Addressing co ‐occurring suicidal thoughts and behaviors and posttraumatic stress disorder in evidence‐based psychotherapies for adults: A systematic review

AbstractPosttraumatic stress disorder (PTSD) is a well-established risk factor for suicidal thoughts and behaviors. Historically, guidelines for treating PTSD have recommended against the use of trauma-focused therapies for patients who are at high risk for suicide, likely due to concerns about potential suicide-related iatrogenesis, specifically the “triggering” of suicidal behaviors. This systematic review examined evidence of the impact of treatments specifically designed to treat PTSD or suicide on both PTSD- and suicide-related outcomes. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were foll owed, and a total of 33 articles met the full inclusion criteria: 23 examining PTSD treatments, four examining suicide-focused treatments, and six examining combined treatments. PTSD and combined treatments reduced both PTSD- and suicide-related outcomes, with most studies focusing on cognitive proc essing therapy or prolonged exposure. Suicide-focused treatments (e.g., cognitive therapies for suicide prevention) also reduced suicide-related outcomes, but the findings were mixed for their impact on PTSD-related outcomes. Overall, PTSD treatments had the most support, primarily due to a larger n umber of studies examining their outcomes. This supports current clinical guidelines, which suggest utilizing PTSD treatments for individuals who have PTSD and are at risk for suicide. Suicide-focused and combined treatments also appear...
Source: Journal of Traumatic Stress - Category: Psychiatry & Psychology Authors: Tags: RESEARCH ARTICLE Source Type: research

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This study evaluated whether Mindfulness-Based Cognitive Therapy for Preventing Suicide Behavior (MBCT-S) effectively augmented treatment-as-usual enhanced for suicide prevention (eTAU). METHODS: From December 2013 through March 2018, ve...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Economics of Injury and Safety, PTSD, Injury Outcomes Source Type: news
The original version of this article contained a mistake in the Table 3. In Table 3: Two rows were accidentally cut out which reported the B coefficients and standard errors for two variables in the multiple regression model, the hyperoursal symptom cluster, avoidance/numbing symptom cluster. The corrected table is presented below.
Source: Cognitive Therapy and Research - Category: Psychiatry & Psychology Source Type: research
As the COVID-19 pandemic and its economic effects spread, concerns about mental health impacts continue to grow. For example, we worry for health and human services professionals whose duties involve higher risk for trauma exposure and post-traumatic stress. Reports of global increases in family violence also suggest that there will be many violence victims and witnesses in need of mental health support. Add to this the potential effects of social isolation, health-related anxiety, and that these mental health problems may persist and worsen long after society goes back to “normal.” And this is all happening as...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Mental Health and Wellness Psychology Stress Suicide coronavirus COVID-19 Depression pandemic Task sharing Source Type: blogs
ConclusionsYounger participants had greater symptom improvement, particularly if they received individual treatment. Other pretreatment variables did not predict outcome. CPT appears to be robust across most pretreatment variables, such that comorbid disorders, baseline symptom severity, and suicidal ideation do not interfere with application of CPT. However, individual CPT may be a better option particularly for younger service members.
Source: Cognitive Therapy and Research - Category: Psychiatry & Psychology Source Type: research
DiscussionThe expected results will be a major step forward in establishing empirically supported psychological treatments for survivors of CA suffering from Complex PTSD.Trial registrationGerman Clinical Trials Register: registration numberDRKS00005578, date of registration 19 December 2013.
Source: Borderline Personality Disorder and Emotion Dysregulation - Category: Psychiatry Source Type: research
AbstractPurpose of ReviewPost-traumatic nightmares (PTN) are a common and enduring problem for individuals with post-traumatic stress disorder (PTSD) and other clinical presentations. PTN cause significant distress, are associated with large costs, and are an independent risk factor for suicide. Pharmacological and non-pharmacological treatment options for PTN exist. A previous review in this journal demonstrated that Prazosin, an alpha blocker, was a preferred pharmacological treatment for PTN and imagery rescripting therapy (IRT) was a preferred non-pharmacological treatment. Since that time, new and important research f...
Source: Current Psychiatry Reports - Category: Psychiatry Source Type: research
AbstractWith approximately 20 veteran suicide deaths per day, suicidal ideation (SI) among veterans is an important concern. Posttraumatic stress disorder (PTSD) is associated with SI among veterans, yet mechanisms of this relationship remain unclear. Negative posttraumatic cognitions contribute to the development and maintenance of PTSD, yet no studies have prospectively examined the relationship between posttraumatic cognitions and SI. Veterans (N = 177; 66% Male) participating in a 3-week intensive outpatient program for PTSD completed assessments of PTSD severity, depressive symptoms, SI, and posttraumati...
Source: Cognitive Therapy and Research - Category: Psychiatry & Psychology Source Type: research
AbstractResearch has yet to establish a relationship between posttraumatic mental contamination and suicide risk, despite theoretical overlap. The present study examined relationships between posttraumatic mental contamination and suicide risk via posttraumatic stress symptom clusters and appraisals of perceived burdensomeness and thwarted belongingness. Trauma-exposed participants (N = 183) completed measures of posttraumatic mental contamination, posttraumatic stress symptoms, thwarted belongingness, perceived burdensomeness, and suicide risk. Findings revealed significant indirect effects of posttraumatic ...
Source: Cognitive Therapy and Research - Category: Psychiatry & Psychology Source Type: research
DiscussionCBT for anxiety disorders was associated with significant reductions in SI over time, with no evidence for exacerbation of suicide risk. Clinical implications are discussed, as well as future research directions to further understand the effect of anxiety disorder treatments on SI.
Source: Journal of Anxiety Disorders - Category: Psychiatry Source Type: research
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 trauma...
Source: Psychological Services - Category: Psychiatry & Psychology Source Type: research
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