Spotlight on Evidence Synthesis Program
Suicide Prevention Interventions and Suicide Risk Factors and Risk Assessment Tools
John Bradley, MD
Elizabeth Haney, MD
Maya O'Neil, PhD
Marcia Valenstein, MD, MS
Seminar date: 6/11/2012
Description: This Cyberseminar will present two systematic reviews on suicide risk and prevention. The body of research on suicide prevention approaches has been reviewed previously by Gaynes et al., and Mann et al., which we update in these reports. 1) Suicide Risk Factors and Risk Assessment Tools: Risk factors for suicide in Veteran and military populations identified in more than one study include: white race, bipolar disorder, and substance abuse, and for suicide attempts include: PTSD, depression, psychiatric conditions, prior suicide attempt, alcohol misuse, and history of sexual abuse. Few studies evaluate emerging risk factors, such as traumatic brain injury, among current military personnel and Veterans. There is limited research on the predictive power of suicide risk assessment tools, particularly in populations of Veterans and members of the military. Civilian research has highlighted tools such as the Beck Hopelessness Scale, among others, as showing the most promise for prediction of self-directed violence. Future research should emphasize assessment tools that are brief, conducive to primary care settings, and commonly used in VA and military settings. 2) Suicide Prevention Interventions and Referral/Follow-up Services: Research on pharmacological and psychotherapeutic interventions, as well as referral and follow-up services, will be reviewed and summarized. Overall, there is limited evidence supporting the effectiveness of pharmacological interventions and referral and follow-up services in preventing suicidal self-directed violence. The best available evidence supports the use of Problem Solving Therapy with patients who have a history of hospitalization for repeated self-harm and Dialectical Behavior Therapy with patients who have a diagnosis of Borderline Personality Disorder.
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