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One of the factors that contributes to suicide risk is what is known as a "suicidal belief system." This belief system is made up of several cognitions that been associated with suicide risk among military personnel. Modification of these cognitions may reduce suicidal thoughts and behaviors. The study team has developed a brief mobile intervention entitled the Mobile Intervention for Suicidal Thoughts (MIST) that uses evidence-based interpretation bias modification techniques to reduce these suicide cognitions. The goal of this project is to is to conduct a pilot trial of the MIST intervention to evaluate whether it is feasible an acceptable as an adjunct treatment for Veterans with suicidal ideation.
One of the factors that contributes to suicide risk is what is known as a "suicidal belief system." This belief system is made up of several cognitions, including hopelessness, thwarted belongingness, perceived burdensomeness, unlovability, unbearability, and unsolvability. These cognitions have all been associated with suicide risk among military personnel. Modification of these cognitions may reduce suicidal thoughts and behaviors. The study team has developed a brief mobile intervention entitled the Mobile Intervention for Suicidal Thoughts (MIST) that uses evidence-based interpretation bias modification techniques to reduce these suicide cognitions. The goal of this project is to is to conduct a pilot trial of the MIST intervention to evaluate whether it is feasible an acceptable as an adjunct treatment for Veterans with suicidal ideation.
The investigators will conduct a pilot randomized controlled trial (RCT), in which 50 Veterans with suicidal ideation will be randomized to either MIST plus Treatment as Usual and Safety Planning versus Treatment as Usual and Safety Planning. The central hypothesis is that Veterans will find MIST acceptable and will be willing to use it to reduce their suicidal thoughts.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Safety planning, treatment as usual, and MIST | Experimental | Participants will get a safety plan, treatment as usual, and the MIST intervention. |
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| Safety planning and treatment as usual | Active Comparator | Participants will get a safety plan and treatment as usual. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Safety planning | Behavioral | Safety planning (SP) is a single-session intervention that consists of developing a written list of individualized coping strategies and sources of support that can be used during a suicidal crisis. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants recruited | Participant feasibility goal will be met if recruitment is 75% or greater of recruitment expectation. | Through study completion (approximately 18 months) |
| Percentage of enrolled participants who complete the study intervention | Treatment retention feasibility goal will be met if attrition is no more than 25%. | Post-treatment visit (approximately one month after enrollment) |
| Patient satisfaction for MIST app: Client Satisfaction Questionnaire | Patient satisfaction will be assessed with item #7 from the Client Satisfaction Questionnaire. This item is scored on a scale of 1 to 4, with one indicating lower satisfaction and 4 indicating greater satisfaction. The patient satisfaction goal will be met if 80% or greater of participants indicate score a 3 or 4 on this item. | Post-treatment visit (approximately one month after enrollment) |
| MIST intervention utilization | MIST utilization goal will be met if MIST app utilization rates are greater than 50% of expected use. | Post-MIST assessment visit (approximately one month after enrollment) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kirsten H Dillon, PhD | Contact | (919) 286-0411 | Kirsten.Dillon@va.gov | |
| Angela C Kirby, MS | Contact | (919) 286-0411 | 7456 | angela.kirby@va.gov |
| Name | Affiliation | Role |
|---|---|---|
| Kirsten H Dillon, PhD | Durham VA Medical Center, Durham, NC | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Durham VA Medical Center, Durham, NC | Recruiting | Durham | North Carolina | 27705-3875 | United States |
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| ID | Term |
|---|---|
| D013405 | Suicide |
| ID | Term |
|---|---|
| D016728 | Self-Injurious Behavior |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D013812 | Therapeutics |
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50 Veterans with suicidal ideation will be randomized to either MIST plus Treatment as Usual and Safety Planning versus Treatment as Usual and Safety Planning
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The investigator and outcomes assessors will be blinded to the participant condition.
| Treatment as usual | Behavioral | This will include continued care with any of the Veterans' current providers. Study staff will also place appropriate referrals for Veterans, as needed (e.g., Trauma Recovery Program referrals for Veterans with PTSD, Sleep Psychology referrals for Veterans with insomnia). Participants will be encouraged to follow up with their providers' recommendations and treatment plans |
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| MIST Intervention | Behavioral | This is a mobile intervention designed to target and modify suicidal cognitions. Veteran in this condition will be asked to use the intervention 5 times a week for 4 weeks. |
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