abstract Results report a significantly steeper reduction in suicidal ideation with PE-A than with client-centered therapy. But the Methods Participants section limits the study to adolescent females with PTSD following sexual abuse, excluding those at imminent suicide risk; it does not establish the effect for civilians generally. The veteran and active-duty portions of the citing sentence have separate citations and are not attributed to this paper. (LLM, conf=0.86)
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References 27 · Cited by 24
Research works printed but not linked: 2
- Foa EB, Chrestman KR & Gilboa-Schechtman E (2008). Prolonged exposure therapy for adolescents with PTSD: Emotional processing of traumatic experiences: Therapist guide. New York, NY: Oxford University Press.
- Foa EB, & Kozak MJ (1985). Treatment of anxiety disorders: Implications for psychopathology In Tuma AH & Maser JD (Eds.), Anxiety and the anxiety disorders (pp. 421– 452). Hillsdale, NJ, US: Lawrence Erlbaum Associates, Inc.
- Authors
- Brown, L. A., Belli, G., Suzuki, N., Capaldi, S., & Foa, E. B.
- Affiliations
- University of Pennsylvania (US)
- Corresponding author
- Brown, Lily A.
- Venue
- Journal of Clinical Child & Adolescent Psychology
- Publisher
- Informa UK Limited
- Published
- 2019-05-31
- Volume
- 49
- Issue
- 5
- Pages
- 651-659
- ISSN
- 1537-4416 (ISSN-L)
- 1537-4424
- PMC
- PMC6885098
- OpenAlex
- W2947879569
- Cited by
- 24
- References
- 27
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 8 · 2023: 6 · 2022: 2 · 2021: 2 · 2020: 1
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Child & Adolescent Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01 MH074505)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- suicidal ideation, prolonged exposure therapy, adolescents, post-traumatic stress disorder, sexual assault, client-centered therapy, depression, PTSD symptom reduction, suicide risk, trauma-focused psychotherapy
- MeSH terms
- Adolescent, Female, Humans, Implosive Therapy, Male, Stress Disorders, Post-Traumatic, Suicidal Ideation
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