Intervening on Thwarted Belongingness and Perceived Burdensomeness to Reduce Suicidality Among Veterans: Subanalyses From a Randomized Controlled Trial

Nicole A Short, Lauren Stentz, Amanda M Raines, Joseph W Boffa, Norman B Schmidt, Nicole A Short, Lauren Stentz, Amanda M Raines, Joseph W Boffa, Norman B Schmidt

Abstract

Suicide is a growing public health crisis among military veterans. Despite recent attention to this area, there are few empirically supported preventative interventions for suicidality among veterans. In the context of an empirically supported theoretical framework, the Interpersonal Theory of Suicide, the current study targeted suicide risk factors (i.e., perceived burdensomeness and thwarted belongingness) among a sample of 46 veterans selected from a larger clinical trial. Participants were randomized to receive either a newly developed computerized intervention aimed at decreasing perceived burdensomeness and thwarted belongingness, or participate in a repeated contact control condition. Results indicated a direct effect of the intervention on both perceived burdensomeness and thwarted belongingness. Temporal mediation analyses also revealed an indirect effect of condition on suicidality at Month 1 follow-up via reductions in perceived burdensomeness. The current results are the first to indicate that factors from the interpersonal theory of suicide can be reduced among veterans, and to demonstrate that these reductions in perceived burdensomeness lead to reductions in suicidality. Because of the brevity and computer delivery system, this intervention could be widely and rapidly disseminated among military veterans to reduce the public health burden of suicide in this population.

Trial registration: ClinicalTrials.gov NCT01941862.

Keywords: perceived burdensomeness; suicidality; suicide; thwarted belongingness; veterans.

Copyright © 2019. Published by Elsevier Ltd.

Figures

Figure 1.
Figure 1.
CONSORT Diagram.
Figure 2.
Figure 2.
Depiction of Mediation Results.* = p <.05. B = unstandardized regression coefficient. B1 refers to mediation models with Perceived Burdensomeness, B2 refers to paths with Thwarted Belongingness.
Figure 3.
Figure 3.
Example screenshots from the Perceived Burdensomeness/Thwarted Belongingness Intervention

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