Craig J Bryan1, Jim Mintz1, Tracy A Clemans1, T Scott Burch1, Bruce Leeson1, Sean Williams1, M David Rudd1. 1. Dr. Bryan, Dr. Clemans, and Mr. Williams are with the National Center for Veterans Studies, University of Utah, Salt Lake City; Dr. Mintz is with the Psychiatry Department, University of Texas Health Sciences Center, San Antonio; Dr. Burch and Dr. Leeson are with the U.S. Army Medical Department Activity, Fort Carson, Colorado Springs, Colorado; Dr. Rudd is with the University of Memphis, Memphis, Tennessee.
Abstract
OBJECTIVE: The study examined the immediate effect of crisis interventions on the emotional state of acutely suicidal soldiers and clinician decision making. METHODS:Soldiers (N=97) presenting to a military emergency department or behavioral health clinic were randomly assigned to receive a contract for safety (N=32), standard crisis response plan (S-CRP; N=32), or enhanced crisis response plan (E-CRP; N=33). Soldiers completed self-report scales before and after the intervention. Clinicians blinded to treatment group assignment rated participants' suicide risk level and made a decision about inpatient psychiatric admission. RESULTS: Larger reductions in negative emotional states occurred in S-CRP and E-CRP. Larger increases in positive emotional states occurred in E-CRP. Clinician suicide risk ratings did not differ across treatment groups. Participants in E-CRP were less likely to be psychiatrically admitted. CONCLUSIONS: The CRP immediately reduces negative emotional states among acutely suicidal soldiers. Discussing a patient's reasons for living during a CRP also reduces the likelihood of inpatient psychiatric admission.
RCT Entities:
OBJECTIVE: The study examined the immediate effect of crisis interventions on the emotional state of acutely suicidal soldiers and clinician decision making. METHODS: Soldiers (N=97) presenting to a military emergency department or behavioral health clinic were randomly assigned to receive a contract for safety (N=32), standard crisis response plan (S-CRP; N=32), or enhanced crisis response plan (E-CRP; N=33). Soldiers completed self-report scales before and after the intervention. Clinicians blinded to treatment group assignment rated participants' suicide risk level and made a decision about inpatient psychiatric admission. RESULTS: Larger reductions in negative emotional states occurred in S-CRP and E-CRP. Larger increases in positive emotional states occurred in E-CRP. Clinician suicide risk ratings did not differ across treatment groups. Participants in E-CRP were less likely to be psychiatrically admitted. CONCLUSIONS: The CRP immediately reduces negative emotional states among acutely suicidal soldiers. Discussing a patient's reasons for living during a CRP also reduces the likelihood of inpatient psychiatric admission.
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Authors: Lily A Brown; Craig J Bryan; Jonathan E Butner; Jeffrey V Tabares; Stacey Young-McCaughan; Willie J Hale; Brooke A Fina; Edna B Foa; Patricia A Resick; Daniel J Taylor; Hillary Coon; Douglas E Williamson; Katherine A Dondanville; Elisa V Borah; Carmen P McLean; Jennifer Schuster Wachen; Kristi E Pruiksma; Ann Marie Hernandez; Brett T Litz; Jim Mintz; Jeffrey S Yarvis; Adam M Borah; Karin L Nicholson; Douglas M Maurer; Kevin M Kelly; Alan L Peterson Journal: Contemp Clin Trials Commun Date: 2021-02-16