Rocky Mountain MIRECC for VA Suicide Prevention - Erin Poindexter, PhD - MIRECC / CoE
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Rocky Mountain MIRECC for VA Suicide Prevention - Erin Poindexter, PhD

Rocky Mountain MIRECC for Veteran Suicide Prevention

Updated: 20 July 2018


Erin Poindexter, PhD
Title: Rocky Mountain MIRECC Psychology Fellow – Denver
Dr. Erin Poindexter earned her Ph.D. in Clinical Psychology from Texas Tech University in 2016. She joined the Rocky Mountain MIRECC as a Postdoctoral Fellow in September 2016. Dr. Poindexter’s primary research interest includes investigating biopsychosocial risk factors for suicide, with an emphasis in understanding causal indicators of acute suicide risk. She is also interested in understanding how trauma exposure relates to increased suicide risk. Dr. Poindexter serves on the editorial board for Journal of Loss and Trauma.

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Abbreviated Publications

Veteran 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
Poindexter, E. K., Mitchell, S., Jahn, D. R., Smith, P.N., Hirsch, J. K. & Cukrowicz, K. C. (2015). PTSD symptoms and suicide ideation: Testing the conditional indirect effects of thwarted interpersonal needs and substance use. Personality and Individual Differences, 77, 167-172. doi: 10.1016/j.paid.2014.12.043Posttraumatic stress disorder (PTSD) symptoms and substance use have been associated with increased suicide ideation, but have rarely been examined within a larger theoretical context of suicide risk. The interpersonal theory of suicide posits that feeling disconnected from others (i.e., thwarted belongingness) and feeling like a burden on others (i.e., perceived burdensomeness) are associated with increased suicide ideation. We hypothesized that perceived burdensomeness and thwarted belongingness would mediate the relation between PTSD symptoms and suicide ideation, and that using substances to cope would moderate these relations. Participants were 254 college students reporting exposure to potentially traumatic experiences. Findings from a moderated mediation analysis indicated that perceived burdensomeness, but not thwarted belongingness, mediated the relation between PTSD symptoms and suicide ideation, and using substances to cope moderated this relation. Therapeutic interventions aimed at reducing suicide ideation might benefit from decreasing perceived burdensomeness and the use of substances to cope.Keywords: Interpersonal theory of suicide; PTSD; Substances Smith, P. N., Wolford-Clevenger, C., Selwyn, C. Poindexter, E. K., Lechner, W. V., Grant, D. M., & Cukrowicz, K. C. (2015). An exploratory analysis of the rate of psychological habituation, the acquired capability for suicide, and acute risk factors for suicide. Journal of Aggression, Conflict, and Peace Research, 7, 139-148. doi:10.1108/JACPR-07-2014-0130Purpose – The interpersonal theory of suicide proposes that an individual must acquire the capability for suicide to carry out a near-lethal or lethal suicide attempt. This capability develops via habituation in response to painful and provocative life events. Some individuals might be more vulnerable to developing the capability for suicide because they habituate more quickly to stimuli. The purpose of this paper is to examine the relations between the rate of physiological habituation and acquired capability, proxies for acquired capability, and acute risk factors for suicide. Design/methodology/approach – Depressed, suicidal individuals completed self-report assessments and a startle reflex task assessing the rate or speed of physiological habituation in response to repeated bursts of white noise. Findings – Slower habituation was associated with hopelessness and negative stressors. The rate of habituation was not associated with acquired capability. Originality/value – The current study informs the understanding of how physiological habituation is related to suicide risk factors.Keywords: Depression, Acquired capability for suicide, Hopelessness, Interpersonal theory of suicide, Physiological habituation, Suicidal ideation Cukrowicz, K. C., Jahn, D. R., Graham, R., Poindexter, E. K., & Williams, R. B. (2013). Suicide risk in older adults: Evaluating models of risk and predicting excess zeros in a primary care sample. Journal of Abnormal Psychology, 122, 1021-1030. doi:10.1037/a0034953Research is needed that examines theory-based risk factors for suicide in older adults. The interpersonal theory of suicide (Joiner, 2005; Van Orden et al., 2010) provides specific hypotheses regarding variables that contribute to the development and variability in death ideation and suicide ideation; however, data suggest that older adults may not report suicide ideation in research settings or to treatment providers even when they experience it (Heisel et al., 2006). The purpose of this study was to test theory-based predictions regarding variables that contribute to death ideation (i.e., a passive wish to die) and suicide ideation in older adults. This study introduces the application of zero-inflated negative binomial regression (ZINB) to the study of suicidal behavior. ZINB was used to test theory-based predictions, while also testing a hypothesis regarding variables associated with denial of suicide ideation among participants who endorsed risk factors associated with suicide risk. Participants included 239 adults aged 60 and older recruited from primary care clinics who completed a variety of self-report instruments. The results of this study indicated that perceived burdensomeness and hopelessness were significantly associated with variability in death ideation. Additional results indicated that elevated scores on thwarted belonging, the interaction between perceived burdensomeness and hopelessness, and the interaction between thwarted belonging and perceived burdensomeness were associated with a significant reduction in the probability of a participant being a suicide ideator. These results offer substantial support for the interpersonal theory of suicide. The implications of these findings are discussed.PsycINFO Database Record (c) 2013 APA, all rights reserved. Smith, P.N., Poindexter, E. K., & Cukrowicz, K.C. (2010). The effect of participating in suicide research: Does participating in a research protocol on suicide and psychiatric symptoms increase suicide ideation and attempts? Suicide and Life Threatening Behavior, 40, 535-543. doi:10.1521./suli.2010.40.6.535The effect of engaging in an intensive research protocol that inquired extensively about psychiatric and suicide symptoms and exposed participants to a number of images, including suicide-related content was explored. Individuals experiencing a major depressive episode were called at 1 and 3 months after the initial protocol. Participants were asked about changes in suicide ideation and the occurrence of self-harm or suicide attempts following participation. Participants reported experiencing reductions in suicide ideation at the first follow-up and no changes at the second follow-up. No participant reported having engaged in self-harm or having attempted suicide at either follow-up. Results suggest that basic science/nontreatment research can be conducted safely with suicidal participants and in a manner that does not increase suicide symptoms or suicide risk.Keywords: Suicide Research, Suicide Ideation, Suicide Attempts, Self-Harm, Follow-up Smith PN, Cukrowicz KC, Poindexter EK, Hobson V, Cohen LM. The acquired capability for suicide: a comparison of suicide attempters, suicide ideators, and non-suicidal controls. Depress Anxiety. 2010 Sep;27(9):871-7. doi: 10.1002/da.20701.BACKGROUND: The Interpersonal Theory of Suicide states that to make a serious or lethal suicide attempt, a person must experience reductions in fear and pain sensitivity sufficient to overcome self preservation reflexes (i.e., the acquired capability for suicide). The purpose of this study was to examine the fearlessness component of the acquired capability for suicide using self-report assessment instruments and an objective measure of aversion (the affectively modulated startle reflex task). METHODS: Depressed suicide ideators (n=15), depressed suicide attempters (n=15), and a group of control participants (n=14) were compared on their self-report of acquired capability and painful and provocative life events, and completed the affectively modulated startle reflex task. This task compared electromyography recordings of participants' eye-blink response to a startle probe while viewing pictures of varying hedonic valence (neutral, positive, negative, and suicide-related). RESULTS: Suicide attempters reported the highest levels of fearlessness and pain insensitivity and a greater history of painful and provocative life events. Although no group differences were found on the psychophysiology data, participants reacted to suicide-related images with less aversion compared to neutral images with no differences between suicide-related and positive images. CONCLUSIONS: Self-reported fearlessness and pain insensitivity can differentiate suicide attempters and suicide ideators. Results suggest that one's self-perception (i.e., cognitions regarding fear and pain tolerance) are more functionally related to suicide attempts than psychophysiological reactivity to suicide-related stimuli. © 2010 Wiley-Liss, Inc.
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