Evidence-Based Treatments for PTSD

2017 ◽  
pp. 131-146
Author(s):  
Afsoon Eftekhari ◽  
Sara J. Landes ◽  
Katherine C. Bailey ◽  
Hana J. Shin ◽  
Josef I. Ruzek
Keyword(s):  
Suicidal Ideation ◽  
Suicide Risk ◽  
Self Report ◽  
Suicidal Patient ◽  
Evidence Based ◽  
Delivery Of Care ◽  
Treatment Providers ◽  
Therapeutic Rapport ◽  
Evidence Based Treatments ◽  
Ptsd Assessment

Because suicide risk appears to be heightened with individuals who have posttraumatic stress disorder (PTSD), it is crucial that PTSD treatment providers assess for suicidal ideation and that, when mental health clinicians are working with a suicidal patient, they assess for PTSD. Evidence-based treatments for PTSD can significantly help those experiencing both PTSD and suicidality. Although co-occurring suicidality does not prohibit proceeding with these treatments, it does involve additional considerations in delivery of care. Good PTSD assessment involves both diagnostic interviewing and ongoing assessment via administration of self-report measures. A written safety plan should also be developed, actively engaging veterans and minimizing barriers to treatment. Once the decision is made to proceed with PTSD care, all treatments are implemented as usual with ongoing monitoring of suicidal ideation. Strong therapeutic rapport is a critical part of all evidence-based treatments for PTSD, as well as for effective response to suicide risk.

Examining the link between prior suicidality and subsequent suicidal ideation among high-risk US military service members

2018 ◽  
Vol 49 (13) ◽  
pp. 2237-2246 ◽  
Author(s):  
Melanie A. Hom ◽  
Mary E. Duffy ◽  
Megan L. Rogers ◽  
Jetta E. Hanson ◽  
Peter M. Gutierrez ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Military Service ◽  
Suicide Risk ◽  
Self Report ◽  
Service Members ◽  
Thwarted Belongingness ◽  
Us Military ◽  
Military Service Members ◽  
The Relationship

AbstractBackgroundResearch is needed to identify the factors that explain the link between prior and future suicidality. This study evaluated possible mediators of the relationship between: (1) the severity of prior suicidality and (2) suicidal ideation severity at 3-month follow-up among a sample of high-risk military personnel.MethodsUS military service members referred to or seeking care for suicide risk (N = 624) completed self-report psychiatric domain measures and a clinician interview assessing prior suicidality severity at baseline. Three months later, participants completed a self-report measure of suicidal ideation severity. Three separate percentile bootstrap mediation models were used to examine psychiatric factors (i.e. alcohol abuse, anxiety sensitivity, hopelessness, insomnia, posttraumatic stress symptoms, suicidal ideation, and thwarted belongingness) as parallel mediators of the relationship between prior suicidality severity (specifically, suicidal ideation, suicide attempt, and overall suicidality – i.e. ideation/attempt severity combined) at baseline and suicidal ideation severity at follow-up.ResultsHopelessness, specifically, and the total effect of all mediators, each significantly accounted for the relationship between prior suicidality severity and subsequent ideation severity across models. In the models with attempt severity and overall suicidality severity as predictors, thwarted belongingness was also a significant mediator.ConclusionsHopelessness, thwarted belongingness, and overall severity of psychiatric indices may explain the relationship between prior suicidality severity and future suicidal ideation severity among service members at elevated suicide risk. Research is needed to replicate these findings and examine other possible mediators.

Differences in Suicide Risk Severity Among Suicidal Youth With Anxiety Disorders

Crisis ◽  
2019 ◽  
Vol 40 (5) ◽  
pp. 333-339 ◽  
Author(s):  
Joanna Herres ◽  
Annie Shearer ◽  
Tamar Kodish ◽  
Barunie Kim ◽  
Shirley B. Wang ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Suicidal Ideation ◽  
Social Anxiety ◽  
Anxiety Disorders ◽  
Suicide Risk ◽  
Suicide Ideation ◽  
Self Report ◽  
Health Concern ◽  
Future Research ◽  
Major Depressive

Abstract. Background: Adolescent suicidality is a growing public health concern. Although evidence supports a link between anxiety and suicidality, little is known about risk associated with specific anxiety disorders. Aims: This study examined the prevalence of anxiety disorders in a sample of adolescents with depression and suicidal ideation and the associations between specific anxiety disorders and suicide ideation severity and attempt history. Method: The sample consisted of 115 adolescents ( Mage= 14.96 years; 55.8% African American) entering a clinical trial for suicidal ideation and depressive symptoms. Prior to treatment, adolescents completed self-report and interview measures. Results: In all, 48% of the sample met criteria for an anxiety disorder, 22% met criteria for social anxiety disorder (SAD), and 40% met criteria for major depressive disorder (MDD). SAD was uniquely associated with more severe suicidal ideation. Limitations: Findings may not generalize to all suicidal adolescents, and non-measured variables may account for the observed relationships. Conclusion: Future research should examine whether targeting social anxiety would improve treatment response for suicidal adolescents.

Evaluating and Managing Suicide Risk with the Adult Patient

2015 ◽  
Author(s):  
Bruce Bongar ◽  
Glenn Sullivan ◽  
Victoria Kendrick ◽  
Joseph Tomlins
Keyword(s):  
Health Care ◽  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Health Care Professionals ◽  
Suicide Risk ◽  
Suicidal Patient ◽  
Suicide Assessment ◽  
Potential Harm ◽  
The World ◽  
Suicidal Patients

Suicide and suicidal behavior are major medical and social problems in many parts of the world, despite a growing understanding of how to adequately prevent suicide. Many health-care professionals do not have a sufficient knowledge base and the training to provide adequate suicide assessment, nor do they have an understanding of the protocols necessary for management of suicidal patients. Without validated predictive tools to use in cases of suspected suicidal ideation, it is usually left to the clinician to make a decision regarding risk and potential harm. In this chapter we describe how to identify a suicidal patient and the procedures necessary to adequately provide services.

Improving Suicide Risk Assessment in a Managed-Care Environment

Crisis ◽  
2003 ◽  
Vol 24 (2) ◽  
pp. 49-55 ◽  
Author(s):  
G.S. Brown ◽  
Edward R. Jones ◽  
Ellen Betts ◽  
Jingyang Wu
Keyword(s):  
Suicidal Ideation ◽  
High Frequency ◽  
Suicide Risk ◽  
Self Report ◽  
Quality Improvement Intervention ◽  
Care Environment ◽  
Clinical Interviews ◽  
Behavioral Healthcare ◽  
Managed Behavioral Healthcare

Summary: This article describes the quality improvement intervention of a managed behavioral healthcare company to improve the quality of suicide risk assessments by its panel of providers. At-risk cases are identified by the patient's self-reported high frequency of suicidal ideation on a standardized outcome measure. Clinicians also assess severity of suicidal ideation based on clinical interviews. The clinician's assessment is identified as probably erroneous if the patient report indicates a high frequency of suicidal ideation and the clinicians assessment of suicidal ideation is none. The article describes the methods used to encourage clinicians to utilize information from the patient self-report measure as part of the clinical assessment. Probable suicidal ideation assessment errors were subsequently reduced by 29% over a 1-year period of administration.

Self-Disgust and Its Relationship With Lifetime Suicidal Ideation and Behavior

Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 344-350 ◽  
Author(s):  
Anne Schienle ◽  
Daniela Schwab ◽  
Carina Höfler ◽  
Harald H. Freudenthaler
Keyword(s):  
Suicidal Ideation ◽  
Suicide Risk ◽  
Coping Styles ◽  
Cross Sectional Study ◽  
Self Report ◽  
Hierarchical Regression ◽  
Cross Sectional ◽  
Mediation Analyses ◽  
Disgust Proneness ◽  
And Behavior

Abstract. Background: The emotion disgust is typically directed toward stimuli in the external environment, but sometimes people develop self-directed disgust responses. Aims: The current questionnaire study focused on the role of self-disgust in lifetime suicidal ideation and behavior. Method: A total of 1,167 individuals participated in an Internet-based survey containing self-report measures of self-disgust, externally directed disgust proneness, coping styles, diagnoses of mental disorders, and suicide risk. Hierarchical regression analyses as well as mediation analyses were computed. Results: Self-disgust was the most relevant predictor of suicide risk among the assessed variables. Self-disgust was negatively associated with the use of support by others, and positively associated with evasive coping (self-blame, venting, denial), which in turn was positively associated with suicidality. Limitations: This cross-sectional study provided information on the relationship between self-disgust and suicidality in a self-selected sample. Longitudinal studies are warranted. Conclusion: Future studies are required to replicate these findings. Additionally, stronger research designs are needed in order to investigate whether self-disgust should be targeted in suicide prevention programs and interventions.

Mental Health Professionals' Suicide Risk Assessment and Management Practices

Crisis ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Jared F. Roush ◽  
Sarah L. Brown ◽  
Danielle R. Jahn ◽  
Sean M. Mitchell ◽  
Nathanael J. Taylor ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Suicide Risk ◽  
Management Practices ◽  
Self Report ◽  
Evidence Based ◽  
Suicide Risk Assessment ◽  
Risk Assessment And Management

Abstract. Background: Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. Aims: The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Method: Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Results: Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. Limitations: The study utilized a cross-sectional design and self-report questionnaires. Conclusion: Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

Suicidal Ideation, Planning, and Attempts Among Synthetic Cannabinoid Users Across Different Demographic Subgroups

Crisis ◽  
2021 ◽  
Author(s):  
John Stogner ◽  
Courtney Patterson
Keyword(s):  
Suicidal Ideation ◽  
Suicide Risk ◽  
Synthetic Cannabinoid ◽  
Self Report ◽  
Suicidal Thoughts ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Psychoactive Effects ◽  
And Bisexual ◽  
Demographic Subgroups

Abstract. Background: Case studies have linked synthetic cannabinoid (SC) use to suicide risk both during and following acute psychoactive effects. No study has explored whether a meaningful relationship exists between SC use and suicidal ideation, planning, and attempts within a generalizable sample. Aims: This work attempted to determine whether SC use is significantly associated with suicidal thoughts, planning, or attempts and whether the association between SC use and suicide may be stronger in certain demographic groups. Method: Cross-sectional self-report data from the Youth Risk Behavior Surveillance System were utilized. Logistic regression models were explored within a sample of 29,384 adolescents. Results: A clear connection emerged between SC use and suicidal thoughts and attempts. SC use and suicide risk were strongly related within the lesbian, gay, and bisexual and African Americans populations, even after controlling for depressive symptoms. Limitations: The study was cross-sectional and respondents may have underreported substance use or suicidal thoughts. Conclusion: Whether SC use has an impact on suicidal ideation directly, indirectly, or if it is simply a co-occurring phenomenon, it may serve as a flag of enhanced risk. Physicians must remain cognizant of the SC–suicide risk connection, particularly among African American and/or lesbian, gay, or bisexual patients.

Suicidal ideation and suicide attempts: associations with sleep duration, insomnia, and inflammation

2020 ◽  
pp. 1-10 ◽  
Author(s):  
Michael R. Dolsen ◽  
Aric A. Prather ◽  
Femke Lamers ◽  
Brenda W. J. H. Penninx
Keyword(s):  
Suicidal Ideation ◽  
Sleep Disturbance ◽  
Sleep Duration ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Self Report ◽  
Short Sleep Duration ◽  
Long Sleep ◽  
Normal Sleep ◽  
Insomnia Symptoms

Abstract Background Sleep disturbance has been consistently identified as an independent contributor to suicide risk. Inflammation has emerged as a potential mechanism linked to both sleep disturbance and suicide risk. This study tested associations between sleep duration, insomnia, and inflammation on suicidal ideation (SI) and history of a suicide attempt (SA). Methods Participants included 2329 adults with current or remitted depression and/or anxiety enrolled in the Netherlands Study of Depression and Anxiety. Sleep duration, insomnia, past week SI, and SA were assessed with self-report measures. Plasma levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α were obtained. Results Short sleep duration (⩽6 h) compared to normal sleep duration (7–9 h) was associated with reporting a prior SA, adjusting for covariates [adjusted odds ratio (AOR) 1.68, 95% CI 1.13–2.51]. A higher likelihood of SI during the past week was observed for participants with long sleep duration (⩾10 h) compared to normal sleep duration (AOR 2.22, 95% CI 1.02–4.82), more insomnia symptoms (AOR 1.44, 95% CI 1.14–1.83), and higher IL-6 (AOR 1.31, 95% CI 1.02–1.68). Mediation analyses indicated that the association between long sleep duration and SI was partially explained by IL-6 (AOR 1.02, 95% CI 1.00–1.05). Conclusions These findings from a large sample of adults with depression and/or anxiety provide evidence that both short and long sleep duration, insomnia symptoms, and IL-6 are associated with the indicators of suicide risk. Furthermore, the association between long sleep duration and SI may operate through IL-6.

scholarly journals Domains of the autism phenotype, cognitive control, and rumination as transdiagnostic predictors of DSM-5 suicide risk

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245562
Author(s):  
Darren Hedley ◽  
Mirko Uljarević ◽  
Ru Ying Cai ◽  
Simon M. Bury ◽  
Mark A. Stokes ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Cognitive Control ◽  
Social Communication ◽  
Suicide Risk ◽  
Longitudinal Research ◽  
Autism Spectrum ◽  
Self Report ◽  
Insistence On Sameness ◽  
Cross Sectional ◽  
Communication Difficulties

Suicide is a global health problem affecting both normative and clinical populations. Theoretical models that examine mechanisms underlying suicide risk across heterogeneous samples are needed. The present study explored core characteristics associated with autism spectrum disorder (ASD), a sub-population at high risk of suicide, as well as two dimensional cognitive constructs, as potential transdiagnostic predictors of suicidal ideation in a clinically diverse sample. Participants (n = 1851, 62% female) aged 18 to 89 years completed online questionnaires assessing: social communication difficulties; insistence on sameness; cognitive control; and rumination. Forty-three percent of participants reported the presence of at least one neurodevelopmental or neuropsychiatric disorder. One third of the sample reported some suicidal ideation (SI), and 40 percent met the threshold for concern for depression. All hypothesized constructs were associated with SI and depression and, with the exception of rumination, contributed significantly to SI. Participants reporting SI returned significantly higher social communication difficulties and insistence on sameness, and lower levels of cognitive control than those reporting no-SI. The study was limited by the use of a cross-sectional sample assessed with self-report measures. All diagnoses were self-reported and the study was additionally limited by the use of a single item indicator of suicidal ideation. These findings support a role for constructs associated with the ASD phenotype and associated broad cognitive domains as potential risk factors underlying suicidal ideation in a large clinically diverse sample. Our findings suggest directions for future longitudinal research studies, along with specific targets for suicide prevention and clinical practice.

Family Dysfunction and Suicide Risk in a Community Corrections Sample

Crisis ◽  
2016 ◽  
Vol 37 (6) ◽  
pp. 454-460 ◽  
Author(s):  
C. Brendan Clark ◽  
Ye Li ◽  
Karen L. Cropsey
Keyword(s):  
Anxiety Disorder ◽  
Suicidal Ideation ◽  
Physical Health ◽  
Suicide Risk ◽  
Family Dysfunction ◽  
Community Corrections ◽  
Self Report ◽  
Health Complaints ◽  
Prison Populations ◽  
Sample Method

Abstract. Background: When comparted with the general population, the suicide rate in correctional populations is elevated. While predictors of suicide are well researched in jail and prison populations, much less work has been done to examine predictors of suicide in community corrections samples where 80% of the US correctional population is currently supervised. Aims: The goal of this study was to determine factors associated with suicide risk in a community corrections sample. Method: Self-reported current ideation was examined in a sample of 512 individuals under supervision. Results: When univariate associations between current suicidal ideation and predictor variables were examined, current suicidal ideation was associated with being female, being White, reporting an increased level of stress, reporting an increased level of depression, meeting criteria for an anxiety disorder, an increased number of physical health complaints, and self-report of family dysfunction. In a multivariate analysis predicting suicide risk, only meeting criteria for an anxiety disorder, an increased number of physical health complaints, and self-report of family dysfunction were significant. Conclusion: Mental and physical health complaints as well as self-report of family dysfunction are salient predictors of suicide risk in the community corrections population.

Sign in / Sign up

Export Citation Format

Share Document