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.

Objective: Effectively responding to suicide risk among veterans involves further developing understanding of reactions to combat experiences, including life-threatening events, traumatic losses, and morally injurious experiences. An important determinant of whether stressors lead to poor mental health outcomes is the perception of meaning. The current study aimed to determine whether global meaning (i.e., general beliefs, goals, and sense of purpose in life) moderates the relationship between morally injurious experiences and suicide ideation among combat veterans. Method: This analysis examined 564 participants in the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of U.S. military veterans, who reported a history of deployment to a combat zone. Multivariable logistic regressions examined interactions between morally injurious experiences and global meaning as predictors of the likelihood of current suicide ideation. Results: There were significant interactions between global meaning and 2 morally injurious experience subtypes-transgressions by others and betrayal experiences. Higher global meaning was associated with significantly lower likelihood of experiencing suicide ideation at higher levels of transgression by others and betrayal experiences. Conclusions: Veterans who report higher levels of morally injurious experiences involving transgressions by others and betrayal experiences in the presence of higher levels of global meaning are significantly less likely to experience suicide ideation. Continued research is needed to determine whether interventions aimed at cultivating global meaning may help mitigate suicide risk in combat veterans with high exposure to certain potentially morally injurious experiences. Clinical Impact StatementThe current study provides evidence that having a greater sense of global meaning in life (i.e., general beliefs, goals, and sense of purpose in life) is associated with lower likelihood of reporting suicide ideation among U.S. combat veterans with exposure to morally injurious experiences involving witnessing transgressions by others and betrayal. This information may be of use to those who seek to further understand experiences that place combat veterans at increased risk for suicide, and to develop interventions aimed at reducing suicide risk in this population.

The studies presented compare two methodologies for categorizing suicidal patients based on clinical data. Discussion follows regarding implications for risk assessment and treatment. In these studies, 52 outpatient subjects were placed into different groups based on coding their "suicidal motivation" (Study 1) and their "internal struggle" ratings (Study 2) using data collected at intake. Self-report ratings of 6 Suicide Status Form (SSF) Core Constructs (Psychological Pain, Stress, Agitation, Hopelessness, Self-Hate, and Overall Risk of Suicide) recorded both at intake and at completion of treatment were then compared to determine differences in Core Construct ratings among groups at different time points. In Study 1, overall differences among motivation groups (Life-motivated, Ambivalent, and Death-motivated) were significant for ratings at treatment completion of Overall Risk of Suicide, Self-Hate, and Psychological Pain. In Study 2, overall differences among groups (Wish to live, Ambivalent, and Wish to die) were significant for ratings at intake of Overall Risk of Suicide. At completion of treatment, overall differences among groups were significant for ratings of Overall Risk of Suicide, Hopelessness, and Self-Hate. In addition, significant interactions were found between test time and group for Overall Risk of Suicide and Self-Hate. Results suggest that categorizing suicidal patients by motivation and by the nature of their internal struggle could be beneficial to differential risk assessment with implications for clinical treatment.