Posted May 29, 2015
Peter M. Gutierrez, Ph.D., Rocky Mountain Mental Illness Research, Education and Clinical Center, Denver, Colorado, and Thomas Joiner, Ph.D., Florida State University, Tallahassee, Florida

Drs. Peter M. Gutierrez and Thomas Joiner Suicide is one of the leading causes of death among U.S. military Service Members and Veterans. The Department of Defense (DoD) has funded a number of studies proposing to investigate methods to better identify who is at risk for, and to decrease the likelihood of, suicidal behavior. The Denver Research Institute and Florida State University received funding from the Military Operational Medicine Research Program through the fiscal year 2008 U.S. Army Medical Research and Materiel Command (USAMRMC) Broad Agency Announcement (BAA) to create a consortium with the goal of integrating and synchronizing DoD and civilian efforts to implement a multidisciplinary approach to suicide prevention. These awards, which comprise the Military Suicide Research Consortium (MSRC), are led by Drs. Peter Gutierrez and Thomas Joiner.

The MSRC-funded 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. Twenty-one studies have been funded by the MSRC in addition to several Postdoctoral Pilot Projects and Dissertation Completion Awards. These studies are being conducted at numerous VA and military installations across the country and cover a broad spectrum of the research continuum, ranging from etiological, to prevention/screening, and treatment. Populations being studied include Service Members, Veterans, and family members of Service Members and Veterans.

The MSRC has developed a database to capture Common Data Elements (CDEs) collected in each of the funded studies. This database allows for secondary analysis of aggregate data across all funded studies. Additionally, the MSRC is specifically identified in "The National Research Action Plan for Improving Access to Mental Health Services for Veterans, Service Members, and Military Families," a plan developed by multiple Federal agencies in response to an Executive Order issued by the President, as playing a role in achieving the vision for suicide prevention research.

Three of the funded studies are now complete and have yielded important results. Of note, a Virtual Hope Box mobile application was released for free download in Android and iOS marketplaces in 2014 as a result of Dr. Nigel Bush's pilot work. A randomized clinical trial is now underway to refine and evaluate the effectiveness of the mobile application. Additionally, results from Dr. Julie Cerel's work related to suicide bereavement showed that almost half of Veterans reported lifetime exposure to suicide. Conclusions drawn from Dr. Cerel's work include that: (1) suicide exposure confers psychiatric risk in Veterans, (2) perceptions of closeness to decedents may increase risk in suicide-exposed individuals, and (3) multiple exposures to suicide and traumatic death may lead to significant suicide risk. Work conducted by Drs. Holm-Denoma and Witte, using MSRC CDEs, showed strong evidence that serious suicide risk is a discrete category. As work on the ongoing studies continues, other important findings are expected to emerge.


Anestis, MD, Joiner, T, Hanson, JE, & Gutierrez, PM (in press). Response to commentary on the modal suicide decedent did not consume alcohol just prior to the time of death: An analysis with implications for understanding suicidal behavior. Journal of Abnormal Psychology.

Anestis MD, Joiner Jr TE, Gutierrez PM, and Hanson JE. 2014. The modal suicide decedent was not intoxicated at the time of death: A meta-analysis with implications for understanding suicidal behavior and human nature. Journal of Abnormal Psychology 123(4):835-840. DOI: 10.1037/a0037480

Anestis MD, Soberay KA, Gutierrez PM, Hernández TD, and Joiner TE Jr. 2014. Reconsidering the link between impulsivity and suicidal behavior. Personality and Social Psychology Review 18:366-386. DOI: 10.1177/1088868314535988

Anestis, MD, Khazem, LR, Mohn, RS, & Green, BA (in press). Testing the main hypotheses of the interpersonal-psychological theory of suicidal behavior in a large diverse sample of United States military personnel. Comprehensive Psychiatry

Anestis, MD, & Green, BA (in press). The impact of varying levels of confidentiality on disclosure of suicidal thoughts in a sample of United States National Guard personnel. Journal of Clinical Psychology.

Bernert RA, Kim JS, Iwata NG, Perlis ML. March 2015. Sleep Disturbances as an Evidence-Based Suicide Risk Factor. Current Psychiatry Reports, 17(15): 554-62

Bernert RA, Nadorff (In Press). Sleep and Suicide Risk. Sleep Medicine Clinics.

Bodell, LP, Forney, KJ, Keel, PK, Gutierrez, PM & Joiner, TE. 2014. Consequences of Making Weight: A Review of Eating Disorder Symptoms and Diagnoses in the United States Military. Clinical Psychology: Science and Practice, 21, 398-409.

Brenner LA. December 11, 2012. White Paper Response at Request of COL Castro (MOMRP/DOD), on Window to Hope: Evaluating a Psychological Treatment for Hopelessness among Veterans with TBI. 2011 Dec 15.

Brenner LA. December 2012. Exploring the link between suicide and TBI, Interview with Voelker R of the APA Monitor Vol 43, No. 11.

Brenner LA, Simpson GK, Forster JE, Signoracci, GM, Matarazzo BB, Clemans TA, Hoffberg AS. May 2014. Window to hope: Preliminary results from a randomized controlled trial (RCT) of a psychological treatment for hopelessness among US veterans with traumatic brain injury (TBI). Brain Inj; 28(5-6), 737-737.

Bryan, CJ, Clemans, TA, Leeson, BA, & Rudd, MD (in press). Acute versus chronic stressors, multiple suicide attempters, and persistent suicide ideation in U.S. Soldiers. Journal of Nervous and Mental Disease.

Bush NE, Dobscha SK, Denneson LM, Hoffman JE, Crain A, Crumpton R, Cromer R, and Kinn JT. 2014. A virtual Hope Box smartphone app as an accessory to therapy: Proof of concept in a clinical sample of veterans. Suicide & Life-Threatening Behavior. DOI: 10.1111/sltb.12103

Cerel J, Maple M, van de Venne J, Moore M, Flaherty C, Brown M. and Brown S. 2013. Exposure to suicide in the community: A random digit dial study. Crisis. DOI: 10.1027/0227-5910/a000220

Cerel J, van de Venne J, Moore M, Maple M, Flaherty C, Brown MM. March 2015. Veteran exposure to suicide: Prevalence and correlates. Journal of Affective Disorders 179:82-87. DOI: 10.1016/j.jad.2015.03.017

Gutierrez PM. 2014. Viewing suicide risk through a new lens: The benefits of examining symptom trajectories. [Accompanies the article Post-deployment suicidal ideations and trajectories of post-traumatic stress disorder in Danish soldiers - A 3-year follow-up of the USPER study.] The Journal of Clinical Psychiatry 75(9):e945-946.

Holm-Denoma, J, & Witte, T. March 4, 2015. A Taxometric Study of Suicide Risk.

Johnson LL, O'Connor SS, Kaminer B, Jobes DA, and Gutierrez PM. 2014. Suicide-focused group therapy for veterans. Military Behavioral Health. DOI: 10.1080/21635781.2014.963762

Khazem, LR, Law, KC, Green, BA, & Anestis, MD (in press). Examining the relationship between coping strategies and suicidal desire in a sample of United States military personnel. Comprehensive Psychiatry.

Legarreta M, Bueler E, DiMuzio J, McGlade E, Yurgelun-Todd D (01/31/2015). Neuropsychological Performance in Veterans with Chronic Pain [Abstract]. Journal of the International Neuropsychological Society.

Matarazzo BB, Barnes SM, Pease JL, Russell LM, Hanson JE, Soberay KA, and Gutierrez PM. 2014. Suicide risk among lesbian, gay, bisexual, and transgender military personnel and veterans: What does the literature tell us? Suicide & Life-Threatening Behavior 44:200-217. DOI: 10.1111/sltb.12073

Matarazzo B, Clemans T, Signoracci G, Hoffberg A, Simpson GK, Brenner LA. 2014. Cross-cultural adaptation of window to hope: A psychological Intervention to Reduce Hopelessness in Individuals with a history of traumatic brain injury. Brain Injury 10:1238-1247. DOI: 10.3109/02699052.2014.916419

McGlade E, Rogowska J, Yurgelun-Todd D (In Press). Sex Differences in Orbitofrontal Connectivity in Male and Female Veterans with TBI. Brain Imaging Behav.

Mitchell, MA, Capron, DW, Raines, AM, & Schmidt, NB. 2014. Reduction in cognitive concerns of anxiety sensitivity is associated with reduction in PTSD and depressive symptoms: A comparison of civilians and veterans. Journal of Psychiatric Research, 48, 25-31.

Ribeiro JD, Pease JL, Gutierrez PM, Silva C, Bernert RA, Rudd MD, and Joiner TE Jr. 2012. Sleep problems outperform depression and hopelessness as cross-sectional and longitudinal predictors of suicidal ideation and behavior in young adults in the military. Journal of Affective Disorders 136:743-750. DOI: 10.1016/j.jad.2011.09.049

Schmidt NB, Capron DW, Raines AM, and Allan NP. 2014. Randomized clinical trial evaluating the efficacy of a brief intervention targeting anxiety sensitivity cognitive concerns. Journal of Consulting and Clinical Psychology 82(6):1023-1033. DOI: 10.1037/a0036651

Top of Page