People who commit suicide are known to differ from other individuals in a variety of ways. They are much more sensitive to feelings of anxiety, for example; whereas most people do not worry much about a rapidly beating heart, racing thoughts, or an inability to concentrate, some people—including many who are at high risk for suicide—interpret such symptoms as signs of a major problem, such as an impending heart attack or losing control of one’s thoughts and going crazy. Similarly, individuals who feel that they do not have meaningful relationships with others and that they are a burden to those they care about are also at a high risk for suicide. Thus Brad Schmidt, a psychologist at Florida State University, is studying whether it is possible to reduce the risk of suicide in high-risk individuals by targeting these traits.
Schmidt’s current research is a follow-up study to consortium-funded work he has recently finished on reducing anxiety sensitivity in members of the military. The Web-based treatment program that he developed was shown to reduce sensitivity to anxiety among service members and also to reduce thoughts about suicide. It was an encouraging result, Schmidt says, but he wanted to build on it by coming up with additional factors that could also be addressed by adding to the Web-based program he had created.
Schmidt chose to focus on two mood factors that are believed to be key aspects in determining whether a person will commit suicide: thwarted belongingness and perceived burdensomeness. The first of these is the sense that one does not really belong with other people in any meaningful sense, while the second is the feeling that one is a burden to other people. To help individuals deal with these two types of feelings, Schmidt has developed a new Web-based treatment program aimed at helping people recognize them and address them. This is a completely new approach to treating suicidal patients, he said; no one has tried this before. Schmidt has combined this treatment program with the one he had previously created for dealing with anxiety sensitivity into one Web-based intervention that takes about 45 minutes to complete.
To determine whether this Web-based program can help reduce the risk of suicide among members of the military and Veterans, Schmidt will be recruiting 300 at-risk people for a randomized controlled trial. A quarter of them will be given treatment for anxiety sensitivity, a quarter will be given the treatment for the two mood factors, a quarter will be given both treatments, and a quarter will be given treatment as usual. By assessing the people in the different groups at the end of their treatment and at one-, three-, and six-month follow-up visits, he will be able to determine how effective the different treatments are at preventing suicidal thoughts and suicide attempts.
As part of the study, Schmidt and a colleague, Ed Bernat, will be performing electroencephalograms (EEGs) on the subjects to look for patterns of brain activity that correspond to various suicide-related traits, specifically anxiety sensitivity, thwarted belongingness, and perceived burdensomeness. The goal is to find EEG patterns that can be used to identify those people who experience those feelings or who are likely to and thus have a tool besides the usual questionnaires that can screen for high-risk individuals.
One of the interesting aspects of the study, Schmidt says, is the chance to study the relationship between anxiety and two mood factors. People at high risk of suicide seem to score high on all three factors, and it seems likely that there is some interaction among them. Figuring out what that relationship might be could point to yet another approach to reducing the risk of suicide.