Posttraumatic stress disorder and suicidal ideation, plans, and impulses: The mediating role of anxiety sensitivity cognitive concerns among veterans

Raines, Amanda M.; Capron, Daniel W.; Stentz, Lauren A.; Walton, John N.; McManus, Eliza S.; Uddo, Madeline; True, Gala; Franklin, C. Laurel

doi:10.1016/j.jad.2017.06.035

Cited by 20 publications

(18 citation statements)

References 51 publications

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“…Stanley and colleagues (2017a) found that AS mediated the association between PTSD symptoms and global suicide risk, even after controlling for depression symptoms. Consistent with prior work, AS cognitive concerns appeared to be most implicated as the link between PTSD symptoms, including the DSM-5 PTSD symptom clusters, and suicide risk, a finding that was replicated in a sample of male veterans (Raines et al, 2017). These studies are noted for their elucidation of a malleable vulnerability factor that may in part explain why PTSD symptoms confer increased risk for suicide among protective service workers, including firefighters.…”

supporting

confidence: 81%

“…Moreover, given the theoretical basis for the position of AS as a maintenance factor of pre-existing PTSD symptoms and suicidality, we conducted these analyses among individuals with (1) a self-reported history of trauma exposure and (2) non-zero suicide risk. Consistent with prior reports (Raines et al, 2017; Stanley et al, 2017), it was hypothesized that AS cognitive concerns would emerge as the only significant mediator of this relationship when accounting for the other two AS domains (physical and social). As a replication of prior work, we tested these effects in a sample of exclusively male firefighters.…”

supporting

confidence: 54%

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Posttraumatic Stress Disorder Symptoms and Suicide Risk in Male Firefighters

Boffa¹,

Stanley²,

Smith³

et al. 2018

J Nerv Ment Dis

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Posttraumatic stress disorder (PTSD) symptoms are positively related to suicide risk among firefighters. One mechanism that may account for this relationship is anxiety sensitivity (AS) cognitive concerns-the fear that cognitive symptoms of anxiety will have catastrophic consequences. We sought to replicate the mediating effect of AS cognitive concerns on the relationship between PTSD symptoms and suicide risk among 214 trauma-exposed male firefighters with non-zero suicide risk. Bootstrap mediation analyses tested AS cognitive concerns as a statistical mediator of PTSD symptoms (total and symptoms clusters scores) and suicide risk, controlling for depression symptoms and relevant demographic variables. AS cognitive concerns statistically mediated the relationship between PTSD symptoms (total score, as well as intrusion, avoidance, and arousal-reactivity symptoms clusters) and suicide risk; however, the reverse was also true. AS cognitive concerns may confer risk for suicide among trauma-exposed firefighters. Firefighters may benefit from AS-specific interventions, which are shown to reduce PTSD symptoms and suicidality.

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supporting

confidence: 81%

supporting

confidence: 54%

Posttraumatic Stress Disorder Symptoms and Suicide Risk in Male Firefighters

Boffa¹,

Stanley²,

Smith³

et al. 2018

J Nerv Ment Dis

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“…Posttraumatic stress disorder (PTSD), one of the most frequently diagnosed psychiatric conditions among veterans, is an established risk factor for suicidal ideation (Brown, Contractor, & Benhamou, 2018;Fanning & Pietrzak, 2013;Pompili et al, 2013;Raines et al, 2017). PTSD is associated with elevated rates of SI in veterans of many service eras, including service in Iraq, Afghanistan (Gradus, Smith, & Vogt, 2015;Guerra, Calhoun, & Mid-Atlantic Mental Illness Research Education and Clinical Center Workgroup, 2011;Jakupcak et al, 2009;Lemaire & Graham, 2011;Pietrzak et al, 2010;Wisco, Marx, Holowka, & Keane, 2014), and Vietnam (Bell & Nye, 2007).…”

Section: Introductionmentioning

confidence: 99%

Courses of suicidal ideation among military veterans in residential treatment for posttraumatic stress disorder

et al. 2020

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Background Suicidal thoughts are common among veterans with posttraumatic stress disorder (PTSD). The aim of this study was to examine the prevalence and correlates of four courses of suicidal (SI) among veterans receiving residential PTSD treatment. Methods A total of 1,807 veterans receiving residential PTSD treatment at Department of Veterans Affairs medical facilities who completed self‐report measures at admission and discharge were included. Results The prevalence of SI courses were No SI (33.6%), Remitted SI (23.0%), SI onset (6.0%), and Chronic SI (37.4%). There were group differences between the four SI courses in PTSD symptoms at baseline, magnitude of PTSD symptom change during treatment, race/ethnicity and baseline depression, substance use, physical functioning, and pain. Chronic SI was associated with highest baseline PTSD, depression, substance use, pain and worse physical functioning. Remitted SI course was associated with greatest pre‐posttreatment PTSD improvement, followed by No SI, Chronic SI, and SI Onset. Multinomial logistic regressions revealed that PTSD symptom improvement and baseline PTSD symptoms most consistently related to symptomatic SI courses compared to less symptomatic or No SI courses. Receipt of trauma‐focused psychotherapy (none, some, or adequate) and length of stay were not related to SI courses and did not differ between groups. Conclusions Findings indicate that treating PTSD symptoms could be impactful for reducing suicidal thoughts. Although many veterans had remitted or reduced severity of SI at discharge, a significant proportion of veterans reported SI at discharge (43.4%), potentially highlighting the need for suicide specific treatment interventions within the context of PTSD treatment.

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“…− For example, Brent et al . found that individual personality and psychological issues increased the suicide risk, and the psychological constructs seem more associated with psychiatric diagnoses and subsequent suicide . In addition, physical illnesses can lead to a high risk of suicide .…”

Section: Introductionmentioning

confidence: 99%

“…found that individual personality and psychological issues increased the suicide risk, 5,8 and the psychological constructs 5 seem more associated with psychiatric diagnoses and subsequent suicide. 9,10 In addition, physical illnesses can lead to a high risk of suicide. 6,7,11 Whitlock 12 reported that more than one-third of suicide victims suffered from physical illness at the time of their death.…”

Section: Introductionmentioning

confidence: 99%

Interactions between psychiatric and physical disorders and their effects on the risks of suicide: a nested case–control study

Chang

Yeh

Chien

et al. 2019

Annals of the New York Academy of Sciences

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Previous studies, which included predominantly Caucasian populations, examined psychiatric and physical illness and associated suicide risk. We used a nationwide database to reassess the findings in an Asian population, and also analyzed the influence of different onset timing of psychiatric and physical illness and the suicide risk. We included 55,630 suicide cases aged 20–110 years. Using an incidence density sampling approach, we selected 222,520 controls matched by age, sex, and residence area from 2000 to 2012. We included most major psychiatric and physical illnesses defined by ICD‐9‐CM codes with anatomical classifications. By using conditional logistic regression models with adjustment of covariates, such as patients’ marital status and education levels, we found that patients with psychiatric illness had higher suicide risk (adjusted IRR, 7.72; 95% CI: 7.35–8.09) compared with those with neither physical nor psychiatric illness and the risk increased substantially in patients with both psychiatric and physical illnesses (adjusted IRR, 18.35; 95% CI: 16.40–20.86). Specifically, we found the suicide risk was relatively higher (adjusted IRR, 1.28; 95% CI: 1.10–1.40) when psychiatric disorders occurred before physical illness compared with the other way around. The findings warrant attention to high suicide risk and preventive treatments in patients with both psychiatric and physical illnesses.

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Posttraumatic stress disorder and suicidal ideation, plans, and impulses: The mediating role of anxiety sensitivity cognitive concerns among veterans

Cited by 20 publications

References 51 publications

Posttraumatic Stress Disorder Symptoms and Suicide Risk in Male Firefighters

Posttraumatic Stress Disorder Symptoms and Suicide Risk in Male Firefighters

Courses of suicidal ideation among military veterans in residential treatment for posttraumatic stress disorder

Interactions between psychiatric and physical disorders and their effects on the risks of suicide: a nested case–control study

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