title: Rationale and study design of a trial of mindfulness-based cognitive therapy for preventing suicidal behavior (MBCT-S) in military veterans.
abstract: Although suicide ranks 10th as a cause of death in the United States, and 1st among active military personnel, there are surprisingly few evidence-based therapies addressing suicidality, and development of new treatments is limited. This paper describes a clinical trial testing a novel therapy for reducing suicide risk in military veterans. The intervention, Mindfulness-Based Cognitive Therapy for Preventing Suicide Behavior (MBCT-S), is a 10-week group intervention adapted from an existing treatment for depression (Mindfulness-Based Cognitive Therapy - MBCT). MBCT-S incorporates the Safety Planning Intervention, which is currently implemented throughout the Veterans Health Administration (VHA) for veterans at high suicide risk.
  
  
  
  MBCT-S is being tested in a VHA setting using an intention-to-treat, two-group randomized trial design in which 164 high suicide risk veterans are randomized to either VHA Treatment As Usual (TAU; n=82) or TAU+MBCT-S (n=82). Our primary outcome measure, suicide-related event, defined to include suicide preparatory behaviors, self-harm behavior with suicidal or indeterminate intent, suicide-related hospitalizations and Emergency Department (ED) visits, will be measured through five assessments administered by blinded assessors between baseline and 12months post-baseline. We will measure suicide attempts and suicide deaths as a secondary outcome, because of their anticipated low incidence during the study period. Secondary outcomes also include severity of suicidal ideation, hopelessness and depression.
  
  
  
  This study has the potential to significantly enhance the quality and efficiency of VHA care for veterans at suicide risk and to substantially improve the quality of life for veterans and their families.
authors: Department of Psychiatry, Rutgers, The State University of New Jersey, Robert Wood Johnson Medical School, Piscataway, New Jersey, United States. Electronic address: anna.kline@rutgers.edu.
authors: Anna
authors: A
authors: Kline
authors: Department of Psychology, William Paterson University, Wayne, NJ, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States.
authors: Megan
authors: M
authors: Chesin
authors: Mental Health & Behavioral Sciences, VA New Jersey Healthcare System, Lyons, New Jersey, United States.
authors: Miriam
authors: M
authors: Latorre
authors: Mental Health & Behavioral Sciences, VA New Jersey Healthcare System, Lyons, New Jersey, United States.
authors: Rachael
authors: R
authors: Miller
authors: Mental Health & Behavioral Sciences, VA New Jersey Healthcare System, Lyons, New Jersey, United States.
authors: Lauren
authors: L
authors: St Hill
authors: Mental Health & Behavioral Sciences, VA New Jersey Healthcare System, Lyons, New Jersey, United States.
authors: Anton
authors: A
authors: Shcherbakov
authors: Mental Health & Behavioral Sciences, VA New Jersey Healthcare System, Lyons, New Jersey, United States.
authors: Arlene
authors: A
authors: King
authors: Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States.
authors: Barbara
authors: B
authors: Stanley
authors: Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, New Jersey, United States.
authors: Marc D
authors: MD
authors: Weiner
authors: Department of Psychiatry, Rutgers, The State University of New Jersey, Robert Wood Johnson Medical School, Piscataway, New Jersey, United States; Mental Health & Behavioral Sciences, VA New Jersey Healthcare System, Lyons, New Jersey, United States.
authors: Alejandro
authors: A
authors: Interian
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006801:Humans; D064866:Mindfulness / Q000379:methods*; D011788:Quality of Life; D012107:Research Design; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000517:prevention & control; D016037:Single-Blind Method; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000517:prevention & control; D014728:Veterans; D000092864:Suicide Prevention
keywords: Clinical trial; Mindfulness; Randomized controlled trial; Suicide; Veterans