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.”

(Image: kasha_malasha/shutterstock.com)

Disclaimer

The content of Psychiatric News does not necessarily reflect the views of APA or the editors. Unless so stated, neither Psychiatric News nor APA guarantees, warrants, or endorses information or advertising in this newspaper. Clinical opinions are not peer reviewed and thus should be independently verified.