Posted March 24, 2015
M. David Rudd, Ph.D., A.B.P.P., University of Memphis
Suicide prevention is of significant interest to the military due to the rise in suicide rates among Active Duty Service Members and Veterans over the last decade. The Department of Defense (DoD) has funded a number of studies in order to investigate the reasons for this increase and to explore possible prevention and intervention methods. The University of Utah received funding from the Military Operational Medicine Research Program through the fiscal year 2008 Suicide Prevention and Counseling Research Program Announcement to contribute to this body of research. This award, led by Dr. David Rudd, involved a randomized controlled trial comparing treatment as usual to treatment as usual plus brief cognitive behavioral therapy (CBT) in a sample of active duty Soldiers at Fort Carson.
The focus of Dr. Rudd's work was to determine whether brief CBT could reduce suicide attempts in the 24-month period following treatment. The trial included 152 active duty Soldiers who exhibited recent suicidal ideation and/or who had made a recent suicide attempt; participants were randomly placed in either the brief CBT group or the treatment as usual group, with 76 participants assigned to each group. Brief CBT consisted of 12, weekly or biweekly, outpatient individual psychotherapy sessions. Rather than focusing on symptom reduction, brief CBT focuses on emotion regulation and the development of problem-solving skills. After the initial assessment, participants were followed up at 3, 6, 12, 18, and 24 months.
Dr. Rudd's data suggest that Soldiers who received brief CBT were 60% less likely to attempt suicide during the follow-up period than Soldiers who received usual treatment. Additionally, despite falling short of statistical significance, a decreased likelihood for medical retirement was seen among participants who received brief CBT compared to participants who received usual treatment. These results have important implications for suicide prevention within the military; however, further research is warranted.
Dr. Rudd's work was conducted as an affiliated study of STRONG STAR (the South Texas Research Organizational Network Guiding Studies on Trauma and Resilience), a consortium funded by the DoD under the fiscal year 2007 mechanism PTSD Multidisciplinary Research Consortium Award. STRONG STAR brings together leading experts from the military, Department of Veterans Affairs, and civilian institutions to develop and evaluate the most effective early interventions possible for the detection, prevention, and treatment of combat-related post-traumatic stress disorder (PTSD) and other combat-related disorders. As an affiliated study, Dr. Rudd's work shares the mission and involves the participation of STRONG STAR investigators and resources and helps build strong, resilient Warriors.
Rudd MD, Bryan CJ, Wertenberger EG, et al. 2015. Brief cognitive-behavioral therapy effects on post-treatment suicide attempts in a military sample: Results of a randomized clinical trial with 2-year follow-up. American Journal of Psychiatry 00:1-9.
Bryan CJ, Rudd MD, Wertenberger E, et al. 2014. Improving the detection and prediction of suicidal behavior among military personnel by measuring suicidal beliefs: An evaluation of the Suicide Cognitions Scale. Journal of Affective Disorders 159:15-22.