identifying risk and providing evidence-based prevention and treatment strategies

Travel to AAS19 and learn from MSRC

The MSRC pre-conference research training day is to be held Wednesday April 24 prior to the 2019 American Association of Suicidology (AAS) conference, in Denver, CO. This opportunity is available to up to 30 trainees who at the time of application are students or research fellows. Applications are due by January 18, 2019.

About MSRC

MSRC is part of an ongoing strategy to integrate and synchronize U.S. Department of Defense and civilian efforts to implement a multidisciplinary research approach to suicide prevention. Funded through the Defense Health Program and managed by the Military Operational Medicine Research Program (MOMRP), this innovative cutting-edge research aims to enhance the military’s ability to quickly identify those at risk for suicide and provide effective evidence-based prevention and treatment strategies.

MSRC is incorporated in the National Research Action Plan (NRAP) on posttraumatic stress disorder (PTSD), other mental health conditions, and Traumatic Brain Injury (TBI). The plan was developed to improve the coordination of government agency research into these conditions and reduce the number of affected men and women through better prevention, diagnosis, and treatment. Suicide prevention research is a key theme of NRAP.

Consortium Spotlight

The MSRC Research Program runs cutting-edge empirical studies to further the knowledge base on topics such as risk assessment, treatment, and prevention, as they pertain to suicidal behavior in the military.

A Taxometric Investigation of Suicide

What differentiates people who die by suicide from other people? This is a key question for any clinician or professional who would like to be able to predict which people are most at risk for death by suicide. Unfortunately there is still very much about that question that remains unknown, including a very basic issue: Is suicidality a categorical trait - people either are suicidal, or they aren’t - or is it more of a continuous trait, where people can fall anywhere on a spectrum from not suicidal at all to highly suicidal? The answer has implications both for the assessment of suicidality and for its treatment.

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Retraining reactions to smells

One of the major factors that has been found to contribute to suicide risk is a pattern of experiencing feelings of anxiety. If ways could be found to help Veterans reduce feelings of anxiety, it could also reduce suicide risk in those Veterans. This is exactly what Wen Li and Brad Schmidt have set out to do, focusing on helping Veterans and others learn to handle anxiety-causing smells.

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Preventing Suicide by Decreasing Anxiety and Improving Mood

Two mood factors are believed to be key aspects in determining whether a person will commit suicide: thwarted belongingness and perceived burdensomeness.

To help individuals deal with these two types of feelings, Brad Schmidt has developed a new Web-based treatment program aimed at helping people recognize them and address them.

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Group Therapy for Treating Suicidal Veterans

Therapists have found group therapy to be effective for treating Veterans for depression, chronic traumatic stress, and various other mental ailments, but it has generally not been used to deal with suicide-related issues. For the past several years Johnson, with funding from the MSRC, has been exploring the use of group therapy for treating suicidal Veterans, including those who have attempted suicide.

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An Improved Virtual Hope Box

One of the strategies that clinicians have used to help patients remember their reasons for living is the "hope box." It can be a real wooden box, a shoe box, a manila envelope, or pretty much any other sort of container.

Throughout 2013 Nigel Bush at the National Center for Telehealth and Technology carried out usability testing on an initial version of the virtual hope box. Although the original version seemed quite successful, Bush expects the new version to prove to be even better.

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Behavioral Sleep Intervention for the Prevention of Suicide

Recent research has shown a link between suicidal behaviors and poor sleep quality. Those with suicidal thoughts appear to be at greater risk for sleep disturbances, including insomnia symptoms, poor sleep quality, and nightmares.

Rebecca Bernert and Alan Schatzberg are carrying out a clinical trial testing the use of a brief behavioral sleep therapy to improve sleep and evaluate its therapeutic impact on suicide prevention.

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Will Hope Notes Work at the E.R.?

A successful treatment technique used by therapists is to put together a list written on a note card of things that make the patient’s life worth living.

Craig Bryan and his coworkers will be testing the effectiveness of providing military patients with these note cards at crisis-triggered visits to a clinician, instead of through multi-session psychotherapy.

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Looking for Suicide Warning Signs

Looking for Suicide Warning Signs Clinicians have a variety of well-tested ways of identifying individuals who are at highest risk for suicide, but they have no such well-tested methods for determining when a particular individual is most likely to attempt suicide

Courtney Bagge and Kenneth Conner will be studying Veterans and civilians who have recently attempted suicide to try and answer the question ‘Why today?'

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Predicting Suicide Risk in a Military Population

Michael Anestis at the University of Southern Mississippi is testing several existing prediction models on a group of Veterans to see which are most effective at predicting the likelihood of suicide. He is also adding his own twist with the use of “collateral reporters” in an attempt to improve the models’ ability to predict suicidal behavior.

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Improving the Inpatient-to-Outpatient Transition

For suicidal Veterans who are treated on an inpatient psychiatric unit, the weeks and months following their discharge pose a special risk. Much of the risk seems to be rooted in the transition from inpatient care to outpatient care, which can leave Veterans feeling unsettled.

Bridget Matarazzo at the Rocky Mountain MIRECC is testing the Home-Based Mental Health Evaluation program, or HOME, designed to lower the risk. 

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Studying the Connection between Suicidality and Being in Touch with Your Body

The scientific term for sensitivity to the internal states of the body is interoception. Research has found that people who score low on measures of interoception are more likely to try to injure themselves or attempt suicide. With this in mind, April Smith of Miami University is leading a research effort to study the relationship between interoception and self-injuring and suicidal behaviors specifically in a military population.

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Texting a brief intervention to prevent suicidal ideation and behavior

"Caring letters" have long been identified as an effective suicide intervention. This study aims to use text messaging or short messaging service (SMS) as a low cost caring contact, in hopes of decreasing suicidal thinking and behavior for active duty military personnel.

Participants will receive text messages at pre-scheduled times over a 12 month period to asses the effectiveness of such intervention.

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Looking for Cognitive Differences in Suicidal Veterans

It is well known that people at high risk for suicide have certain emotional differences from those people who are not at risk, but are there cognitive differences as well?

This is a question that Matthew Nock at Harvard University has set out to answer in a study that will eventually involve 400 subjects at Harvard and at the Boston VA Medical Center.

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Suicide Bereavement in Veterans and Military Families

When someone dies by suicide, it can have devastating effects on the people left behind. This is particularly true in close-knit communities such as the military. Some of the survivors may even be more likely to attempt suicide themselves.

Julie Cerel is conducting a study focused on determining how many Veterans know someone who died by suicide and what their reactions are to the suicide. Cerel’s goal is to find out how many people are affected by military suicides, how strongly they are affected, and how bereavement following a suicide differs from bereavement following other types of violent death.

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A Web-Based Treatment for Insomnia

Over the past decade or so it has become increasingly clear that there is a link between sleep problems and suicide. The evidence indicates that insomnia is a separate risk factor that itself makes a person more likely to think about and to attempt suicide.

Sarra Nazem, a clinical research psychologist at the Denver VA Medical Center and the University of Colorado Medical Center, is testing an Internet-based intervention that is designed to help Veterans and Service Members address problems with insomnia.

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Window to Hope: A cognitive behavioral approach to reducing hopelessness

Veterans with traumatic brain injury are significantly more likely than other Veterans to die by suicide. A recent study in Australia found that it was possible to reduce hopelessness among adults with traumatic brain injury with a treatment program using cognitive behavioral therapy.

For that reason Lisa Brenner of the Denver VA and the University of Colorado School of Medicine and Grahame Simpson from Australia, are heading up a study to determine if a similar cognitive behavioral approach can reduce hopelessness among a group of U.S. Veterans suffering from lasting effects of traumatic brain injury.

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Toward a Gold Standard for Suicide Risk Assessment for Military Personnel

When a clinician deals with an emotionally troubled patient, one of the most important questions to ask is, “How great is the risk that this person will engage in some form of suicidal behavior in the near future?” Unfortunately there is still no clear-cut best way to gauge the likelihood of near-term suicidal behavior in a given individual.

To identify such a “gold standard” for clinical suicide risk assessment, Thomas Joiner and Peter Gutierrez are testing four widely used measures to determine which measure or combination of measures offers the most accurate prediction of suicide-related behaviors three months into the future.

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Improving Marriages to Decrease Suicide Risk

Research has shown that interpersonal problems are closely linked with an increased risk of suicide, so it seems likely that the high rates of marital disruption among service members and Veterans might influence the high rates of suicide among these groups.

James McNulty and Michael A. Olson are hoping to improve military marriages with a novel, computer-based technique for strengthening relationships.

They hope that by helping the spouses feel more positive about each other they can develop a new tool for decreasing the risk of suicide among service members and Veterans.

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Using Anger-Reduction Treatment to Reduce Suicide Risk

Anger Reduction It is well known that suicide is closely linked to depression and feelings of hopelessness, but research has found links between suicide and various other emotions such as anger and hostility. Research into the connection between anger and suicide suggests that people who are angry much of the time tend to isolate themselves from others and that they are much more likely to feel that they are a burden to others.

Given the relationship between anger and increased suicide risk, a natural question to ask is whether reducing feelings of anger among those at high risk for suicide could reduce the likelihood that they would attempt to harm themselves. This is the question that Jesse Cougle at Florida State University has set out to answer.

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Using Brain Imaging to Study Suicide Risk

Neuroscientists have used brain imaging techniques to learn many things about the brain but there have been few studies attempting to find brain characteristics that are associated with suicidal behavior.

Thus Deborah Yurgelun-Todd of the University of Utah is now studying a group of Veterans, half of whom have a history of self-directed violence, to search for brain differences between Veterans who have attempted to hurt themselves and those who have not.

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Studying Group Therapy for Suicidal Veterans

Group therapy has proved effective in dealing with a variety of mental health issues, from depression to chronic traumatic stress in Veterans, but it has rarely been used to help individuals at risk of suicide.

Lora Johnson of the VA Medical Center in Louisville, Kentucky, is using group therapy to treat suicidal Veterans, including many who have attempted suicide, in order to develop objective evidence on the method’s effectiveness.

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Thinking Under Stress and the Risk of Suicide

When people are under stress, they naturally find it more difficult to think clearly and to deal with the sorts of problems that arise in daily living.

In a study being carried out at the VA medical center in Boston, researchers are examining differences in the effects that stress has on the thinking of people with suicidal thoughts versus those who do not have suicidal thoughts. This may point the way to identifying Veterans at risk of developing suicidal behavior

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