Randomized Clinical Trial of Re-Evaluating Suicidal Thoughts in Veterans
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorVA Office of Research and Development
About this trial
Suicide prevention is a top priority for VA as all continue to seek new and inventive ways to reduce suicide rates among Veterans. Many experts agree that suicide prevention efforts could be improved by making suicide-specific interventions easier to access. The current project aims to move toward that goal by testing a web-based suicide prevention intervention using an experimental design. The roughly 40-minute intervention aims to teach Veterans coping skills that are designed to ease the emotional distress that often comes with thoughts of suicide. The project will evaluate whether Veterans who receive this intervention report more improvement in suicidal thoughts and behaviors than Veterans who receive a standard course of health care visits. Suicidal thoughts and behaviors will be measured over the course of one month. The investigators hypothesize that Veterans who receive the intervention will report lower suicidal thoughts and behaviors than those who receive the standard course of health care.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Veteran
18 years or older
Past two-week suicidal ideation as indicated by positive reply to C-SSRS questions ("Have you had any actual thoughts of killing yourself," or, "Have you been thinking about how you might do this?")
Disqualifiers
Active psychosis
Unmedicated bipolar disorder
Instances in which a substance use disorder would indicate inpatient detoxification prior to engaging in other outpatient mental health interventions
Trial design
Design model
Parallel
Treatments tested in this trial
Treatment-as-usual
Other interventionVeterans in the TAU-only control condition will remain engaged in their normal standard of mental health care throughout their participation in this study. Veterans in the TAU condition will have access to and receive referrals for any of the following services normally afforded to patients at this VA hospital: VA Office of Connected Care web-based training programs and mobile mental health applications; primary care appointments; PCMHI consultation; outpatient mental health individual and group therapies; psychiatry appointments; inpatient hospitalization in the event of a suicidal crisis during study participation; and post-discharge mental health follow-up appointments following inpatient hospitalization for medical or mental health reasons.
Re-Evaluating Suicidal Thoughts
BehavioralREST is a brief, computerized intervention designed to mitigate psychological inflexibility associated with the experience of suicidal ideation. Most individuals complete the intervention in under one hour. REST provides psychoeducation to correct common misconceptions about suicidal ideation and help Veterans de-catastrophize the occurrence and meaning of these thoughts. This includes information about the prevalence of suicidal ideation among Veterans, a conceptualization of suicidal ideation as a response to stress, normalizing emotional reactions to suicidal ideation, and framing suicidal ideation as "thoughts and conjectures" as opposed to "truth and reality." These components were chosen to directly address emotional distress related to suicidal thoughts, which is central to the construct of psychological inflexibility. Veterans randomized to receive REST will have access to and be encouraged to utilize any and all of these options described in the TAU-only condition.
Treatment groups
180 Participants
are divided into 2 treatment groupsGroup A: REST + TAUExperimental treatment 1 intervention
Group B: TAUOther 1 intervention
Trial outcomes
Primary outcomes
1
Suicidal ideation severity change
Data sourced from Beck Scale for Suicidal Ideation (BSS) self-report measure total score. BSS scores range from 0-38 on 19 items rated on a 0-2 scale. Higher scores indicate greater suicidal ideation severity.
Time frame
Baseline and one month2
Psychological inflexibility of suicidal ideation change
Data sourced from Acceptance and Action Questionnaire for Suicidal Ideation (AAQ-SI) self-report measure total scores. AAQ-SI scores range from 4-28 on seven items rated on a 1-7 scale. Higher scores indicate greater experiential avoidance of suicidal ideation.
Time frame
Baseline and two weeks3
Suicidal behaviors change
Data sourced from the Columbia Suicide Severity Rating Scale clinical interview (C-SSRS). The presence or absence of five categories of suicidal behaviors is indicated on a dichotomous (Yes/No) scale. Categories include: (1) Preparatory acts or behavior, (2) aborted attempt, (3) interrupted attempt, (4) actual attempt (non-fatal), and (5) completed suicide. Higher assigned score indicates greater severity of suicidal behavior.
Time frame
Baseline and one monthSponsors and contacts
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Source ClinicalTrials.gov