title: EVALUATING POTENTIAL IATROGENIC SUICIDE RISK IN TRAUMA-FOCUSED GROUP COGNITIVE BEHAVIORAL THERAPY FOR THE TREATMENT OF PTSD IN ACTIVE DUTY MILITARY PERSONNEL.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  NCT01286415, https://clinicaltrials.gov/ct2/show/NCT01286415.
authors.affiliation: National Center for Veterans Studies, Salt Lake City, Utah.|Department of Psychology, The University of Utah, Salt Lake City, Utah.
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Bryan
authors.affiliation: National Center for Veterans Studies, Salt Lake City, Utah.
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Clemans
authors.affiliation: Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Hernandez
authors.affiliation: Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Jim
authors.initials: J
authors.lastname: Mintz
authors.affiliation: Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas.|South Texas Veterans Health Care System, San Antonio, Texas.|Department of Psychology, University of Texas at San Antonio, San Antonio, Texas.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Peterson
authors.affiliation: Department of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Hood, Texas.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Yarvis
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Resick
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D059020:Suicidal Ideation; D055815:Young Adult
keywords: PTSD; adverse effects; depression; psychotherapy; suicidal ideation