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Treating Posttraumatic Stress Disorder in the Presence of Acute Suicide Risk in Veterans and Active Duty Service Members

A Call for Research

Holliday, Ryan PhD*†; Holder, Nicholas PhD‡§∥; Olson-Madden, Jennifer H. PhD*†; Monteith, Lindsey L. PhD*†

The Journal of Nervous and Mental Disease: July 2019 - Volume 207 - Issue 7 - p 611–614
doi: 10.1097/NMD.0000000000001022

Posttraumatic stress disorder (PTSD) is associated with increased risk for suicide, and clinicians often encounter acute suicide risk during the process of intervening upon PTSD. Although the Department of Veterans Affairs (VA) and the Department of Defense (DoD) have disseminated evidence-based treatments for PTSD, prior clinical trials have used inconsistent definitions and unclear assessment methods of suicide risk. Consequently, translating findings from PTSD treatment research to clinical practice remains challenging. This article describes challenges inherent to the current PTSD interventional research literature related to concurrent acute suicide risk among veterans and active duty service members. We reviewed prior trials and how their assessment methods and nomenclature compare with strategies and definitions mandated within the VA/DoD. Furthermore, we describe methodological recommendations for future research, including consistent use of mandated universal suicide nomenclature, standardization for classifying suicide risk, transparency in reporting assessment means and measures, and examination of current models of PTSD treatment in the context of acute suicide risk.

*Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention;

University of Colorado Anschutz Medical Campus, Aurora, Colorado;

San Francisco Veterans Affairs Health Care System;

§Sierra Pacific Mental Illness Research, Education and Clinical Center; and

University of California San Francisco School of Medicine, San Francisco, California.

Send reprint requests to Ryan Holliday, PhD, Rocky Mountain Regional VA Medical Center, Rocky Mountain Mental Illness Research, Education and Clinical Center, 1700 North Wheeling, Aurora, CO 80045. E-mail:

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