SPCR2 High Risk Suicidal Behavior in Veterans - Assessment of Predictors and Efficacy of Dialectical Behavioral Therapy.

摘要

Approximately one third of the Army s completed suicides last year occurred in the post-deployment period (Alvarez 2009) highlighting the importance of studying high-risk suicidal veteran populations. This project proposes two related studies. The first project is a randomized clinical trial of 120 veterans identified with high-risk suicidal behavior comparing the efficacy of Dialectical Behavioral Therapy (DBT) vs. treatment as usual (TAU) on suicidal behavior as a primary outcome measure. A second aim of the project is to examine group differences between 150 veterans at high risk (HR) for suicide and 150 veterans at low risk (LR) in a variety of symptom domains. The goal of this will be to identify symptoms associated with suicidal behavior that may advise future treatment. Over the 41 months since study approval, 322 subjects have been consented and 293 baseline assessments were completed. 90 high-risk suicidal subjects have been randomized for the clinical trial and 44 have completed the six-month treatment trial. A no-cost extension for year 5 of the trial will allow us to recruit additional subjects for the treatment trial as we aim for 100 subjects total. We will easily meet recruitment goals of 300 for the baseline assessment. Our supplemental project on affective startle is meeting recruitment goals and we hope to begin final data analysis on baseline testing within the next 3 months. Thus far, the supplement has assessed 149 subjects at baseline and completed 14 6-month follow-ups. Post-treatment follow- up assessments will continue into next year.