Women veterans (WV) are the fastest growing veteran subpopulation and recognized to be at increased risk for suicide compared with civilians. Improving engagement (e.g., response rates) of WV in survey research is critical to ensuring valid and generalizable findings, which can inform suicide prevention programs tailored for this population. Many factors are known to influence response rates, yet little is known about ways to optimize survey response rates among WV. Three recruitment cohorts (Waves 1 [W1], 2a [W2a], and 2b [W2b]) of WV were invited to participate in an online survey for a national, mixed‐methods study examining suicide risk among WV using reproductive health care services paid for or provided by the Veterans Health Administration. To examine the effects of enhanced recruitment efforts, standard recruitment materials were mailed to all three cohorts, with the additions of: a study flyer aiming to build trust between participants and researchers (W2a, W2b) and a paper survey (W2b). Characteristics of responders and non‐responders were compared by wave and across survey modalities. Response rates were significantly higher for groups receiving enhanced (W2a = 17.1%; W2b = 24.6%) versus standard (W1 = 12.2%) recruitment materials. WV residing in rural areas were significantly more likely to respond by paper (37.1%) than online (19.8%). Non‐respondents were disproportionately racial and ethnic minorities. Disclosure of sensitive information (e.g., military sexual trauma) did not differ by survey modality. Findings suggest that enhanced recruitment materials improve survey response rates among WV, an important consideration for future research with this population.

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Objective Examine the association between insomnia symptom severity and suicidal ideation (SI), after adjusting for clinical comorbidity in veterans meeting diagnostic criteria for insomnia disorder. Methods Secondary data analyses of psychometrically validated baseline assessments of depression, posttraumatic stress disorder (PTSD), and anxiety symptoms from two online insomnia intervention randomized clinical trials (n = 232; n = 80) were conducted. Multiple linear regression was used to determine the association between insomnia symptom severity and SI, after controlling for clinical comorbidity and demographics. Results Insomnia symptom severity was significantly correlated with comorbid depression, PTSD, and anxiety symptoms in both cohorts and significantly correlated with SI in one. After controlling for demographics and clinical comorbidity, insomnia symptom severity was not significantly associated with SI in linear regression models. Conclusion Findings extend insomnia‐suicide research by providing evidence that insomnia symptom severity may not confer a unique risk for SI above comorbid mental health symptoms in veterans meeting diagnostic criteria for insomnia disorder.

BACKGROUND Despite a growing evidence base that internet-delivered cognitive behavioral therapy for insomnia (iCBT-I) is associated with decreased insomnia severity, its efficacy has been minimally examined in non-veterans. OBJECTIVE The objective of our study was to evaluate the efficacy of an unguided iCBT-I (Sleep Healthy Using the Internet [SHUTi]) among veterans. METHODS In this single-blind, randomized clinical trial, Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans eligible for Veterans Health Administration care were randomly assigned (1:1) to receive SHUTi, a self-guided, interactive program, or an Insomnia Education Website (IEW) that provided nontailored and fixed insomnia information. Online assessments were administered at baseline, post-intervention, and 6-months and 1-year post-intervention. The primary outcome was self-reported insomnia severity (Insomnia Severity Index [ISI]). Secondary outcomes were self-reported mental and physical health functioning (Short Form Health Survey for Veterans [VR-36]). Exploratory outcomes comprised sleep diary parameters. RESULTS Of the 231 randomized participants (mean [SD] age, 39.3 [7.8] years; 170 male sex [73.5%]); 172 White [74.5%], 26 Black [11.3%], 10 Multiracial [4.3%], 17 Other [7.4%]; 36 Hispanic [15.6%]) randomized between April 2018 and January 2019, 116 (50.2%) were randomly assigned to SHUTi, and 115 (49.8%) to the IEW. In intent-to-treat analyses, SHUTi participants experienced significantly larger ISI decreases compared to IEW participants at all timepoints (n2G = 0.13, 0.12, 0.10, respectively). These corresponded to estimated larger differences in change of -3.47 (95% confidence interval [CI]: -4.78, -2.16), -3.80 (95% CI: -5.34, -2.27), and -3.42 (95% CI: -4.97, 1.88) points on the ISI for the SHUTi group. SHUTi participants experienced significant improvements in physical (6-month η2G = 0.04) and mental health functioning (6-month and 1 year generalized η2Gs = 0.04). Significant sleep parameter improvements were noted for SHUTi, though the pattern and magnitude of these reductions varied by parameter. No adverse events were reported. CONCLUSIONS Self-administered iCBT-I was associated with immediate and long-term improvements in insomnia severity. Findings suggest that leveraging technology to meet insomnia treatment demands among veterans may be a promising approach. CLINICALTRIAL ClinicalTrials.gov NCT03366870; https://clinicaltrials.gov/ct2/show/NCT03366870

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To determine where another person is looking, the visual system engages a process of emergent integration, pooling information across space from both the head and eyes. Gaze is dynamic, however, and in order to achieve a temporally stabilized metric of a person's direction of attention, this integrative process might also occur across time. Here, we tested and confirmed this prediction. Even when seen separately and in succession, the rotation of a head attracted the perceived gaze of a pair of eyes. This integration depended on temporal continuity-attraction decayed with longer delays between the face parts and prolonged viewing of the head reduced integration. Nevertheless, gaze integration persisted across delays of 2 s and even occurred against a backdrop of changing emotional expression. Gaze is a complex feature that orchestrates social interactions over time. Our results demonstrate that the representation and perception of emergent gaze is dynamic as well. (PsycINFO Database Record