Depression, hopelessness, and low self-esteem are implicated as vulnerability factors for suicide ideation. The association of self-esteem with suicide ideation after controlling for depressed mood and hopelessness was examined. Adult psychiatric outpatients (N = 338) completed measures of self-esteem, suicide ideation, hopelessness, and depression. Self-esteem was operationalized as beliefs about oneself (self-based self-esteem) and beliefs about how other people regard oneself (other-based self-esteem). Each dimension of self-esteem was negatively associated with suicide ideation after controlling for depression and hopelessness. Of the two dimensions of self-esteem, other-based self-esteem was the more robust predictor of suicide ideation. These findings suggest that even in the context of depression and hopelessness, low self-esteem may add to the risk for suicide ideation.

Joiner's (2005) theory attributes suicide to an individual's acquired capability to enact self-harm, perceived burdensomeness, and thwarted belongingness. This study evaluated whether Joiner's theory could differentiate United States (US) Air Force (AF) personnel (n = 60) who died by suicide from a living active duty AF personnel comparison sample (n = 122). Responses from AF personnel on several scales assessing Joiner's constructs were compared to data from a random sample of postmortem investigatory files of AF personnel who died by suicide between 1996-2006. This research also introduced a newly designed measure, the Interpersonal-Psychological Survey (IPS), designed to assess the three components of Joiner's theory in one, easy-to-administer instrument. Analyses of the psychometric properties of the IPS support initial validation efforts to establish this scale as a predictive measure for suicide. Findings support that one's score on the Acquired Capability to Commit Suicide subscale of the IPS and the IPS overall score reliably distinguished between the two groups. The implications of these findings in relation to suicide prevention efforts in the US military are discussed.

Reducing deaths from veteran suicide is a public health priority for veterans who receive their care from the Department of Veterans Affairs (VA) and those who receive services in community settings. Emergency departments frequently function as the primary or sole point of contact with the health care system for suicidal individuals; therefore, they represent an important venue in which to identify and treat veterans who are at risk for suicide. We describe the design, implementation and initial evaluation of a brief behavioral intervention for suicidal veterans seeking care at VA emergency departments. Initial findings of the feasibility and acceptability of the intervention suggest it may be transferable to diverse VA and non-VA settings, including community emergency departments and urgent care centers.

Cross-cultural examinations of the validity and reliability of the Beck Depression Inventory-II (Beck, Steer, Ball, & Ranieri, 1996) is essential for its use in assessment and monitoring of the effectiveness of suicide interventions across racial groups. We tested the fit of a second-order, two-factor model and the internal reliability of the BDI-II in a sample of 133 African Americans with a recent history of suicide attempts. Additionally, we examined the convergent validity with the Hamilton Rating Scale for Depression (Reynolds & Koback, 1995). The results indicate that the BDI-II is a reliable and valid measure of depressive symptoms for African American suicide attempters.The Beck Depression Inventory-II (BDI-II; Beck, Steer, Ball, & Ranieri, 1996) is one of the most commonly used instruments in research and practice to measure the presence and severity of depression and has been widely used in suicide prevention research (Brown, 2001). Suicide has increased among ethnic minorities, and 60% of suicides suffer from depression (Goldsmith, Pellmar, Kleinman, & Bunney, 2002). Therefore, accurate assessment of depression among ethnic minorities, especially in individuals with a history of suicide behavior, will be an important task. Comparative studies have raised questions about the validity of measures used to assess depression (Bryne, Stewart, & Lee, 2004). Concurrently, in the past decade, research has spawned interest in ethnic, racial, and cultural differences in depression, as several studies have pointed to the possibility that the characteristics of depression as measured by the BDI-II may differ across cultural groups (Dutton et al., 2004;Paniagua, 2000).Most participants in previous BDI-II studies have been White and middle-class (Grothe et al., 2005). Only one study examined the BDI-II factor structure in an African American sample. Among low-income, African American medical outpatients (N = 220), Grothe et al. (2005) confirmed fit of a second-order, two-factor structure. However, the generalizability of these results is limited to medical patients. Prior research has suggested that the experiences of depression among medically ill patients are qualitatively different from psychiatric patients (Morley, Williams, & Black, 2002). For instance, medically ill patients are more likely to endorse somatic items and less likely to endorse affective items, and their depression is not characterized by a depreciating view of self, key symptoms among psychiatric patients (Morley et al., 2002). Therefore, in this study, we sought to replicate and extend the work begun by NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptGrothe et al. by examining the psychometric properties of the BDI-II in a psychiatric sample of African American participants who recently attempted suicide. In addition, we assessed the internal reliability and convergent validity of the BDI-II. Method SampleThe sample was collected as a part of a randomized clinical trial examining the effectiveness of cognitive ...

No abstract

Cognitive therapy for the prevention of suicide provides rapid changes within 6 months on negative problem orientation and impulsivity/carelessness problem-solving style. Given that individuals are at the greatest risk for suicide within 6 months of their last suicide attempt, the current study demonstrates that a brief cognitive intervention produces a rapid rate of improvement in two important domains of problem-solving appraisal during this sensitive period.

Suicide remains a significant public health problem for the United States military. Trauma-related diagnoses such as acute stress disorder (ASD) or posttraumatic stress disorder (PTSD) may exacerbate suicide risk, particularly among service members psychiatrically hospitalized following suicide-related events. To date, treatments to address suicide risk and trauma symptomatology among service members within inpatient milieus have been nonexistent. To address this gap, a randomized controlled pilot trial of Post-Admission Cognitive Therapy (PACT) was conducted to evaluate a targeted cognitive-behavioral program among traumatized military personnel (N = 36) hospitalized following a recent suicide attempt. All participants met criteria for ASD or PTSD and were randomly assigned to receive either PACT and enhanced usual care (PACT + EUC) or EUC alone. PACT consisted of six 60- to 90-min individual psychotherapy sessions, adapted from Brown et al.'s (2005) cognitive therapy protocol for suicide prevention. Blinded follow-up assessments were conducted at 1-, 2-, and 3-months postpsychiatric discharge. The primary outcome was days until repeat suicide attempt. Secondary outcomes included depression, hopelessness, suicide ideation, and PTSD symptoms. Participants did not significantly differ in reattempt status. However, based on reliable change index analyses, a greater proportion of PACT + EUC versus EUC participants met criteria for clinically significant change on measures of depression (100% vs. 78%), hopelessness (83% vs. 57%), and PTSD symptom severity (100% vs. 38%), but not for suicide ideation (60% vs. 67%). PACT is an innovative inpatient protocol, currently under evaluation in a well-powered multisite RCT for its efficacy in reducing subsequent suicidal behaviors. (PsycINFO Database Record

Suicide is a significant public health concern within the United States military. Suicide may occur before, during, and after military deployment or service for a multitude of reasons that may or may not be directly related to deployment. Therefore, it is crucial that mental health counselors are trained to identify risk at an early stage so they can offer evidence-based practices to manage and reduce it. Enhanced understanding of the similarities and differences in suicide risk and protective factors for civilian and military individuals is crucial for counselors who work directly with Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) active-duty personnel, veterans, and family members. This review aims to educate counselors about the role of demographic, life event, psychopathology, and behavioral and psychological variables in exacerbating or alleviating the desire to die. The information presented is based on an electronic search of medical and psychological databases for terms related to suicide by military service members. Recommendations related to identification, prevention, and management of suicide risk in OEF/OIF service members and beneficiaries are presented.