Effectiveness of a Web-Based Self-Help Program for Suicidal Thinking in an Australian Community Sample: Randomized Controlled Trial
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Abstract
BACKGROUND: Treatment for suicidality can be delivered online, but evidence for its effectiveness is needed. OBJECTIVE: The goal of our study was to examine the effectiveness of an online self-help intervention for suicidal thinking compared to an attention-matched control program. METHODS: A 2-arm randomized controlled trial was conducted with assessment at postintervention, 6, and, 12 months. Through media and community advertizing, 418 suicidal adults were recruited to an online portal and were delivered the intervention program (Living with Deadly Thoughts) or a control program (Living Well). The primary outcome was severity of suicidal thinking, assessed using the Columbia Suicide Severity Rating Scale. RESULTS: Intention-to-treat analyses showed significant reductions in the severity of suicidal thinking at postintervention, 6, and 12 months. However, no overall group differences were found. CONCLUSIONS: Living with Deadly Thoughts was of no greater effectiveness than the control group. Further investigation into the conditions under which this program may be beneficial is now needed. Limitations of this trial include it being underpowered given the effect size ultimately observed, a high attrition rate, and the inability of determining suicide deaths or of verifying self-reported suicide attempts. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12613000410752; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?id=364016 (Archived by WebCite at http://www.webcitation.org/6vK5FvQXy); Universal Trial Number U1111-1141-6595.
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A sample size of 189 for each condition (total N=378) will be required to detect the expected effect size with a power of 0.80 and alpha of .05, based on an attrition rate of 30% and a 0.50 correlation between pre- and posttest scores.
“Based on an attrition rate of 30% [28,29] and a 0.50 correlation between pre- and posttest scores of the primary outcome, a sample size of 189 for each condition (total N=378) will be required to detect the expected effect size with a power of 0.80 and alpha of .05.”
From A mobile health intervention (LifeBuoy App) to help young people manage suicidal thoughts: protocol for a mixed-methods randomized controlled trial (2020) · cites this paper as [29]
Internet-administered self-help treatments may offer approaches for hard-to-reach groups, but these findings were not replicated in a similar trial.
“Another study showed that Internet-administered self-help treatments may offer approaches for hard-to-reach groups, such as persons who have had negative health care experiences or persons with financial or time constraints that impede access to care,73 but these findings were not replicated in a similar trial.74”
From Suicide (2020) · cites this paper as [74]
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Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765 · cited 1× · see citing works
“Secondary outcome measures included presence of ideation and behavior, measured by the Suicidal Ideation and Suicidal Behavior subscales of the C-SSRS, respectively; reasons for living, using the Brief Reasons for Living Scale [19]; perceived burdensomeness and thwarted belongingness, assessed by the Interpersonal Nee…”
MethodSpitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802 · cited 1× · see citing works
“Secondary outcome measures included presence of ideation and behavior, measured by the Suicidal Ideation and Suicidal Behavior subscales of the C-SSRS, respectively; reasons for living, using the Brief Reasons for Living Scale [19]; perceived burdensomeness and thwarted belongingness, assessed by the Interpersonal Nee…”
MethodBush, K. (1998) · Archives of Internal Medicine · doi:10.1001/archinte.158.16.1789 · Cited by 6,196 · cited 1× · see citing works
“Secondary outcome measures included presence of ideation and behavior, measured by the Suicidal Ideation and Suicidal Behavior subscales of the C-SSRS, respectively; reasons for living, using the Brief Reasons for Living Scale [19]; perceived burdensomeness and thwarted belongingness, assessed by the Interpersonal Nee…”
MethodPosner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A., Currier, G. W., Melvin, G. A., Greenhill, L., Shen, S., et al. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10111704 · Cited by 5,157 · cited 1× · see citing works
“The primary outcome was severity of suicidal thinking, assessed using the Intensity of Suicidal Ideation subscale of the Columbia Suicide Severity Rating Scale (C-SSRS) [18].”
MethodMorin, C. M., Belleville, G., Bélanger, L., & Ivers, H. (2011) · Sleep · doi:10.1093/sleep/34.5.601 · Cited by 4,620 · cited 1× · see citing works
“Secondary outcome measures included presence of ideation and behavior, measured by the Suicidal Ideation and Suicidal Behavior subscales of the C-SSRS, respectively; reasons for living, using the Brief Reasons for Living Scale [19]; perceived burdensomeness and thwarted belongingness, assessed by the Interpersonal Nee…”
MethodNolen-Hoeksema, S., & Morrow, J. (1991) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.61.1.115 · Cited by 3,276 · see citing works
Cross-national prevalence and risk factors for suicidal ideation, plans and attempts
Nock, M. K., Borges, G., Bromet, E. J., Alonso, J., Angermeyer, M., Beautrais, A., Bruffaerts, R., Chiu, W. T., de Girolamo, G., Gluzman, S., et al. (2008) · British Journal of Psychiatry · doi:10.1192/bjp.bp.107.040113 · Cited by 2,654 · cited 1× · see citing works
“Suicidal thinking is common and often precedes suicidal plans and attempts [1,2].”
BackgroundSuicide prevention strategies revisited: 10-year systematic review
Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., et al. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)30030-x · Cited by 1,765 · cited 1× · see citing works
“Effective treatments exist for suicidal thinking [3,4], but many individuals do not seek help due to factors such as low suicide literacy (ie, having little knowledge about suicidality), lack of perceived need, preference to manage the problem alone, stigma, shame, beliefs about receiving professional help, fear of ho…”
BackgroundInternet-based cognitive behaviour therapy for symptoms of depression and anxiety: A meta-analysis
SPEK, V., CUIJPERS, P., NYKLÍČEK, I., RIPER, H., KEYZER, J., & POP, V. (2007) · Psychological Medicine · doi:10.1017/s0033291706008944 · Cited by 1,586 · cited 1× · see citing works
“Some online programs that are completed in combination with professional support report lower rates of attrition [37].”
Background(2010) · Virtual Defense Library (Ministerio de Defensa) · Cited by 1,530 · see citing works
Andrews, G., Cuijpers, P., Craske, M. G., McEvoy, P., & Titov, N. (2010) · PLoS ONE · doi:10.1371/journal.pone.0013196 · Cited by 1,311 · see citing works
Safety planning intervention: a brief intervention to mitigate suicide risk.
Stanley, B., & Brown, G. K. (2012) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2011.01.001 · Cited by 1,267 · cited 1× · see citing works
“The monitoring of suicide ideation itself combined with the intervention by the call back service provides a safety protocol procedure that is known to have an effect [33].”
BackgroundAdherence in Internet Interventions for Anxiety and Depression
Christensen, H., Griffiths, K. M., & Farrer, L. (2009) · Journal of Medical Internet Research · doi:10.2196/jmir.1194 · Cited by 1,133 · cited 2× · see citing works
“In this study, attrition was 46% at postintervention, which is at the higher end of rates of attrition of online interventions [35,36].”
BackgroundSelf-citationVan Orden, K. A., Witte, T. K., Gordon, K. H., Bender, T. W., & Joiner, T. E. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.1.72 · Cited by 1,126 · cited 1× · see citing works
“Secondary outcome measures included presence of ideation and behavior, measured by the Suicidal Ideation and Suicidal Behavior subscales of the C-SSRS, respectively; reasons for living, using the Brief Reasons for Living Scale [19]; perceived burdensomeness and thwarted belongingness, assessed by the Interpersonal Nee…”
MethodAndersson, G., Cuijpers, P., Carlbring, P., Riper, H., & Hedman, E. (2014) · World Psychiatry · doi:10.1002/wps.20151 · Cited by 1,077 · cited 1× · see citing works
“While there is good evidence that Web-based programs are effective for a variety of mental health problems [10,11], suicidality is often an exclusion criteria in these trials and interventions [12].”
BackgroundSocial-psychological factors affecting help-seeking for emotional problems
Rickwood, D. J., & Braithwaite, V. A. (1994) · Social Science & Medicine · doi:10.1016/0277-9536(94)90099-x · Cited by 583 · cited 1× · see citing works
“Effective treatments exist for suicidal thinking [3,4], but many individuals do not seek help due to factors such as low suicide literacy (ie, having little knowledge about suicidality), lack of perceived need, preference to manage the problem alone, stigma, shame, beliefs about receiving professional help, fear of ho…”
BackgroundCognitive-behavioral treatment of borderline personality disorder
Brasfield, C. R. (1994) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)90183-x · Cited by 517 · see citing works
van Spijker, B. A. J., Batterham, P. J., Calear, A. L., Farrer, L., Christensen, H., Reynolds, J., & Kerkhof, A. J. F. M. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12084 · Cited by 492 · cited 1× · see citing works
“The Suicidal Ideation Attributes Scale (SIDAS) [29] was included to validate its psychometric features.”
MethodSelf-citationHom, M. A., Stanley, I. H., & Joiner, T. E. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.05.006 · Cited by 462 · cited 1× · see citing works
“Effective treatments exist for suicidal thinking [3,4], but many individuals do not seek help due to factors such as low suicide literacy (ie, having little knowledge about suicidality), lack of perceived need, preference to manage the problem alone, stigma, shame, beliefs about receiving professional help, fear of ho…”
Backgroundvan Ballegooijen, W., Cuijpers, P., van Straten, A., Karyotaki, E., Andersson, G., Smit, J. H., & Riper, H. (2014) · PLoS ONE · doi:10.1371/journal.pone.0100674 · Cited by 409 · see citing works
Waller, R., & Gilbody, S. (2009) · Psychological Medicine · doi:10.1017/s0033291708004224 · Cited by 393 · cited 1× · see citing works
“While there is good evidence that Web-based programs are effective for a variety of mental health problems [10,11], suicidality is often an exclusion criteria in these trials and interventions [12].”
BackgroundCognitive-Behavioral Interventions to Reduce Suicide Behavior: A Systematic Review and Meta-Analysis
Tarrier, N., Taylor, K., & Gooding, P. (2008) · Behavior Modification · doi:10.1177/0145445507304728 · Cited by 384 · see citing works
Cognitive therapy for suicidal patients: Scientific and clinical applications.
Wenzel, A., Brown, G. K., & Beck, A. T. (2009) · doi:10.1037/11862-000 · Cited by 369 · see citing works
Help-Seeking for Suicidal Thoughts and Self-Harm in Young People: A Systematic Review
Michelmore, L., & Hindley, P. (2012) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2012.00108.x · Cited by 346 · cited 1× · see citing works
“Lack of anonymity poses an obstacle to help-seeking for many individuals [34].”
BackgroundTreatment of suicidal people around the world
Bruffaerts, R., Demyttenaere, K., Hwang, I., Chiu, W.-T., Sampson, N., Kessler, R. C., Alonso, J., Borges, G., de Girolamo, G., de Graaf, R., et al. (2011) · British Journal of Psychiatry · doi:10.1192/bjp.bp.110.084129 · Cited by 338 · cited 1× · see citing works
“Effective treatments exist for suicidal thinking [3,4], but many individuals do not seek help due to factors such as low suicide literacy (ie, having little knowledge about suicidality), lack of perceived need, preference to manage the problem alone, stigma, shame, beliefs about receiving professional help, fear of ho…”
BackgroundModerators of Treatment Outcomes: Clinical, Research, and Policy Importance
Kraemer, H. C., Frank, E., & Kupfer, D. J. (2006) · JAMA · doi:10.1001/jama.296.10.1286 · Cited by 310 · cited 1× · see citing works
“Moderation was tested using an identical MMRM approach with the addition of the moderating variable of interest as a factor into the model with 2- and 3-way interactions with group and time [30].”
MethodCalear, A. L., Batterham, P. J., & Christensen, H. M. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.06.027 · Cited by 270 · cited 1× · see citing works
“Effective treatments exist for suicidal thinking [3,4], but many individuals do not seek help due to factors such as low suicide literacy (ie, having little knowledge about suicidality), lack of perceived need, preference to manage the problem alone, stigma, shame, beliefs about receiving professional help, fear of ho…”
BackgroundSelf-citationJohnston, A. K., Pirkis, J., & Burgess, P. M. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670902970874 · Cited by 159 · cited 1× · see citing works
“Effective treatments exist for suicidal thinking [3,4], but many individuals do not seek help due to factors such as low suicide literacy (ie, having little knowledge about suicidality), lack of perceived need, preference to manage the problem alone, stigma, shame, beliefs about receiving professional help, fear of ho…”
BackgroundEffectiveness of Online Self-Help for Suicidal Thoughts: Results of a Randomised Controlled Trial
van Spijker, B. A. J., van Straten, A., & Kerkhof, A. J. F. M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0090118 · Cited by 142 · see citing works
Self-citationEvidence-Based Psychotherapies for Suicide Prevention
Brown, G. K., & Jager-Hyman, S. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.06.008 · Cited by 120 · cited 1× · see citing works
“Effective treatments exist for suicidal thinking [3,4], but many individuals do not seek help due to factors such as low suicide literacy (ie, having little knowledge about suicidality), lack of perceived need, preference to manage the problem alone, stigma, shame, beliefs about receiving professional help, fear of ho…”
BackgroundThe brief Reasons for Living Inventory for adolescents (BRFL-A)
Osman, A., Kopper, B. A., Barrios, F. X., Osman, J. R., Besett, T. M., & Linehan, M. M. (1996) · Research on Child and Adolescent Psychopathology · doi:10.1007/bf01441566 · Cited by 99 · cited 1× · see citing works
“Secondary outcome measures included presence of ideation and behavior, measured by the Suicidal Ideation and Suicidal Behavior subscales of the C-SSRS, respectively; reasons for living, using the Brief Reasons for Living Scale [19]; perceived burdensomeness and thwarted belongingness, assessed by the Interpersonal Nee…”
Methodvan Spijker, B. A. J., van Straten, A., & Kerkhof, A. J. F. M. (2010) · Trials · doi:10.1186/1745-6215-11-25 · Cited by 85 · see citing works
Self-citationvan Spijker, B. A. J., Calear, A. L., Batterham, P. J., Mackinnon, A. J., Gosling, J. A., Kerkhof, A. J. F. M., Solomon, D., & Christensen, H. M. (2015) · Trials · doi:10.1186/s13063-015-0589-1 · Cited by 30 · cited 1× · see citing works
“Full details on the study methodology can be found in the trial protocol [15].”
BackgroundSelf-citationMadsen, T., van Spijker, B. A. J., Karstoft, K., Nordentoft, M., & Kerkhof, A. J. F. M. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5904 · Cited by 22 · cited 1× · see citing works
“It should also be noted here that the Dutch trial found more pronounced effects for severe suicidality [13,32], which contradicts the current findings.”
ResultSelf-citationKerkhof, A. J. F. M., & van Spijker, B. A. J. (2012) · Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) · Cited by 5 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- [31]American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. 5th Edition 2013 Arlington American Psychiatric Association
Cited by
Sorted by citations
Fazel, S., & Runeson, B. (2020) · New England Journal of Medicine · doi:10.1056/nejmra1902944 · Cited by 502 · see citing works
Torok, M., Han, J., Baker, S., Werner-Seidler, A., Wong, I., Larsen, M. E., & Christensen, H. (2020) · The Lancet Digital Health · doi:10.1016/s2589-7500(19)30199-2 · Cited by 273 · see citing works
Self-citationTorous, J., Larsen, M. E., Depp, C., Cosco, T. D., Barnett, I., Nock, M. K., & Firth, J. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0914-y · Cited by 207 · see citing works
Treatments for the Prevention and Management of Suicide: A Systematic Review
D'Anci, K. E., Uhl, S., Giradi, G., & Martin, C. (2019) · Annals of Internal Medicine · doi:10.7326/m19-0869 · Cited by 187 · see citing works
O’Connor, R. C., & Portzky, G. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.02139 · Cited by 146 · see citing works
Watson, N. L., Mull, K. E., Heffner, J. L., McClure, J. B., & Bricker, J. B. (2018) · Journal of Medical Internet Research · doi:10.2196/10351 · Cited by 118 · see citing works
“Another major methodological challenge faced by online eHealth trials is keeping participants engaged in the study protocol and achieving adequate rates of outcome data retention [2,9,16-19].”
BackgroundPsychosocial interventions for self-harm in adults
Witt, K., Hetrick, S. E., Rajaram, G., Hazell, P., Salisbury, T. T., Townsend, E., & Hawton, K. E. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013668.pub2 · Cited by 134 · see citing works
Internet-Based Cognitive Behavioral Therapy to Reduce Suicidal Ideation
Büscher, R., Torok, M. H., Terhorst, Y., & Sander, L. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.3933 · Cited by 124 · see citing works
Petkovic, J., Duench, S., Trawin, J., Dewidar, O., Pardo, J. P., Simeon, R., DesMeules, M., Gagnon, D., Roberts, J. H., Hossain, A., et al. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012932.pub2 · Cited by 133 · see citing works
Arshad, U., Farhat-ul-Ain, F.-U., Gauntlett, J., Husain, N., Chaudhry, N., & Taylor, P. J. (2019) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12583 · Cited by 118 · see citing works
Information and Communication Technology Use in Suicide Prevention: Scoping Review
Rassy, J., Bardon, C., Dargis, L., Côté, L., Corthésy-Blondin, L., Mörch, C., & Labelle, R. J. (2021) · Journal of Medical Internet Research · doi:10.2196/25288 · Cited by 72 · see citing works
“Moreover, there is a growing body of evidence supporting the use of ICT in the development of promising suicide prevention practices [1,2].”
De Jaegere, E., van Landschoot, R., van Heeringen, K., van Spijker, B. A. J., Kerkhof, A. J. F. M., Mokkenstorm, J. K., & Portzky, G. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.05.003 · Cited by 71 · see citing works
Self-citationBatterham, P. J., van Spijker, B. A. J., Mackinnon, A. J., Calear, A. L., Wong, Q. J. J., & Christensen, H. M. (2018) · Depression and Anxiety · doi:10.1002/da.22863 · Cited by 70 · see citing works
“Full details of the studymethodology are provided in the trial protocol (van Spijker et al., 2015) and primary outcomes paper (van Spijker et al., 2018), with a summary provided below.”
BackgroundMethodSelf-citationPigeon, W., Funderburk, J., Cross, W. F., Bishop, T., & Crean, H. F. (2019) · Translational Behavioral Medicine · doi:10.1093/tbm/ibz108 · Cited by 55 · see citing works
Bailey, E., Alvarez-Jimenez, M., Robinson, J., D’Alfonso, S., Nedeljkovic, M., Davey, C. G., Bendall, S., Gilbertson, T., Phillips, J., Bloom, L., et al. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17072435 · Cited by 58 · see citing works
MUBS: A Personalized Recommender System for Behavioral Activation in Mental Health
Rohani, D. A., Lopategui, A. Q., Tuxen, N., Faurholt‐Jepsen, M., Kessing, L. V., & Bardram, J. E. (2020) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3313831.3376879 · Cited by 56 · see citing works
Eylem, Ö., van Straten, A., de Wit, L. M., Rathod, S., Bhui, K. S., & Kerkhof, A. J. F. M. (2021) · Pilot and Feasibility Studies · doi:10.1186/s40814-021-00772-9 · Cited by 48 · see citing works
“The effectiveness of a suicide prevention app for indigenous Australian youths: study protocol for a randomized controlled trial.”
BackgroundResultInfluentialSelf-citationBüscher, R., Beisemann, M., Doebler, P., Micklitz, H. M., Kerkhof, A. J. F. M., Cuijpers, P. J., Batterham, P. J., Calear, A. L., Christensen, H. M., Jaegere, E. D., et al. (2022) · Evidence-Based Mental Health · doi:10.1136/ebmental-2022-300540 · Cited by 49 · see citing works
Self-citationSander, L., Gerhardinger, K., Bailey, E., Robinson, J., Lin, J., Cuijpers, P. J., & Mühlmann, C. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.11.045 · Cited by 44 · see citing works
Are digital interventions effective in reducing suicidal ideation and self-harm? A systematic review
Stefanopoulou, E., Hogarth, H., Taylor, M., Russell-Haines, K., Lewis, D., & Larkin, J. (2020) · Journal of Mental Health · doi:10.1080/09638237.2020.1714009 · Cited by 37 · see citing works
“…targeting depression (Moritz et al., 2012; Christensen et al., 2013, 2016; Wagner et al., 2014; Handley et al., 2013; Batterham et al., 2018; Wilks et al., 2018), rather than suicidal ideation or self-harm only (Franklin et al., 2016; van Spijker et al., 2014, 2018; Tighe et al., 2017).”
BackgroundMethodResultInfluentialBailey, E., Mühlmann, C., Rice, S., Nedeljkovic, M., Álvarez‐Jiménez, M., Sander, L., Calear, A. L., Batterham, P. J., & Robinson, J. (2020) · BMC Medical Ethics · doi:10.1186/s12910-020-00479-1 · Cited by 40 · see citing works
Self-citationBailey, E., Rice, S., Robinson, J., Nedeljkovic, M., & Álvarez‐Jiménez, M. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.06.028 · Cited by 35 · see citing works
Moineau, B., Myers, M., Ali, S., Popović, M. R., & Hitzig, S. L. (2019) · Disability and Rehabilitation Assistive Technology · doi:10.1080/17483107.2019.1668974 · Cited by 34 · see citing works
Sander, L., Beisemann, M., Doebler, P., Micklitz, H. M., Kerkhof, A. J. F. M., Cuijpers, P. J., Batterham, P. J., Calear, A. L., Christensen, H. M., Jaegere, E. D., et al. (2023) · Journal of Medical Internet Research · doi:10.2196/46771 · Cited by 34 · see citing works
“%) trials [31-38], whereas in 1 case, data were not available [39].”
Self-citationResilience to suicidal behavior in young adults: a cross-sectional study
Han, J., Wong, I., Christensen, H. M., & Batterham, P. J. (2022) · Scientific Reports · doi:10.1038/s41598-022-15468-0 · Cited by 29 · see citing works
Self-citationDigital Technology for Suicide Prevention
Braciszewski, J. M. (2021) · Advances in Psychiatry and Behavioral Health · doi:10.1016/j.ypsc.2021.05.008 · Cited by 28 · see citing works
Batterham, P. J., Calear, A. L., Farrer, L. M., Gulliver, A., & Kurz, E. (2020) · Journal of Medical Internet Research · doi:10.2196/22698 · Cited by 25 · see citing works
Self-citationDreier, M., Ludwig, J., Härter, M. C., Knesebeck, O. V. D., Baumgardt, J., Bock, T. A., Dirmaier, J., Kennedy, A. J., Brumby, S. A., & Liebherz, S. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2137-0 · Cited by 25 · see citing works
Development and Evaluation of a Web-Based Resource for Suicidal Thoughts: NowMattersNow.org
Whiteside, U. S., Richards, J. A., Huh, D., Hidalgo, R., Nordhauser, R., Wong, A. J., Zhang, X., Luxton, D. D., Ellsworth, M., & Lezine, D. A. (2019) · Journal of Medical Internet Research · doi:10.2196/13183 · Cited by 24 · see citing works
“Web-based suicide-prevention resources are available around the clock and have the potential to address several major challenges to caring for suicidal patients [9,10].”
Hu, F., Xu, J., Jia, Y., Ge, M., Zhang, W., Tang, W. H., Zhao, D., Hu, S., Du, W. D., Shen, W., et al. (2024) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2024.103913 · Cited by 26 · see citing works
Han, J., McGillivray, L., Wong, Q. J., Werner-Seidler, A., Wong, I., Calear, A., Christensen, H., & Torok, M. (2020) · JMIR Research Protocols · doi:10.2196/23655 · Cited by 17 · see citing works
Self-citationLindsay, J. A. B., McGowan, N. M., Henning, T., Harriss, E., & Saunders, K. (2024) · Journal of Medical Internet Research · doi:10.2196/54941 · Cited by 20 · see citing works
Reuter, C., Bellettiere, J., Liles, S., Di, C., Sears, D. D., LaMonte, M. J., Stefanick, M. L., LaCroix, A. Z., & Natarajan, L. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-00992-x · Cited by 20 · see citing works
Yu, T., Hu, D., Teng, F., Mao, J., Xu, K., Han, Y., Liu, Y., & Wu, M. (2021) · Psychology Health & Medicine · doi:10.1080/13548506.2021.1930073 · Cited by 19 · see citing works
Efficacy of an online-group intervention after suicide bereavement: A randomized controlled trial
Wagner, B., Grafiadeli, R., Schäfer, T., & Hofmann, L. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100542 · Cited by 21 · see citing works
Interventions for attempted suicide
Menon, V., & Vijayakumar, L. (2022) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000807 · Cited by 17 · see citing works
Sütöri, S., Hadlaczky, G., Eliasson, E. T., Wasserman, D., & Carli, V. (2023) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-023-00374-7 · Cited by 16 · see citing works
“Three out of the four studies reported on the number of suicide attempts (Mühlmann et al., 2021; van Spijker et al., 2014, 2018).”
Effects of Digital Psychotherapy on Suicide: A Systematic Review and Meta-Analysis
Oh, J., Ho, J.-G., Lee, S., & Park, J. (2024) · Healthcare · doi:10.3390/healthcare12141435 · Cited by 14 · see citing works
Núñez, D. E., Meza, D., Andaur, J., Robinson, J., & Gaete, J. (2024) · BMC Psychology · doi:10.1186/s40359-024-02300-9 · Cited by 13 · see citing works
van Spijker, B. A. J., Batterham, P. J., Calear, A. L., Wong, Q. J. J., Werner‐Seidler, A., & Christensen, H. M. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.11.050 · Cited by 12 · see citing works
Self-citationEfficacy of BrighterSide, a Self-Guided App for Suicidal Ideation: Randomized Controlled Trial
Josifovski, N., Torok, M. H., Batterham, P. J., Wong, Q. J. J., Beames, J. R., Theobald, A., Holland, S., Huckvale, K., Riley, J., Cockayne, N. L., et al. (2024) · JMIR Mental Health · doi:10.2196/55528 · Cited by 11 · see citing works
Self-citationWong, Q. J. J., Torok, M. H., van Spijker, B. A. J., Werner‐Seidler, A., Calear, A. L., Batterham, P. J., Han, J., & Christensen, H. M. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113406 · Cited by 11 · see citing works
Self-citationBatterham, P. J., Christensen, H. M., Calear, A. L., Werner‐Seidler, A., & Kazan, D. (2020) · Archives of Suicide Research · doi:10.1080/13811118.2020.1848671 · Cited by 11 · see citing works
“The primary outcomes of the trial (van Spijker et al., 2018) and typical trajectories of change in the trial (Batterham et al., 2019) have already been reported, and suggest that the program was not effective overall in reducing suicidal ideation or behavior compared to an active control condition,…”
BackgroundMethodResultInfluentialSelf-citationMeyerhoff, J., Kruzan, K. P., Kim, K. A., Orden, K. A. V., & Mohr, D. C. (2022) · Archives of Suicide Research · doi:10.1080/13811118.2022.2096520 · Cited by 10 · see citing works
“…severity among individuals with suicidal ideation (Bush et al., 2015; De Jaegere et al., 2019; Hetrick et al., 2017; Hill & Pettit, 2019; Mewton & Andrews, 2015; Robinson et al., 2016; Spijker, Straten, & Kerkhof, 2014; Stallard, Porter, & Grist, 2018; Tighe et al., 2017; van Spijker et al., 2018).”
BackgroundKruzan, K. P., Biernesser, C. L., Hoffmann, J. A., & Meyerhoff, J. (2024) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-024-00318-9 · Cited by 12 · see citing works
Orsolini, L., Appignanesi, C., Pompili, S., & Volpe, U. (2022) · International Review of Psychiatry · doi:10.1080/09540261.2022.2118521 · Cited by 12 · see citing works
“ICT-based studies in suicide prevention programs mainly focussed on the use and application of smart-phone-based tools (Larsen et al., 2019), web-based interventions (Perry et al., 2016; van Spijker et al., 2018), social media (Robinson et al., 2016) and machine-learning (ML)(Bernert et al., 2020).”
BackgroundFactors associated with engagement in online self-help programs among people with suicidal thoughts
Batterham, P. J., Han, J., Mackinnon, A. J., Werner‐Seidler, A., Calear, A. L., Wong, Q. J. J., Torok, M. H., & Christensen, H. M. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.044 · Cited by 9 · see citing works
Self-citationGoger, P., Guo, R., Jo, S., Cha, C. B., Ribeiro, J. D., Huang, X., & Fox, K. R. (2024) · Behavior Therapy · doi:10.1016/j.beth.2024.10.003 · Cited by 9 · see citing works
Suchsland, M. Z., Rahmatullah, I., Lutz, B. R., Lyon, V., Huang, S., Kline, E. C., Graham, C., Cooper, S., Su, P., Smedinghoff, S., et al. (2021) · BMC Infectious Diseases · doi:10.1186/s12879-021-06314-1 · Cited by 8 · see citing works
Beuthin, O., Bhui, K. S., Yu, L., Shahid, S., Almidani, L., Bilalaga, M. M., Hussein, R., Harba, A., & Nasser, Y. (2023) · JMIR Research Protocols · doi:10.2196/47627 · Cited by 9 · see citing works
“Randomized controlled trials of the intervention have found it to be effective in reducing SI compared to treatment as usual—an information website—for general Dutch ( d =0.2) [38] and Belgian populations ( d =0.34) [39], but not for Australian populations [40].”
InfluentialBatterham, P. J., Gendi, M., Christensen, H. M., Calear, A. L., Shand, F., Sunderland, M., Borschmann, R., Banfield, M., O’Dea, B., Larsen, M. E., et al. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05335-1 · Cited by 9 · see citing works
“Social media provides similarly representative samples to other population recruitment methods and is effective and appropriate for recruiting marginalised populations [46, 47].”
BackgroundMethodSelf-citationWong, Q. J. J., Werner‐Seidler, A., Torok, M. H., van Spijker, B. A. J., Calear, A. L., & Christensen, H. M. (2019) · JMIR Mental Health · doi:10.2196/11521 · Cited by 7 · see citing works
Self-citationTong, F., Zhang, Y., & Jiao, Y. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1672957 · Cited by 4 · see citing works
Pyle, M., Loftus, L., Emsley, R., Freeman, D. H., Gillard, S., Gumley, A. I., Sierpatowska, J., Wood, L., O’Connor, R. C., Pfeiffer, P., et al. (2024) · Trials · doi:10.1186/s13063-024-08293-5 · Cited by 4 · see citing works
“One digital CBT intervention included in the review which showed initial promise for reducing suicidal thinking is an online self-guided programme for adults designed to help reduce suicidal ideation (Living with Deadly Thoughts: LwDT) [23].”
BackgroundA Calibrated Sensitivity Analysis for Weighted Causal Decompositions
Shen, A. A., Visoki, E., Barzilay, R., & Pimentel, S. D. (2025) · Statistics in Medicine · doi:10.1002/sim.70010 · Cited by 4 · see citing works
“Recent studies have indicated promising results [7] and research from randomized controlled trials (RCTs) in other high-risk populations have also reported that suicidal ideation can be reduced through interventions such as online self-help programs and pharmacotherapy [8, 9].”
Schmeckenbecher, J., Rattner, K., Cramer, R. J., Plener, P. L., Baran, A., & Kapusta, N. D. (2022) · BJPsych Open · doi:10.1192/bjo.2022.526 · Cited by 4 · see citing works
Carrandi, A., Hu, Y., Wayland, S., & Maple, M. J. (2023) · Health & Social Care in the Community · doi:10.1155/2023/5961793 · Cited by 5 · see citing works
Büscher, R., Sander, L., Nuding, M., Baumeister, H., & Teismann, T. (2023) · JMIR Formative Research · doi:10.2196/49043 · Cited by 4 · see citing works
A systematic review of the barriers associated with help-seeking among students at risk of suicide
Cameron, G. C., Hunter, S. C., McCartney, R. C., & McKain, L. (2024) · Educational Research and Evaluation · doi:10.1080/13803611.2024.2422626 · Cited by 3 · see citing works
“Given that informal help is valuable in reducing suicidality (Nguyen et al., 2021; van Spijker et al., 2018), and is often the “ preferred ” method of help-seeking for mental health problems (Brown et al., 2014), this should be a key component of future research e ff orts.”
Benefits of Using Activity Recommender Technology for Self-management of Depressive Symptoms
Rohani, D. A., Faurholt‐Jepsen, M., Kessing, L. V., & Bardram, J. E. (2021) · ACM Transactions on Computing for Healthcare · doi:10.1145/3462212 · Cited by 3 · see citing works
Wirken Online-Peer-Suizidpräventionsprogramme?
Hildebrand, A., Weiss, M., Braun‐Scharm, H., & Stemmler, M. (2022) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026/1616-3443/a000663 · Cited by 2 · see citing works
Yang, J. H., Park, C. H. K., Rhee, S. J., Kang, D. H., Lee, S. Y., Yang, C.-M., Shim, S.-H., Moon, J., Cho, S.-J., Lee, H., et al. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.12.034 · Cited by 2 · see citing works
Schure, M. B., McCrory, B., Greist, J. H., & Weissman, R. S. (2022) · Discover Psychology · doi:10.1007/s44202-022-00030-w · Cited by 2 · see citing works
Shinde, F., Wagani, R., & Sasidhar, K. (2023) · Perspectives on Global Development and Technology · doi:10.1163/15691497-12341631 · Cited by 2 · see citing works
The role of the internet in suicide prevention from the public health perspective
Westerlund, M., & Krysinska, K. E. (2021) · doi:10.1093/med/9780198834441.003.0076 · Cited by 2 · see citing works
Kearns, J. C., Polizzi, C. P., Naganuma-Carreras, J., Bourassa, K. J., Halverson, T. F., Perskaudas, R., Kimbrel, N. A., Interian, A., Bossarte, R. M., DeBeer, B. B., et al. (2025) · Clinical Psychology Review · doi:10.1016/j.cpr.2025.102614 · Cited by 3 · see citing works
Abbasi, F., Rahimi, M., Sedighifar, Z., Norouzi, S., Jandaghian-Bidgoli, M., Rohollah, F., Mohammadi, Z., & Ahmadi, S. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07594-6 · Cited by 1 · see citing works
“In contrast, studies relying on unguided self-help approaches may suffer from lower engagement and adherence, reducing their overall impact [40].”
Wesołowski, A., Skawińska, J., & Soroko, E. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1141856 · Cited by 1 · see citing works
Woods, M. A., Hampton, D. C., Okoli, C. T. C., Heath, J., & Moreland, G. (2024) · Journal of the American Psychiatric Nurses Association · doi:10.1177/10783903241247216 · Cited by 1 · see citing works
“Web-based suicide prevention training can increase knowledge (Kullberg et al., 2020; Lancaster et al., 2014; Peterson, 2020) and confidence (Bektas & Yardimci, 2018; Kerr et al., 2020) while decreasing suicidal thoughts and anxiety (Guille et al., 2015; Van Spijker et al., 2018).”
Beuthin, O., Shahid, S., Yu, L., & Bhui, K. S. (2024) · JMIR Research Protocols · doi:10.2196/56957 · Cited by 1 · see citing works
Pyke, R. E. (2018) · Sexual Medicine Reviews · doi:10.1016/j.sxmr.2018.07.002 · Cited by 1 · see citing works
Gaete, J., Núñez, D. E., Meza, D., Andaur, J., & Robinson, J. (2024) · Research Square · doi:10.21203/rs.3.rs-4824452/v1 · Cited by 1 · see citing works
Takahashi, A., Sueki, H., & Ito, J. (2021) · Asian Journal of Human Services · doi:10.14391/ajhs.20.19
Resilience To Suicidal Behaviour In Young Adults: A Cross-Sectional StudyPreprint
Han, J., Wong, I., Christensen, H. M., & Batterham, P. J. (2022) · Research Square · doi:10.21203/rs.3.rs-1233434/v1
“History of suicide attempts was assessed by a question on a three-point Likert scale, ranging from “No, never (0)”, “Yes, once (1)”, to “Yes, more than once (2)” 45 .”
MethodSelf-citationBrighterSide: A randomised controlled trial of a self-guided app for suicidal ideation (Preprint)Preprint
Josifovski, N., Torok, M. H., Batterham, P. J., Wong, Q. J. J., Beames, J. R., Theobald, A., Holland, S., Huckvale, K., Riley, J., Cockayne, N. L., et al. (2024) · doi:10.2196/preprints.55528
Self-citationPyle, M., Loftus, L., Emsley, R., Freeman, D. H., Gillard, S., Gumley, A. I., Sierpatowska, J., Wood, L., O’Connor, R. C., Pfeiffer, P. N., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26197452
Bailey, E., Mühlmann, C., Rice, S., Nedeljkovic, M., Álvarez‐Jiménez, M., Sander, L., Calear, A. L., Batterham, P. J., & Robinson, J. (2020) · Figshare · doi:10.6084/m9.figshare.12299264
Self-citationJanssen, W. C., Mérelle, S. Y. M., Gilissen, R., & Bockting, C. (2026) · Trials · doi:10.1186/s13063-026-09725-0
“Online interventions, including the control intervention used in this study, are known to suffer from low adherence rates [55].”
State of the Science in Practice: Interventions Based on the Interpersonal Theory of Suicide
Udupa, N. S., Edenbaum, E. R., Prostko, S., Campione, M. T., Robison, M., Rice, T. B., & Joiner, T. E. (2026) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2026.06.003
- Authors
- van Spijker, B. A., Werner-Seidler, A., Batterham, P. J., Mackinnon, A., Calear, A. L., Gosling, J. A., Reynolds, J., Kerkhof, A. J., Solomon, D., Shand, F., & Christensen, H.
- Affiliations
- Australian National University (AU)
- Black Dog Institute (AU)
- Amsterdam Public Health (NL)
- Corresponding author
- Christensen, Helen
- ORCID
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2018-02-14
- Volume
- 20
- Issue
- 2
- Pages
- e15
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC5830610
- OpenAlex
- W2786928256
- Cited by
- 80
- References
- 36
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 15 · 2023: 8 · 2022: 10 · 2021: 11 · 2020: 13 · 2019: 11 · 2018: 6
- FWCI
- 12.04
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- ANU Open Research (Australian National University) (submittedVersion, cc-by)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Medical Research Council
- National Health and Medical Research Council (1083311, 1122544, 1042580, 1046317, 1056964)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- suicidal ideation, online self-help intervention, online intervention, suicide prevention, Columbia Suicide Severity Rating Scale, intervention effectiveness, attrition
- MeSH terms
- Adolescent, Adult, Aged, Australia, Female, Humans, Male, Middle Aged, Self-Help Groups, Internet, Young Adult, Suicidal Ideation
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