Tuesday, February 24, 2015

Brief CBT Appears Effective in Reducing Suicide Risk in Military With Suicidal Ideation

Brief cognitive-behavioral therapy (CBT) appears to be effective in preventing follow-up suicide attempts among active-duty military service members with current suicidal ideation and/or a recent suicide attempt, according to the report "Brief Cognitive-Behavioral Therapy Effects on Post-Treatment Suicide Attempts in a Military Sample: Results of a Randomized Clinical Trial With 2-Year Follow-Up" in AJP in Advance.

The study was conducted by M. David Rudd, Ph.D., of the National Center for Veterans Studies at the University of Memphis, and colleagues. The subjects were active-duty Army soldiers at Fort Carson, Colo., who had either attempted suicide or experienced suicidal ideation; they were randomly assigned to treatment as usual (N=76) or treatment as usual plus brief CBT (N=76).

Assessment of incidence of suicide attempts during the two-year follow-up period was conducted with the Suicide Attempt Self-Injury Interview. Statistical analysis was used to determine treatment efficacy with regard to incidence and time to suicide attempt, and differences in psychiatric symptoms were evaluated over time.

Thirty-one suicide attempts were made by 26 participants across both groups during the two-year follow-up, including two deaths by suicide (one in the brief CBT group and one in the treatment-as-usual group). Eight participants in brief CBT and 18 participants in treatment as usual made at least one suicide attempt during the two-year follow-up , which suggests that soldiers in brief CBT were approximately 60 percent less likely to make a suicide attempt during the follow-up period than soldiers in treatment as usual. There were no between-group differences in severity of psychiatric symptoms.

“It is noteworthy that the observed reduction in suicide attempts occurred despite minimal differences in symptom severity between groups over time, a finding that mirrors previous outcomes from dialectical-behavior therapy and cognitive therapy,” the researchers stated. “Given that the primary goal of brief CBT is emotion regulation and problem-solving-skills development as opposed to symptom reduction, this finding is not surprising and supports the assertion that suicidal thoughts and behaviors should be targeted as a unique treatment goal separate from psychiatric diagnosis and symptom severity.”

For more on this subject, see the Psychiatric News article “Army Learning Complex Factors Associated With Soldier Suicides.”

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