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Rocky Mountain MIRECC for Veteran Suicide Prevention

Rocky Mountain MIRECC for Veteran Suicide Prevention

2018 Rocky Mountain MIRECC News for You Archive

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Updated: 31 December 2018

Military sexual trauma survivorsPub: Military sexual trauma survivors' perceptions of veterans health administration care: A qualitative examination
27 December 2018 - RMIRECC Investigators Lindsey Monteith, PhD, Nazanin Bahraini, PhD, Brooke Dorsey Holliman, PhD, Alexandra Schneider, BA, Ryan Holliday, PhD, and Bridget Matarazzo, PsyD combined with Holly Gerber on this qualitative review. The study found, "The majority of participants described neutral or positive perceptions of VHA care; however, a subset of participants described negative perceptions and reservations about using VHA care. Participants expressed concerns regarding distrust, provider compassion, privacy, stigma, shame, and continuity of care. Some women, particularly those who experienced military sexual assault, also described gender-related distress (e.g., feeling anxious or out of place, desire for separate facilities). Both men and women described wanting nonspecific support, improved continuity of care, and the ability to choose from a variety of treatment options (e.g., holistic, gender-specific). Further research is needed to examine if these findings are replicated in other samples. (PsycINFO Database Record (c) 2018 APA, all rights reserved)." Read more
The Food Pantry at the Dayton VAWebinar: Food Insecurity and Mental Health: Contextualizing Nutrition in Psychosocial Functioning
13 December 2018 - Dr. Diana Brostow, PhD, MPH, RDN recently gave an VA HSR&D webinar that explored how consistent, affordable access to nutritious food (food security) is increasingly viewed as an important determinant of health. Emerging research suggests that rather than being solely an issue of hunger and physical food access, food insecurity may be viewed as a complex, multifactorial concept comprised of the psychological, social, cultural, as well as environmental factors that shape eating behaviors. Also, an article appeared in the Dayton Daily News (12 December 2018) detailing how food insecurity affects Veterans locally. Dr. Brostow is quoted, "Veterans are proud, and they have a reason to be proud. Food insecurity has a lot of stigma associated with it. It’s hard for people to ask for help. Food is such a basic, primal need. For a person to say, ‘Hey, I’m having trouble feeding myself,’ takes a lot of courage." Read how the Dayton VA is addressing the issue.
Hal WortzelA Chat with Our Experts: Seeking new ways to alert physicians to Veteran suicide risk
12 December 2018 - The VA Research Quarterly features an interview Dr. Hal Wortzel. Hal is the Director of Neuropsychiatric consultation services and co-director of the VA Suicide Risk Management Consultation Program. He is also an associate professor of psychiatry, neurology, and physical medicine and rehabilitation at the University of Colorado. The article explores his research in suicide prevention and also his thoughts on the emerging idea of using a suicide-specific diagnosis code in Veterans' medical records. Read the full article.
Chris CoronaPodcast: On Moral Injury - A Treatment Perspective with Dr. Chris Corona
12 December 2018 - In this podcast Georgia interviews Dr. Chris Corona, post-doctoral fellow at the VISN 2 Center of Excellence for Suicide Prevention at the Canandaigua VA Medical Center, to continue the discussion on moral injury. Moral injury is a relatively new concept and our understanding of how it relates to suicide risk is limited. Dr. Corona provides a thorough overview of moral injury and ways providers can assess and treat moral injury as well as sharing findings from current research on moral injury and suicide risk in a population of Veterans with substance use disorders and ideas for future research.

Listen to the podcast
Postconcussive Symptoms 12-Months Post-DeploymentPub: Trajectory of Postconcussive Symptoms 12-Months Post-Deployment in Soldiers with and without Mild Traumatic Brain Injury - Warrior STRONG Study
6 December 2018 - RMIRECC Director Dr. Lisa Brenner worked on this Warrior STRONG study that found, "The prevalence of clinically relevant postconcussive symptoms remained relatively constant over one year of follow-up, whether or not symptoms were associated with concussion. Service members with recent mTBI reported more symptoms than non-mTBI at all time-points." Read more.
Predictive modelingPub: Developing Predictive Models to Enhance Clinician Prediction of Suicide Attempts Among Veterans With and Without PTSD
4 December 2018 - RMIRECC Drs. Sean Barnes, Lindsey Monteith, Jeri Forster, Sarra Nazem, Lauren Borges, and Nasi Bahraini and Kelly Stearns-Yoder collaborated on this article. From the abstract, "OBJECTIVE: The authors aimed to build and test a predictive model of Suicide Attampts (SA) that included established risk factors and measures of suicide risk, and Death Implicit Association Test (IAT) scores. The authors also sought to test the predictive validity of the SA model among subgroups of Veterans with and without PTSD. CONCLUSIONS: Findings indicate that predictive models may bolster clinician prediction of SAs and that predictors may differ for Veterans with PTSD." Read more.
Service DogsPub: Exploring service dogs for rehabilitation of veterans with PTSD: A microbiome perspective
4 December 2018 - RMIRECC and MVMCore Drs. Lt. Col. Andrew Hoisington, Katherine Bates, Chris Stamper, Christopher Lowry and Lisa Brenner, also Kelly Stearns-Yoder participated on this paper. From the abstract, "RESULTS: Whether dogs can be used as an intervention to increase function among those with PTSD remains a question. Nonetheless, it has been suggested that dog ownership may improve mental health outcomes via multiple mechanisms, such as decreasing social isolation and increasing physical activity and exposure to green spaces. The presence of a dog in the home may alter the human inhabitants' microbiomes, thereby, potentially providing an additional mechanism through which service dogs may influence human health and well-being. CONCLUSIONS/IMPLICATIONS: Theoretically, the use of service dogs for rehabilitation of Veterans with PTSD could improve mental health outcomes. To the best of our knowledge the impact that therapy dogs have on the microbiome of the owners, as well as their built environments, has yet to be explored." Read more
An initial investigation of nonsuicidal self-injury among male and female survivors of military sexual traumaPub: An initial investigation of nonsuicidal self-injury among male and female survivors of military sexual trauma
20 November 2018 - RMIRECC Drs. Ryan Holliday and Lindsey Monteith teamed up with Dr. Noelle Smith of the VA's Northeast Program Evaluation Center on this article. From the abstract, "The aims of the current study were to: (1) describe characteristics of NSSI among survivors of MST and (2) determine if MST survivors who have engaged in NSSI differ from those who have never engaged in NSSI in terms of the severity of posttraumatic stress disorder (PTSD) and depressive symptoms, trauma-related cognitions, and recent suicidal ideation. MST survivors with a history of NSSI reported more severe PTSD symptoms, recent suicidal ideation, and trauma-related cognitions. NSSI was relatively common in the sample and was associated with a more severe clinical presentation. Longitudinal research is needed to understand the development, maintenance, and function of NSSI in MST survivors, especially as it pertains to risk for suicidal self-directed violence." Read more
Increased efficiency of brain connectivity networks in veterans with suicide attemptsPub: Increased efficiency of brain connectivity networks in veterans with suicide attempts
13 November 2018 - Our RMIRECC site in Salt Lake City lead this research with researchers Margaret Legarreta, Elliott Bueler, Erin McGlade and Deborah Yurgelun-Todd. From the abstract, "Prior research has shown neurobiological factors in suicide. However, studies of neuroimaging correlates of suicide risk have been limited. This study applied complex weighted network analyses to characterize the neural connectivity in white matter in veterans with suicide behavior. CONCLUSION: Veterans with prior suicide attempt had altered connectivity networks characteristics in the white matter. These findings may be distinctive neurobiological markers for individuals with suicide attempt. Strong connectivity in the left PCC may be implicated in impulsivity in veterans with suicide attempt." Read the full article.
Thank you Veterans for participating in researchHSR&D Thanks Veterans for their Participation in Research
Veterans Day 2018 - In honor of Veterans Day, VA's Health Services Research & Development Service (HSR&D) would like to share this short video thanking Veterans for their service and participation in HSR&D research. Eight HSR&D investigators are featured expressing their gratitude for Veterans' role in research, and several also share the personal and professional value they gain from working with, and on behalf of, our nation's Veterans. Thank you to all who have served.RMIRECC joins in thanking all Veterans. Watch the video.
REACHVETPodcast: On Empathy and Caring with Lena Heilmann
7 November 2018 - Lena Heilmann lost her sister Danielle to suicide in 2012. In response to this traumatic loss and as a way to honor her sister, Lena transitioned from her role as a college professor to working in suicide prevention. Now, as the Youth Suicide Prevention Coordinator with the Colorado Office of Suicide Prevention, Lena merges her lived experience with coordinating a SAMHSA Youth Suicide Prevention Grant. In this podcast, Lena talks about how her grief and loss survivor identity inform her work and her personal mission. Adam and Lena's conversation also addresses the role of upstream prevention efforts, an overview of suicide prevention work in Colorado, the importance of authentic interpersonal relationships, and how to prioritize self-care when working in the suicide prevention field.

Listen to the podcast
Visual abstract on safety planning in emergency departmentsPub: Comparison of the Safety Planning Intervention With Follow-up vs Usual Care of Suicidal Patients Treated in the Emergency Department.
2 November 2018 - RMIRECC Director, Lisa Brenner, participated in this study that explored whether providing Safety Planning Interventions in hospital emergency departments would reduce suicidal behavior and increase participation in outpatient care 6 months hence. The results were encouraging in that there was a reduction in suicidal behaviors and an increase in treatment engagements. Read more
Menu of Options for rural suicide preventionPub: A menu of options: Resources for preventing veteran suicide in rural communities
29 October 2018 - RMIRECC authors, Nate Mohatt, Lindsey Monteith and Nazanin Bahraini (as well as former RMIRECC social worker Melodi Billera) contributed to this manuscript that assesses "the availability of evidence-based and promising practices to support a community-based suicide prevention effort for rural veterans." Read more
22 October 2018 - Thanks to the team effort led by Drs. Ryan Holliday and Lindsey Monteith, we sent 1,000 mailings to learn about trauma & health care seeking among women Veterans.
REACHVETPodcast: Predictive Analytics to Reach Veterans at Risk
15 October 2018 - This bonus podcast release is coinciding with a HSR&D Cyberseminar "REACH VET: Applying Predictive Analytics to Clinical Practice." The HSR&D website will have a recording of the seminar. Adam speaks with Aaron Eagan, RN MPH, about the use of predictive analytics to identify Veterans at highest-risk of suicide and intervenes clinically to review and enhance care.

Listen to the podcast
A voice at the tablePub: Orbitofrontal connectivity is associated with depression and anxiety in marijuana-using adolescents
11 October 2018 - Our Associate Director, Deborah Yurgelen-Todd, located in the Salt Lake City office published this paper in the Journal of Affective Disorders. "This study highlights the association between Orbitofrontal connectivity connectivity, marijuana use, and symptoms of depression and anxiety in adolescents. These findings provide further insight into understanding the neural correlates that modulate the relationship between comorbid marijuana use and mood disorders and could potentially help us better develop preventive and treatment measures." Read more
Dr. Michael KauthPodcast: A Conversation with Dr. Michael Kauth - A Lifetime of Achievement in Veterans Care
10 October 2018 - Dr. Michael Kauth is a clinical psychologist and has two major roles in the VA. He is Director of the VHA LGBT Health Program – a position shared with Dr. Jillian Shipherd – and he is also Co-Director of the South Central Mental Illness Research, Education and Clinical Center. In addition, Dr. Kauth is a professor in the Department of Psychiatry at Baylor College of Medicine in Houston, TX. Recently he received The American Psychological Association, Division 18, James Besyner Award for Lifetime Achievement and later this week he and Dr. Shipherd will be receive the 2018 Achievement Award from the Gay/Lesbian Medical Association in Las Vegas. I have known Michael for almost 15 years beginning when he was the National Educational Director for MIRECC/CoE and I maintained the website. I caught up with Michael to reflect on his work and get his view of the future.

Listen to the podcast
Dr. Lindsey MonteithPodcast: Military Sexual Trauma (MST) - A Discussion with Dr. Lindsey Monteith
4 October 2018 - We recorded this podcast to coincide with a series of online trainings that Dr. Monteith is conducting and because this is a particular time in our country where sexual assault is on the minds of many. Lindsey discusses with Adam how we can take a public health approach to sexual violence, one where we can all take responsibility for ending the violence and helping vistims heal. Her research of late has taken a qualitative approach where survivors are given a chance to speak in their own voice and make their own choices. She reminds us to listen with compassion and to believe what survivors are telling us.

Listen to the podcast
A voice at the tableVA National Suicide Data Report Released
27 September 2018 - This September 2018 VA National Suicide Data Report (from the Office of Mental Health and Suicide Prevention) includes data from 2005 through newly released numbers for 2016. It highlights new findings based upon National Death Index mortality data up to 2016, and includes data from all fifty states and District of Columbia. State data sheets offer local data by age group, sex and method, with comparisons to regional as well as national data. Read more
Jess Stohlmann-RaineyPodcast: Giving Credibility to Other Views with Jess Stohlmann-Rainey
26 September 2018 - I read Jess' piece, "Hegemonic Sanity and Suicide" in San Francisco during a rather desultory conference. The essay is a fresh look at a topic we all spend so much time thinking and talking about. For this podcast Jess came into our office at the new Rocky Mountain Regional VAMC, we sat by the window and talked. Jess had a lot of intriguing things to say about how we, society, think of mental health and how our collective inability to understand and accept differences places some of us on the margin and not part of the whole. And once we are on the margin how the credibility of our voices, our experiences are discounted. Tune in to the podcast to understand how listening to those with lived experiences can lead to a place where we trust what we are being told.

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A voice at the tablePodcast: Making Room for Voices All Around with Annmarie Matulis and Tracey Pacheco Medeiros
19 September 2018 - I went to Annmarie and Tracey's website, A Voice at the Table, and the banner shows a winter scene, bare trees in the snow. Then I started editing the recording that Adam did of these two wonders during the 2018 Bridging the Divide conference her in Denver. Listening to these two felt like coming in from the cold and sitting at the table in their kitchen. Laughing and talking big subjects and enveloped in warmth and fine company. Listen to this podcast and immerse yourselves in the power of the human spirit.

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A Rasch analysisA Rasch analysis of the Neurobehavioral Symptom Inventory in a national cohort of Operation Enduring and Iraqi Freedom veterans with mild traumatic brain injury
14 September 2018 - RMIRECC authors Nazanin Bahraini, Trisha Hostetter, Jeri Forster, Alexandra Schneider, and Lisa Brenner published this article recently exploring whether the Neurobehavioral Symptom Inventory (NSI) total score could be used as a global measure of postconcussive symptoms. Find out
DEPARTMENT OF DEFENSE - CONGRESSIONALLY DIRECTED MEDICAL RESEARCH PROGRAMSToward a Gold Standard for Suicide Risk Assessment for Military Personnel
14 September 2018 - Drs. Pete Gutierrez and Thomas Joiner research funded by the U.S. Department of Defense Medical Research Development Program (DMRDP) is highlighted on the Congressionally Directed Medical Research Programs (CDMRP) website. They sought to identify a gold standard diagnostic tool that could reliably and accurately predict suicide risk in Service members; they compared the performance of four prominent suicide assessments, namely the Columbia-Suicide Severity Rating Scale (C-SSRS), Self-Harm Behavior Questionnaire (SHBQ), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Beck Scale for Suicide Ideation (BSS). Learn more.
Intimate Partner Violence & Suicide PreventionPodcast: The Intersection of Intimate Partner Violence & Suicide Prevention with Drs. LeAnn Bruce, Keita Franklin and Lindsey Monteith
12 September 2018 - This podcast is an excellent example of the collaborative relationship between the VA Intimate Partner Violence Assistance Program and the VA Suicide Prevention Program in their mutual efforts to prevent both intimate partner violence (IPV) and suicide for those who have served. Dr. Bruce is the National Program Manager for the VHA Intimate Partner Violence Assistance Program, which serves Veterans, their partners, and VA staff impacted by intimate partner violence. Dr. Franklin is the Executive Director, Suicide Prevention for the U.S. Department of Veterans Affairs Office of Mental Health and Suicide Prevention. And Dr. Monteith is a research/clinical psychologist with Rocky Mountain MIRECC for Suicide Prevention.

Listen to the podcast
The Manidookewigashkibjigan Sacred BundlePodcast: The Manidookewigashkibjigan Sacred Bundle: R.E.S.P.E.C.T (Respect, Engaging, Supporting, Protecting, Empowering, Connecting, and Teaching) Project
5 September 2018 - Thank you for MIRECC’s, for your interest in the Sacred Bundle Project. We are a Garrett Lee Smith (GLS) Tribal grantee, with the full name of our project being “Manidookewigashkibjigan Sacred Bundle: R.E.S.P.E.C.T (Respect, Engaging, Supporting, Protecting, Empowering, Connecting, and Teaching) Project. We are primarily focused on youth suicide prevention concerning Native American/Alaskan Native individuals ages 10-24 years old. We work with 12 federally recognized tribes in Michigan and spread the message that everyone is a #HealingHelper. So similar to the VA message #BeThere.

Listen to the podcast
Ryan HollidayPodcast: Military Sexual Trauma - Trauma Informed Care with Ryan Holliday
22 August 2018 - Adam Hoffberg interviewed Psychology Fellow Dr. Ryan Holliday about the research he is doing related to Military Sexual Trauma. This is a podcast that you could describe to your kids with something like, "Kids, I heard Doc Holliday's original podcast before he became really big." You talk with Ryan and you just know he knows a lot (about evidence-based treatment, MST and PTSD) and isn't afraid to break it down for you.

Listen to the podcast
American Association of SuicidologistPodcast: The 2018 AAS Conference - Part 4
25 July 2018 - Here we are at the end of our series. And we end it with some blockbusters:

An Ecological Approach to Suicide Prevention with Dr. Emma Elliott-Groves

What if We...? Taking a New Look at Risk with Drs. Jessica Ribeiro and Joseph Franklin

The Role of Daily Interpersonal Interactions in Suicide Risk with Dr. Katie Lewis
Drs. Gutierrez and JoinerNEW: SERVE Toolkit for Veteran Engagement
23 July 2018 - RMIRECCs Leah Wendleton is part of the nationwide team that recently released the Strengthening Excellence in Research through Veteran Engagement (SERVE) Toolkit. The toolkit was created to "support VA Research Centers and investigators in efforts to include Veterans and other stakeholders in the development, implementation, and dissemination of research studies. The Toolkit is comprised of five sections, four of which correspond to a stage of development for Veteran Engagement initiatives and a fifth that focuses specifically on evaluation. The sixth section is web-based and contains a number of useful resources that have either been developed by VA colleagues or that our team identified as being useful for engaged research efforts." Learn more
American Association of SuicidologistPodcast: The 2018 AAS Conference - Part 3
18 July 2018 - In this 3rd of our 4 part series from the 2018 AAS conference we diversify and hear from a Health Behaviorist, a gamer and a future seminarian:

Health Promoting Behaviors as Suicide Prevention with Dr. Daniel DeBrule

The Gaming Community Comes to the Rescue with Stack Up's Elvis Walden

Suicide Prevention and the Greek Life with Marshall Taylor
Emmy Award Winning VideoEmmy Award Winning Video - Comedian and Navy Veteran Rodney Perry's Road to Recovery
28 June 2018 - This past weekend at the 60th annual National Capital Chesapeake Bay Chapter regional Emmy Awards, a segment produced for VA’s The American Veteran video series was awarded a regional Emmy by the National Capital Chesapeake Bay Chapter of the National Academy of Television Arts and Sciences. A cool things about this video (other than this Veteran's phenomenal recovery here at the Denver VAMC) is that RMIRECC's own video producer, Rachel Warden, helped during the shooting and production phase in Denver! Watch the full video.
American Association of SuicidologistPodcast: AAS Lived Experience - Part 2
27 June 2018 - This week we wrap our lived experience/expertise cycle with 2 short podcast related to postvention. Later this year we will unveil the Suicide Postvention Resource Center a website and resource center and these podcasts serve as an introduction of sorts:

The Journey of a Loss Survivor with Janet Schnell, MSW, LSW

Postvention: an Introduction with Sarra Nazem and Elaine de Mello
Dr. Ryan HollidayDr. Ryan Holliday Receives 2018 APA Early Career Achievement Award
25 June 2018 - Dr. Ryan Holliday,a psychology fellow at RMIRECC, is the recipient of the 2018 APA Early Career Achievement Award! He is one of 14 people to be chosen out of a very competitive pool of candidates based on his achievements and demonstration of leadership.
American Association of SuicidologistPodcast: AAS Lived Experience - Part 1
20 June 2018 - During the 2018 AAS conference we had the opportunity to record a number of brief podcasts with leaders in the Lived Experience community. This week we'll release 3 of these and next week we'll drop the other 2. So for this week we have:

AFSP Suicide Outreach Program with Doreen Marshall and Shannon Donnick

AFSP Survivors of Suicide Loss Day with Doreen Marshal and Brandon English

Lived Expertise with DeQuincy Lezine
Journal Nervous Mental DiseasePub: Decreases in Suicide Cognitions After Cognitive Processing Therapy Among Veterans With Posttraumatic Stress Disorder Due to Military Sexual Trauma: A Preliminary Examination
14 June 2018 - Drs Lindsey Monteith and Ryan Holliday co-authored this paper examining suicide-specific beliefs over the course of treatment and follow-up in veterans who received cognitive processing therapy (CPT) for MST-related PTSD. "Hierarchical linear models revealed that veterans who received CPT had significant reductions in suicide-specific cognitions regarding unbearability, unlovability, and unsolvability. These preliminary findings warrant replication in a randomized controlled trial with a larger sample that includes participants with more acute suicidal intent." Read more
Never Worry AloneArticles of Note in VA Health Services Research & Development Forum
8 June 2018 - RMIRECC researchers had a number of articles in the Spring 2018 online Forum from VA Health Services Research & Development. Drs Lisa A. Brenner, Claire Hoffmire, Nathaniel Mohatt, and Jeri E. Forster wrote "Preventing Suicide among Veterans Will Require Clinicians and Researchers to Adopt a Public Health Approach". Dr. Claire Hoffmire also co-wrote "Concerning Trends in Suicide Among Women Veterans Point to Need for More Research on Tailored Interventions" and Dr. Lindsey L. Monteith co-wrote "Research Seeks to Better Understand the Relationship between Combat-related Killing and Suicidal Ideation". Download the full newsletter
Never Worry AlonePodcast: Never Worry Alone - The VA Suicide Risk Management Consultation Program
6 June 2018 - In this episode Adam has a great talk with Dr. Bridget Matarazzo about the VA Suicide Risk Management Consultation Program. The program has recently expanded so that anyone working with a Veteran and concerned about suicide can contact them for a free consultation. Bridget discusses the idea behind the service and the great team (Hal S. Wortzel, MD, Sarra Nazem, Ph.D., Georgia Gerard, LCSW, Kaily A. Cannizzaro, PsyD, and Peter Gutierrez, Ph.D.) that provides the consultation.

Rocky Mountain Short Takes Podcast Listen

Dr. Ryan HollidayPub: Predictors of Unbearability, Unlovability, and Unsolvability in Veterans With Military-Sexual-Trauma-Related Posttraumatic Stress Disorder
5 June 2018 - Dr. Ryan Holliday was a co-author on a study investigating potential predictors of unbearability, unlovability, and unsolvability in veterans with MST-related PTSD. "In veterans with MST-related PTSD who express unbearability, unlovability, and unsolvability, assessing and addressing depression, trauma-related negative cognitions about self and self-blame, and physical health functioning may be an important step in reducing SDV." Read more
Dr. Peter GutierrezPub: The Military Suicide Research Consortium Common Data Elements: An Examination of Measurement Invariance Across Current Service Members and Veterans
4 June 2018 - Dr. Peter Gutierrez was part of this study to examine measurement invariance of the Military Suicide Research Consortium Common Data Elements (CDEs) across current service members, younger veterans, and older veterans to better help those at risk of suicide. "The Military Suicide Research Consortium CDEs demonstrate at least adequate model fit for current military service members and veterans, regardless of age. Thus, the CDEs can be validly used across military and veteran populations. Given similar latent structures, research findings in one group may inform clinical and policy decision making for the other." Read more
Military and Behavioral HealthPub: Evaluation of Suicide Risk Assessment Measures in an Israel Defense Forces Military Sample
30 May 2018 - This study published with RMIRECC researchers, Pete Gutierrez, PhD and Jetta Hanson, MA, looks at whether common psychological measures translated to Hebrew and used in a group of Israel Defense Forces maintain reliability and validity. This study suggest they do. Read more.
Veterans Crisis LinePodcast Bonus: Veterans Crisis Line: History, Purpose, and a Look Ahead with Director Matt Miller
25 May 2018 - Curious about the Veterans Crisis Line? Join us for an in-depth conversation with VCL Director Matt Miller about its purpose, history, and what the future holds. Matt takes us on a journey from VCL's initial launch in 2007, to right now, for the ribbon-cutting of the 3rd call center in Topeka, Kansas. We talk about how VCL has expanded to meet increasing demand, responding to over 2000 calls each day. Matt tells us about the services VCL offers, who can use them, and how responders are trained to support Veterans and their loved ones. He also walks us through what happens when someone reaches out to the VCL, and explains the follow-up process connecting Veterans with their local VA Suicide Prevention Coordinator. Matt demystifies the crisis line experience and encourages everyone to be familiar with how to contact the VCL before a crisis happens, including saving the number 1-800-273-8255 press 1 into your phone. Tune in to learn about the latest technological advances being pioneered by the VCL, as well as research and continuous quality improvement underway.

Rocky Mountain Short Takes Podcast Listen

archives suicide researchPub: The Relationship between Suicidal Responses and Traumatic Brain Injury and Severe Insomnia in Active Duty, Veteran, and Civilian Populations
24 May 2018 - This paper including RMIRECC researchers Pete Gutierrez, PhD, Kelly Soberay, MA and Jetta Hanson, MA looks at "how a positive traumatic brain injury (TBI) screening and insomnia severity relates to suicidal outcomes across active duty, veteran, and civilian samples." The study indicates that TBI and insomnia both contribute to suicidal response individually in all populations. For Veterans it appears that both TBI and insomnia both contribute while for active duty personnel insomnia poses a stronger risk. Read more.
Warrior to Soul Mate ProgramPodcast: The Warrior to Soul Mate Program with Clyde Angel and Georgia Gerard
16 May 2018 - In this podcast Georgia interviews Dr. Clyde Angel, Chief of Chaplain Services at the Indianapolis VA and National Coordinator for the Warrior to Soul Mate Program. The effects of deployments and transitioning to civilian life can be stressful for families. Dr. Clyde discusses the growth and effectiveness of the Warrior to Soul Mate Program and how it can help Veterans and their spouses and significant others learn valuable skills, such as effective communication, to reconnect and repair relationships. Listen to the podcast:

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PubMed CentralPub: Altered Cortical GABA in Female Veterans with Suicidal Behavior: Sex Differences and Clinical Correlates
11 May 2018 - Our RMIRECC colleagues in Salt Lake City, Margaret Legarreta, PhD, Perry F. Renshaw, MD, PhD, Erin McGlade, PhD, and Deborah Yurgelun-Todd, PhD, published this open source article on PubMed Central exploring the neurochemical underpinnings of the association between stress/trauma and suicide risk are unclear, especially in regards to sex differences. They hypothesized that gamma-amino butyric acid (GABA), the major inhibitory neurotransmitter may be a neurochemical candidate that is critical in the association between stress and suicide risk in veterans. This study suggests that reduced GABA/Cr+ PCr ratio in the ACC, which may be related to altered inhibitory capacity, may underlie suicide risk in female veterans. Further, the negative association between GABA/Cr+PCr and stress symptomatology and depression scores suggests that MRS studies may shed light on intermediate phenotypes of suicidal behavior. Read more.
Intensive Care MedicinePub: Should all ICU clinicians regularly be tested for burnout? We are not sure
10 May 2018 - Dr. Meredith Mealer is the co-author of this work that appears in Intensive Care Medicine. The paper seeks to answer four questions: Q1) Is burnout syndrome the proper disorder to screen for in ICU clinicians?; Q2) What are the best survey instruments to screen for burnout in ICU clinicians?; Q3) How should the stigma associated with burnout and other psychological disorders be addressed?; Q4) Are we properly prepared to utilize the results of burnout testing to help ICU providers? Read more here.

Also of interest is Dr. Mealer's podcast PTSD and the ICU Nurse: Bolstering Resiliency in the Helping Professions
Treatment Works for Veterans WebsitePodcast Bonus: Treatment Works for Veterans Website Launches!
7 May 2018 - Adam discusses the new website with Dr. Brad Karlin. The website has two purposes. The first is to introduce Veterans to the idea of Evidence-Based Psychotherapies, especially for insomnia and depression (others will be added later). Evidence-Based Psychotherapies (EBP) are treatments that have been shown to work; they have been tested and work. The other part of the website is for clinicians and focuses on Shared Decision Making, a process in which the provider sits down with the person interested in getting treatment and together they decide on what EBP is best for the individual. Best of all the website is free and open to everyone - Veteran and non-Veteran! Listen to the podcast:

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Joseph A. Simonetti, MD, MPHPub: Firearm Storage Practices and Risk Perceptions Among a Nationally Representative Sample of U.S. Veterans With and Without Self-Harm Risk Factors
1 May 2018 - Dr. Joe Simonetti continues his important work in lethal means safety. This article, published with Deborah Azrael PhD Matthew Miller MD, ScD explores storage practices and risk perceptions among Veterans. From the abstract, "Overall, one in three U.S. Veteran firearm owners store household firearms loaded and unlocked, one in twenty believe that a firearm increases household suicide risk, and one in four consider their loaded and unlocked firearm to be inaccessible to suicidal household members. Storage practices and risk perceptions are similar among those with and without self‐reported suicide risk factors. Affecting risk perceptions may be a critical aspect of interventions addressing lethal means safety among U.S. Veterans." Read more.
Lindsey Monteith, Kelly Soberay, Holly Gerber and Nazanin BahrainiPub: The phenomenology of military sexual trauma among male veterans
25 April 2018 - Today also saw the release for Dr. Lindsey Monteith, Dr. Nazanin Bahraini, Kelly Soberay and former Research Assistant, Holly Gerber on PsycNet the publication The phenomenology of military sexual trauma among male veterans. This study looked at Military Sexual Trauma in males. The study used "a phenomenological approach to describe the lived experiences of men exposed to MST." Themes that emerged include "disruptions to their sense of masculinity," and questioning their sexuality among many other themes. Read the abstract.

Not part of this research but a related topic the author Junot Diaz recently wrote about his experience of child sexual abuse that mirrors many of these themes in The New Yorker Magazine.
Lindsey MonteithPub: Suicide Ideation in Female Survivors of Military Sexual Trauma: The Trauma Source Matters
25 April 2018 - Dr Lindsey Monteith published this paper with Rebecca K. Blais, PhD. This study looked "whether experiencing suicidal ideation differs based on the source of PTSD symptoms" That is whether the PTSD is related to Military Sexual Trauma (MST) or to a non-MST source. What they found was the source of the trauma does matter. "Participants who identified MST as the source of their PTSD symptoms were over two times more likely to report SI, compared to those who described non-MST-related events as the source of their PTSD symptoms. Compared to those who reported the source of their PTSD symptoms as combat-/deployment-related, those who identified MST as the source were at least three times as likely to report current SI. Results underscore the importance of efforts to address MST-related PTSD symptoms when working with female service members/Veterans." Read more
Jerry ReedPodcast: Suicide Prevention Master Series with Dr. Jerry Reed
11 April 2018 - Jerry Reed, PhD, MSW, Education Development Center’s Senior Vice President for Practice Leadership and Lead for the U.S. Division’s Suicide, Violence, and Injury Prevention Portfolio, shares his professional journey from the early days of his career experience to his current position of being a well-known leader and expert in the suicide, violence, and injury prevention fields. Read more. Listen to the podcast:

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Federal PractitionerUnderstanding, Assessing, and Conceptualizing Suicide Risk Among Veterans With PTSD
5 April 2018 - Three of our researchers (Ryan Holliday, PhD, Lindsey Monteith, PhD, Hal Wortzel, MD) published today in the journal Federal Practitioner. The article concludes, "Because suicide risk assessment and management can be time sensitive and anxiety provoking, mental health providers can use a TRM (Therapeutic Risk Management) approach to increase their confidence in instituting optimal care and mitigating risk by having a structured, therapeutic assessment process that gathers appropriate suicide- and PTSD-related data to assist in developing suicide risk-related treatment. However, more research is needed to determine the most useful self-report measures and effective interventions when working with veterans with PTSD at risk of suicide." Read more
Journal of Aggression, Maltreatment and TraumaA Single-Arm Meta-Analysis of Cognitive Processing Therapy in Addressing Trauma-Related Negative Cognitions
30 March 2018 - Rocky Mountain MIRECC Psychology Fellow, Dr. Ryan Holliday, keeps publishing and publishing. Today his publication was released in Journal of Aggression, Maltreatment & Trauma. This study looked at the research that has been done related to Cognitive Processing Therapy (CPT) a treatment "designed to address cognitive “stuck points” connected to a patient’s trauma-related negative cognitions (NCs)." From 9 studies there was a reduction in negative cognitions. Read more
Resources for Coping after a Tragic EventResources for Coping after a Tragic Event
27 March 2018 - There are many different responses to traumatic events. Most people have intense responses immediately following, and often for several weeks or even months after, a traumatic event. With the help of the National Center for PTSD, VA Office for Suicide Prevention, we put together this resource for dealing with workplace tragedy. Learn more.
Journal of Psychiatry ResearchReductions in Self-Blame Cognitions Predict PTSD Improvements with Cognitive Processing Therapy for Military Sexual Trauma-Related PTSD
15 March 2018 - Dr. Ryan Holliday, Rocky Mountain MIRECC Psychology Fellow, is the lead author on this paper exploring how reductions in trauma-related negative cognitions during Cognitive Processing Therapy (CPT) are theorized to precede posttraumatic stress disorder (PTSD) symptom reduction. From baseline to 6-months posttreatment, only changes in self-blame predicted and temporally preceded changes in PTSD symptoms, highlighting a potential mechanism of change in CPT for military sexual trauma-related PTSD. Read more.
A Clinical Evidence-Based ApproachA Clinical Evidence-Based Approach to Examine the Effects of mTBI and PTSD Symptoms on ANAM Performance in Recently Deployed Active Duty Soldiers: Results From the Warrior Strong Study
9 March 2018 - Drs. Lisa Betthauser and Lisa Brenner participated in this publication in the Journal of Head Trauma Rehabilitation. The article looks to establish a baseline of how soldiers with mTBI and/or PTSD Symptoms perform a certain standardized test, the ANAM4. The study "results illustrate that a combination of mTBI and PTS is associated with worse ANAM4 performance than either condition alone." Read more
Suicide and Life-Threatening BehaviorVeteran Participation in Intensive Suicide Research Protocols: Evaluating Iatrogenic Effects Across Three Studies
RMIRECC researchers Erin K. Poindexter PhD, Sarra Nazem PhD, Sean M. Barnes PhD, and Trisha A. Hostetter MPH, along with Phillip N. Smith PhD published research as to whether Veterans who participate in suicide prevention research are harmed by that participation (an Iatrogenic effect). The results indicate that Veterans are not harmed by participating in research studies. Read more
Lisa Betthauser, Nazanin Bahraini, Peter Gutierrez10 Years of Great Service: 3 RMIRECCers Honored!
We recently honored a trio of our own for being with us for 10 years. Lisa Betthauser, Nazanin (Nasi) Bahraini and Peter Gutierrez have been with us at least since 2008. Nasi Bahraini first began at RMIRECC as a Psychology Fellow prior to becoming a RMIRECC employee. And now Nasi is the Director of the Education Core and a joy to work with. Lisa Betthauser also has spent time with us as a student and is now a Principle Investigator doing exciting work related Complementary and Alternative Medicine. And Pete Gutierrez has been doing research for us all these many years and is also the co-Director, with Dr. Thomas Joiner at Florida State University, of the DOD Military Suicide Research Consortium. We appreciate this wonderful trio!
Journal of Head Trauma and RehabilitationA Randomized Controlled Trial of the Collaborative Assessment and Management of Suicidality versus Enhanced Care as Usual With Suicidal Soldiers
27 February 2018 - Drs. Brenner and Gutierrez participated in this randomized controlled trial known as "Operation Worth Living" (OWL). The study sought to compare the treatment use of Collaborative Assessment and Management of Suicidality (CAMS) to enhanced care as usual (E-CAU) in the reduction of both suicidal ideation and suicide attempts in US Army Soldiers. From the abstract, "Conclusions: Soldiers receiving CAMS and E-CAU significantly improved post-treatment. Those who received CAMS were less likely to report SI at 3 months; further group differences were not otherwise seen." Read more.
Journal of Head Trauma and RehabilitationPersistent Symptoms and Objectively Measured Balance Performance Among OEF/OIF Veterans With Remote Mild Traumatic Brain Injury
27 February 2018 - RMIRECC authors Jeri Forster PhD, Kelly Stearns-Yoder MA, and Lisa Brenner PhD participated in writing this paper along with colleagues from the University of Colorado School of Medicine, Physical Medicine and Rehabilitation Department. This study explored the relationships between dizziness, fatigue, and depression and PTSD and balance in Veterans with mTBI. "Findings suggest that dizziness, fatigue, depression and PTSD, and time since most recent mTBI may influence balance performance." Read more
Dr. Peter GutierrezEvaluation of Structured Assessment and Mediating Factors of Suicide-Focused Group Therapy for Veterans Recently Discharged from Inpatient Psychiatry
26 February 2018 - Dr. Peter Gutierrez teamed up with six co-authors on this publication which explored whether adding the Suicide Status Form (SSF) to a suicide-focused group therapy for veterans showed benefit. An added note here both Pete and David Jobes have recorded podcasts with us! Catch Pete's podcast "Risk Factors, Warning Signs, and Drivers of Suicide: What Are They, How Do They Differ, and Why Does It Matter?" and David Jobes' podcast "Looking 30 Years Ahead and 30 Years Behind with David A. Jobes".
Lisa Brenner being awarded the 2018 Roger G. Barker Distinguished Research Contribution AwardDr. Lisa Brenner, the 2018 Roger G. Barker Distinguished Research Contribution Award Recipient!
23 February 2018 - The American Psychology Association Division 22, Rehabilitation Psychology awarded Dr. Lisa Brenner with the 2018 Roger G. Barker Distinguished Research Contribution Award. This annual award is conferred upon an individual who is judged to have made an outstanding lifelong contribution to rehabilitation psychology through empirical research, conceptual/theoretical development or both. The award was announced at the Rehabilitation Psychology Mid-Winter Meeting during the Awards Ceremony.
Journal of Psychiatry - Interpersonal and Biological ProcessesPub: Ryan Holliday, Rocky Mountain MIRECC Psychology Fellow, Publishes in Psychiatry
22 February 2018 - Dr. Holliday is one of the authors on "Facilitating Fear-Based Memory Extinction With Dexamethasone: A Randomized Controlled Trial in Male Veterans With Combat-Related PTSD". From the abstract "Animal and preliminary human studies have demonstrated that glucocorticoids enhance the extinction of fear memories. Impaired extinction of fear memories is a critical component in the development and maintenance of posttraumatic stress disorder (PTSD). The purpose of this translational study was to determine the effectiveness of pairing a glucocorticoid with trauma memory reactivation as a novel intervention to treat PTSD and to measure the duration of the effect. Conclusions: Despite insufficient power to test differences in PTSD symptom reduction, findings suggest that this novel intervention may have potential for treatment of combat-related PTSD." Read more
Dr. Bryann DeBeerPodcast: The Role of Health Promoting Behaviors with Dr. Bryann DeBeer
14 February 2018 - In this podcast Adam Hoffberg interviews Dr. Bryann DeBeer, a suicide prevention researcher and clinical research psychologist at the VA VISN 17 Center of Excellence for Research on Returning War Veterans, and an Assistant Professor at Texas A&M Health Science Center. Dr. DeBeer discusses her interesting research which examines risk factors for suicide in Veterans. Her work also focuses on translating these findings into new actionable suicide prevention techniques. Adam and Dr. DeBeer talk about how these findings fit into clinical practice in order to help clinicians improve their work with clients at risk for suicide. Listen to the podcast:

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Margaret Legarreta, PhDPub: Suicide Behavior and Chronic Pain: An Exploration of Pain-Related Catastrophic Thinking, Disability, and Descriptions of the Pain Experience
5 February 2018 - The RMIRECC team in Salt Lake City (Margaret Legarreta, PhD (pictured), Elliott Bueler, BA, Jennifer DiMuzio, BA, Erin McGlade, PhD, and Deborah Yurgelun-Todd, PhD) published this important paper exploring the role of chronic pain in suicide prevention. "The study results support the need to assess pain from a multifaceted perspective and to examine the different experiences of pain, such as sensory and affective constructs, when discussing suicide risk in veterans." Read more.
Coming Home LogoStudy: Coming Home from Afghanistan and Iraq
30 January 2018 - The Coming Home from Afghanistan and Iraq study will help VA understand the effects of military service, deployment, and combat on the health and well-being of Veterans who served during Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND). Researchers are looking at the physical and mental health, vocation or occupation, and social relationships of deployed Veterans, non-deployed Veterans, and similar civilians. Learn more
Lindsey MonteithPub: Understanding Suicidal Self-Directed Violence Among Men Exposed to Military Sexual Trauma: An Ecological Framework
RMIRECC staff (Dr Lindsey Monteith, pictured, Dr Nazanin Bahraini and Kelly Soberay, MA) and former staff (Holly Gerber) contributed to this article published by APA PsycNET. The publication explores a qualitative study "aimed to describe men’s perceptions of the impact of MST on their lives, in relation to their subsequent experiences with suicidal ideation and attempt." The authors findings "suggest a complex, multifaceted etiology of men’s suicidal ideation and suicide attempts following MST. Ecological perspectives that consider processes at interpersonal, institutional, and cultural levels may be particularly informative for enhancing suicide prevention efforts for men who have experienced MST." Read more.
Brooke Dorsey-Holliman PhDPub: Dr. Brooke Dorsey-Holliman Leads 3 RMIRECC Authors on Resiliency, cultural beliefs and practices that mitigate suicide risk among African American female veterans
Dr. Brooke Dorsey-Holliman was the lead author on this publication along with Drs. Lindsey Monteith and Lisa Brenner and former study coordinator Elizabeth Spitzer. The article is from a qualitative study exploring protective factors for suicide among African American women Veterans. "Three themes emerged as being protective against suicide: (a) resilience, (b) social support, and (c) religion. Results underscore the importance of specific cultural beliefs and practices as being protective against suicide among African American women Veterans." Read the whole publication from this open access journal.
Military and Behavioral HealthPub: Factors Influencing Suicide Risk Assessment and Management in VA Primary Care Clinics: A Qualitative Study of Provider Perspectives
22 January 2018 - Former RMIRECC Fellow Megan Petrik and Suicide Risk Management Consultation Program Co-Director and Consultant Bridget Matarazzo co-authored this paper in Military and Behavioral Health. The qualitative study found these themes the impact of a trusting patient–provider relationship, multidisciplinary team-based care, education about suicide prevention from integrated behavioral health providers, reliable access to mental health care, and VA system-wide suicide prevention efforts in supporting generalists' ability to effectively assess and manage veterans' suicide. Read more.
Journal of Anxiety DisordersPub: Study Coordinator Nathalie Dieujuste Publishes in Journal of Anxiety Disorders
19 January 2018 - Nathalie Dieujuste, a study coordinator for RMIRECC co-authored the paper "Construct validation of the hybrid model of posttraumatic stress disorder: Distinctiveness of the new symptom clusters." What is particularly interesting about this study is it shows a negtive result; that is, from the key results reported, "The hybrid model might not provide a meaningful framework for understanding which PTSD symptoms relate to associated features." Studies that report negative results are important because they make us consider why did this experiment not turn out quite as expected. Read more.
Joseph A. Simonetti, MD, MPHPodcast: Promoting Lethal Means Safety to Prevent Veteran Suicide with Joe Simonetti, MD
What is it about Lethal Means Safety (LMS) that makes a difference in suicide prevention? LMS is about increasing the distance between thoughts of suicide and action. In this week’s episode, we are joined by Dr. Joseph Simonetti, MD, MPH, physician and suicide prevention researcher with the Rocky Mountain MIRECC. Dr. Simonetti guides us through the fundamentals of lethal means safety, why it’s important, and provides suggestions on how to ensure that conversations about lethal means safety are Veteran-centered. Download the transcript or listen to the podcast:

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Journal pf Psychiatric PracticeNew Publication: Why Suicide Risk Assessment Still Matters
8 January 2018 - RMIRECC Drs. Hal Wortzel, Sarra Nazem, Nazanin Bahraini and Bridget Matarazzo published this article "Why Suicide Risk Assessment Still Matters" in the Law and Psychiatry Column in the Journal of Psychiatric Practice. The authors state, "When properly performed in concert with patient-centered mental health care, suicide risk assessment and management may add to the therapeutic and recovery-oriented benefits of care, independent of the ability to predict death by suicide." Read more
Also listen to Dr. Peter Gutierrez's podcast "Response to abandoning suicide risk assessment" from 2016.

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