DEPARTMENT OF DEFENSE - CONGRESSIONALLY DIRECTED MEDICAL RESEARCH PROGRAMS

Military Suicide Research Consortium: Recent Accomplishments from Cutting-Edge Studies

Posted December 23, 2016

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

Peter M. Gutierrez, Ph.D., Rocky Mountain Mental Illness Research, Education and Clinical Center, Denver, Colorado

Peter M. Gutierrez, Ph.D., Rocky Mountain Mental Illness Research, Education and Clinical Center, Denver, Colorado
John LiPuma, M.D.

Thomas Joiner, Ph.D., Florida State University, Tallahassee, Florida

The Military Suicide Research Consortium (MSRC), co-directed by Drs. Gutierrez and Joiner, was established in 2010 in an effort to coordinate and focus suicide research efforts across the Department of Defense (DoD) due to the increased rates of suicide in the military. The MSRC is focused on the discovery of scientific knowledge about suicidal behavior in the military, addressing relevant problems that may be solved with policy and/or practice, disseminating consortium knowledge, and training future leaders in military suicide research. The Denver Research Institute and Florida State University received additional funding this year in order to continue the consortium for 5 more years (see https://CDMRP.HEALTH.MIL/search.aspx for abstract). With this additional funding, they aim to continue to produce highly valuable and mission-relevant deliverables in order to address the problem of suicide in the military.

To date, 25 research projects and 4 postdoctoral pilot projects have been funded by the MSRC in addition to multiple dissertation completion awards; additional studies will be funded over the next few years. The postdoctoral pilot projects and 16 of the research projects are now complete. Seven of the recently completed research projects are summarized below.



Title Purpose Impact/Results
Identifying Factors Associated with Future Self-Directed Violence Within a Sample of Mississippi National Guard Personnel

Principal Investigator (PI): Dr. Michael Anestis, University of Southern Mississippi
To examine cross-sectional and prospective predictors of suicide risk within a sample drawn almost entirely from the Army National Guard. Findings provide evidence that military suicide prevention cannot rely upon Soldiers endorsing risk and accepting help, as there are obstacles to Soldiers being identified as high risk through traditional channels. Data indicated that factors unrelated to the development of suicidal ideation may facilitate the transition from suicidal ideation to suicidal behavior. These could be important targets for broad prevention efforts aimed at addressing risk in individuals experiencing suicidal ideation who are unwilling to come forward for treatment. One target includes firearm storage practices. The capacity for suicide may offer simpler intervention strategies that can be implemented on a broad scale, in some cases enabling the leveraging of technologies to expand reach and acceptability.
Brief Interventions for Short-Term Suicide Risk Reduction in Military Populations: Reasons for Living (RFL) Intervention

PI: Dr. Craig Bryan, University of Utah
To conduct a randomized controlled trial to compare the effectiveness of crisis response planning to treatment as usual on the risk for follow-up suicide attempt and suicide ideation among active duty Soldiers presenting to military medical clinics for a behavioral health emergency. Soldiers who received a crisis response plan were significantly less likely to make a suicide attempt during follow-up than Soldiers who received the contract for safety, and they had significantly faster reductions in suicide ideation. There were no observable differences between the enhanced and standard crisis response plans, although the data were not powered for statistical analysis.
Controlled Evaluation of a Computerized Anger Reduction Treatment for Suicide Prevention

PI: Dr. Jesse Cougle, Florida State University
To develop and evaluate an Internet-based interpretation bias modification (IBM) intervention that has shown promise for the treatment of anger and the reduction of suicide risk. Preliminary evidence suggests that the IBM program may be an effective treatment for individuals with problematic anger because it is non-confrontational, requires no homework, and takes only 2 hours. Greater reductions in thwarted belongingness were seen post-treatment in the IBM condition, compared to other conditions among participants with low pain. Future studies seek to determine the specific populations of individuals who will benefit most from the IBM program. The program may only work for individuals whose anger is not caused by chronic pain or a medical condition. Individuals may also require some degree of interactions with others to benefit from this intervention.
Evaluative Conditioning in Marriage

PI: Dr. James McNulty, Florida State University
To target automatic partner attitudes using a novel evaluative conditioning (EC) paradigm, due to the fact that relationship problems often play a role in military suicides. EC is attitude change resulting from repeated pairings of an attitude object and valenced stimuli. Using the EC paradigm, spouses who viewed their partners paired with positive stimuli demonstrated increased positive automatic partner attitudes relative to control spouses, and these attitudes predicted increases in their self-reported marital satisfaction and decreased suicidal ideation over the 8 weeks of the study. Future work will examine whether the use of images or words as unconditioned stimuli is more effective for EC, determine the optimal number of EC sessions, and evaluate the feasibility and efficacy of EC as an intervention to promote marital satisfaction and reduce suicidal ideation among military personnel physically separated from their spouses.
New Approaches to the Measurement and Modification of Suicide-Related Cognition

PI: Dr. Matthew Nock, Harvard University
To develop and test several new, objective methods of measuring and modifying suicide-related cognition among Veterans. Results suggest that suicidal Veterans may have difficulty learning optimal behaviors to alleviate ongoing stress or proactively prevent it. A deficit in future-oriented cognition may render Veterans vulnerable to feelings of hopelessness and increased suicidal thoughts and behavior. Unexpectedly, suicidal Veterans showed decreased attention to psychological pain when in a negative mood. Additionally, the study demonstrated that implicit affect about death and the self, both independently and collectively, are predictive of suicide ideation, plans, and attempts. These results culminated in the development of novel, objective/behavioral tests that measure cognitive processes that appear to increase the risk of suicidal behavior.
Reducing Suicide Risk Associated with Weight Loss

PI: Dr. Pamela Keel, Florida State University
To identify and target factors linking weight suppression and non-suicidal, self-injurious behavior for the development of an intervention program to alter these factors. Identified body dissatisfaction and negative affect as malleable factors that maintain the link between weight suppression and non-suicidal self-injurious behavior. The eBody Project, an online program designed to help young women feel better about their bodies, was modified to serve as an intervention to reduce body dissatisfaction and negative affect in adult women and men in order to eliminate this link. The modified program, which was renamed the Body Acceptance Program, is available online to provide ease of access and dissemination, and it has demonstrated efficacy in reducing body dissatisfaction and negative affect.
Perceptual Retraining to Reduce Suicide Risk

PI: Dr. Wen Li, Florida State University
To develop a novel associative learning paradigm to �retrain� an individual�s hypersensitivity to combat-relevant (i.e., distressing) odors. Ratings of perceived disgust for combat-relevant odors were strongly related to symptoms of post-traumatic stress disorder, physical anxiety, depression, and constructs integral to the interpersonal theory of suicide. Preliminary data suggest that a perceptual retraining paradigm is capable of reducing perceived disgust for combat-relevant odors. This reduction in disgust is associated with a decrease in the perception of threatening odors among other, neutral masking agents. Like other types of interventions that rely on fear extinction, perceptual retraining for combat-relevant odors can reduce disgust to such odors, and thus the perception of threat in ambiguous odors. This perceptual retraining may be a useful mechanism for reducing fear/anxious arousal, and thus the desire to escape these experiences, thereby lessening the risk for suicide.

For additional information about the MSRC and the funded research studies, please visit: https://msrc.fsu.edu/

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