There are few evidence-based approaches for the treatment of suicidality particularly within the Department of Defense settings (DoD) (Schoenbaum, Heinssen, & Pearson, 2009). This article describes a relatively new suicide-specific approach called the "Collaborative Assessment and Management of Suicidality" (CAMS). There is growing evidence that CAMS can meaningfully impact suicidal ideation, overall symptom distress, increase hope, and may positively impact non-mental health utilization. The prospect of using CAMS within military treatment facilities is discussed as a means of clinically assessing and treating suicidal ideation and related behaviors for military personnel.The various psychological stressors associated with recent U.S. military operations, including Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and Operation New Dawn (OND), have come to the forefront of attention for military leaders, policymakers, and the broader U.S. population. Related to these concerns has been the alarming rise in military suicide rates over the past decade. Between 2001 and 2008, the Department of Defense (DoD) has experienced roughly a 50% increase in suicide deaths of active duty service members,
The studies presented compare two methodologies for categorizing suicidal patients based on clinical data. Discussion follows regarding implications for risk assessment and treatment. In these studies, 52 outpatient subjects were placed into different groups based on coding their "suicidal motivation" (Study 1) and their "internal struggle" ratings (Study 2) using data collected at intake. Self-report ratings of 6 Suicide Status Form (SSF) Core Constructs (Psychological Pain, Stress, Agitation, Hopelessness, Self-Hate, and Overall Risk of Suicide) recorded both at intake and at completion of treatment were then compared to determine differences in Core Construct ratings among groups at different time points. In Study 1, overall differences among motivation groups (Life-motivated, Ambivalent, and Death-motivated) were significant for ratings at treatment completion of Overall Risk of Suicide, Self-Hate, and Psychological Pain. In Study 2, overall differences among groups (Wish to live, Ambivalent, and Wish to die) were significant for ratings at intake of Overall Risk of Suicide. At completion of treatment, overall differences among groups were significant for ratings of Overall Risk of Suicide, Hopelessness, and Self-Hate. In addition, significant interactions were found between test time and group for Overall Risk of Suicide and Self-Hate. Results suggest that categorizing suicidal patients by motivation and by the nature of their internal struggle could be beneficial to differential risk assessment with implications for clinical treatment.
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