Veterans Coping Long-Term With Suicide
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 107
- Locations
- 1
- Primary Endpoint
- Changes in Columbia Suicide Severity Rating Scale (C-SSRS) - Behavior
Study Overview
Brief Summary
The proposed study seeks to test the efficacy of an intervention to reduce suicide behaviors in Veterans. The Veterans Coping Long Term with Active Suicide Program (CLASP-VA) is an innovative, telephone-based intervention that combines elements of individual therapy, case management, and significant other/family therapy and is designed to be integrated into a VA system.
Detailed Description
Suicide is a leading cause of death for military personnel, and for the first time in recorded history, rates of military suicides are exceeding civilian rates. Despite public and patient health costs associated with suicidal ideation and behavior, existing efforts haven't appreciably reduced rates of suicidal behavior in the military. Consequently, finding novel, efficacious, and acceptable methods to reduce suicide behaviors is imperative. The Veteran's Coping Long Term with Active Suicide Program (CLASP-VA) is a unique suicide reduction intervention that directly targets high-risk patients at the time of hospital discharge. It is one of the few empirically-developed and promising interventions (e.g., strong pilot data) for individuals hospitalized for suicide behavior.
The primary objective of this study is to test the efficacy of the CLASP intervention compared to a treatment as usual plus Safety Assessment and Follow-up Evaluation (SAFE) control condition. Efficacy will be determined by primary outcomes including: number of attempts, number of re-hospitalizations, severity, and chronicity of suicidal ideation. A secondary objective is identifying the types of patients who receive the most benefit from the CLASP-VA intervention.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Single (Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •suicide attempt or suicidal ideation with any methods, plan, and/or intent to make a suicide attempt within 1 week of hospitalization
- •age greater than 18
- •have a telephone
- •ability to speak, read, and understand spoken English sufficiently well to complete the procedures of the study
Exclusion Criteria
- •long-term psychiatric disorder
- •diagnosis of borderline personality disorder
- •cognitive impairment which would interfere with adequate participation in the project (MMSE <20)
Arms & Interventions
CLASP Intervention
A 6 month adjunctive intervention consisting of 3 individual meetings, one family session, and 11 brief phone contacts with patient and identified significant other.
Intervention: Coping Long Term with Active Suicide (CLASP) (Behavioral)
CLASP Intervention
A 6 month adjunctive intervention consisting of 3 individual meetings, one family session, and 11 brief phone contacts with patient and identified significant other.
Intervention: Safety Assessment and Follow Up Evaluation (Other)
Safety Assessment and follow up Evaluation
Treatment as usual plus enhanced monitoring.
Intervention: Safety Assessment and Follow Up Evaluation (Other)
Outcomes
Primary Outcomes
Changes in Columbia Suicide Severity Rating Scale (C-SSRS) - Behavior
Time Frame: baseline, 3, 6, 9, & 12 month post-hospitalization
Items measuring attempt behavior (number of Actual Attempts, number of Aborted Attempts, number of Interrupted Attempts) From the Columbia Suicide Severity Rating Scale were summed to create a composite variable indexing attempt behavior. Higher scores indicate more attempt behavior. We log transformed this variable at all time points to meet assumptions of normality.
Secondary Outcomes
- Brief Symptom Inventory(Baseline, 3, 6, 9, & 12 month follow up)
- Changes in Beck Hopelessness Scale(Baseline, 3, 6, 9, & 12 month follow up)
- World Health Organization Disability Assessment Schedule (WHODAS) II(Baseline, 3, 6, 9, & 12 month follow ups)
- Treatment History Interview(3, 6, 9, & 12 month follow up)
- Changes in Columbia Suicide Severity Rating Scale (C-SSRS) - Ideation Severity(baseline, 3, 6, 9, & 12 month post-hospitalization)