Developing a Mobile Intervention to Reduce Suicidal Cognitions in Veterans

VA Office of Research and Development

Status: Completed

Conditions: Suicide

Treatments: Behavioral: Mobile Intervention for Reducing Anger (MIRA); Behavioral: Mobile Intervention for Suicidal Thoughts (MIST)

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT04881903

CRX 21-001

Details and patient eligibility

About

Suicide cognitions are conceptualized as enduring, chronic vulnerability factors that predispose individuals to suicidal crises. Therefore, modification of these beliefs may reduce suicidal thoughts and behaviors. The goal of this research is to develop, refine, and pilot-test a mobile intervention to reduce cognitions that contribute to elevated suicide risk and to assess the impact of reductions in suicide cognitions and anger cognitions on suicide risk and functioning.

Full description

Suicide cognitions are conceptualized as enduring, chronic vulnerability factors that predispose individuals to suicidal crises. Therefore, modification of these beliefs may reduce suicidal thoughts and behaviors. In addition to suicide cognitions, another potentially modifiable risk factor for suicide is anger. The goal of this research is to develop, refine, and pilot-test a mobile interpretation bias modification intervention to reduce cognitions that contribute to elevated suicide risk and to assess the impact of reductions in suicide cognitions and hostile interpretation bias (a cognitive bias that is associated with anger) on suicide risk and functioning.

Enrollment: 10 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Veterans 18 years or older
• Diagnosed with PTSD, established via the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)
• Report a score of 12 on the 5-item Dimensions of Anger Reactions Scale
• Can read at least 6th grade level material
• Report a score of 1-3 (indicating ideation without intent) on the Columbia-Suicide Severity Rating Scale (C-SSRS)
• Have attended a mental health appointment within the past month, with another scheduled in the following month (i.e., be engaged in treatment with a mental health provider)

Exclusion criteria

• Diagnosed with bipolar or psychotic disorder.
• Current substance use disorder.
• Current imminent suicide risk or homicidal ideation requiring immediate intervention.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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10 participants in 1 patient group

MIST intervention followed by MIRA intervention

Experimental group

Description:

These are both mobile interventions that use interpretation bias modification (IBM) techniques to reduce cognitive biases. The MIST app targets suicidal cognitions and the MIRA app targets hostile interpretation bias (which contributes to anger). The MIRA application has already been developed, but the MIST application is newly developed based on the same procedures. All participants will complete the MIST intervention and provide feedback so that we can refine it. We will also be collecting EMA data on to examine how changes to suicide cognitions and hostile interpretation bias (by use of the two apps) affects suicidal ideation and functioning.

Treatment:

Behavioral: Mobile Intervention for Suicidal Thoughts (MIST)

Behavioral: Mobile Intervention for Reducing Anger (MIRA)