TY - JOUR
T1 - EVALUATING POTENTIAL IATROGENIC SUICIDE RISK IN TRAUMA-FOCUSED GROUP COGNITIVE BEHAVIORAL THERAPY FOR THE TREATMENT OF PTSD IN ACTIVE DUTY MILITARY PERSONNEL
AU - the STRONG STAR Consortium
AU - Bryan, Craig J.
AU - Clemans, Tracy A.
AU - Hernandez, Ann Marie
AU - Mintz, Jim
AU - Peterson, Alan L.
AU - Yarvis, Jeffrey S.
AU - Resick, Patricia A.
AU - Dondanville, Katherine A.
AU - Litz, Brett T.
AU - Roache, John
AU - Wachen, Jennifer Schuster
AU - Stacey Young-McCaughan, R. N.
N1 - Publisher Copyright:
© 2015 Wiley Periodicals, Inc.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2016/6
Y1 - 2016/6
N2 - Objective: To determine whether group cognitive processing therapy-cognitive only version (CPT-C) is associated with iatrogenic suicide risk in a sample of active duty US Army personnel diagnosed with posttraumatic stress disorder (PTSD). Possible iatrogenic effects considered include the incidence and severity of suicide ideation, worsening of preexisting suicide ideation, incidence of new-onset suicide ideation, and incidence of suicide attempts among soldiers receiving group CPT-C. Comparison with group present-centered therapy (PCT) was made to contextualize findings. Method: One hundred eight soldiers (100 men, eight women) diagnosed with PTSD were randomized to receive either group CPT-C or group PCT. PTSD diagnosis was confirmed via structured clinician interview. Suicide ideation, depression severity, and PTSD severity were assessed at pretreatment, weekly during treatment, and 2 weeks, 6 months, and 12 months posttreatment. Results: Rates of suicide ideation significantly decreased across both treatments. Among soldiers with pretreatment suicide ideation, severity of suicide ideation significantly decreased across both treatments and was maintained for up to 12 months posttreatment. Exacerbation of preexisting suicide ideation was uncommon in both treatments. New-onset suicide ideation was rare and similar across both treatments (<16%). There were no suicide attempts during treatment or follow-up in either group. Change in depression symptoms predicted change in suicide risk. Conclusions: Suicide-related outcomes were similar across both treatments and primarily associated with comorbid depression. Suicide-related outcomes in group CPT-C were rare and comparable to patterns observed in an active, nontrauma-focused therapy, even among soldiers who entered treatment with suicide ideation. Clinical Trials.gov Identifier: NCT01286415, https://clinicaltrials.gov/ct2/show/NCT01286415.
AB - Objective: To determine whether group cognitive processing therapy-cognitive only version (CPT-C) is associated with iatrogenic suicide risk in a sample of active duty US Army personnel diagnosed with posttraumatic stress disorder (PTSD). Possible iatrogenic effects considered include the incidence and severity of suicide ideation, worsening of preexisting suicide ideation, incidence of new-onset suicide ideation, and incidence of suicide attempts among soldiers receiving group CPT-C. Comparison with group present-centered therapy (PCT) was made to contextualize findings. Method: One hundred eight soldiers (100 men, eight women) diagnosed with PTSD were randomized to receive either group CPT-C or group PCT. PTSD diagnosis was confirmed via structured clinician interview. Suicide ideation, depression severity, and PTSD severity were assessed at pretreatment, weekly during treatment, and 2 weeks, 6 months, and 12 months posttreatment. Results: Rates of suicide ideation significantly decreased across both treatments. Among soldiers with pretreatment suicide ideation, severity of suicide ideation significantly decreased across both treatments and was maintained for up to 12 months posttreatment. Exacerbation of preexisting suicide ideation was uncommon in both treatments. New-onset suicide ideation was rare and similar across both treatments (<16%). There were no suicide attempts during treatment or follow-up in either group. Change in depression symptoms predicted change in suicide risk. Conclusions: Suicide-related outcomes were similar across both treatments and primarily associated with comorbid depression. Suicide-related outcomes in group CPT-C were rare and comparable to patterns observed in an active, nontrauma-focused therapy, even among soldiers who entered treatment with suicide ideation. Clinical Trials.gov Identifier: NCT01286415, https://clinicaltrials.gov/ct2/show/NCT01286415.
KW - PTSD
KW - adverse effects
KW - depression
KW - psychotherapy
KW - suicidal ideation
UR - http://www.scopus.com/inward/record.url?scp=85012173068&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85012173068&partnerID=8YFLogxK
U2 - 10.1002/da.22456
DO - 10.1002/da.22456
M3 - Article
C2 - 26636426
AN - SCOPUS:85012173068
VL - 33
SP - 549
EP - 557
JO - Depression and Anxiety
JF - Depression and Anxiety
SN - 1091-4269
IS - 6
ER -