PTSD and moral injury represent separate constructs with unique signs and symptoms. The combination of PTSD and moral injury confers increased risk for suicidal thoughts and behaviors, and differentiates between military personnel who have attempted suicide and those who have only thought about suicide. (PsycINFO Database Record

In the absence of conceptual models that explicitly incorporate protective factors for suicide, research focused on understanding the contributors and causes of suicide among military personnel and veterans has largely overlooked factors that may reduce risk in this population. One proposed protective factor is spirituality, but the mechanisms by which spirituality reduces risk remain unknown. Research suggests that existential aspects of spirituality such as meaning in life and the capacity to forgive oneself for perceived transgressions may reduce risk more so than explicitly religious aspects of spirituality such as belief in a higher power or deity. Preliminary evidence suggests that interventions and treatments that foster personal meaning and selfcompassion in addition to reducing guilt, shame, and self-deprecation can reduce suicidal behavior among military personnel and veterans. Additional research is needed to understand why, how, and for whom spirituality influences suicide risk.

[Correction Notice: An Erratum for this article was reported in Vol 9(4) of (see record 2016-54154-001). In the article, the names of authors Adil Alaoui and Anas Belouali were misspelled as Adil Aloui and Anas Beloui respectively. All versions of this article have been corrected.] Veterans suffering from posttraumatic stress disorder (PTSD) may avoid or fail to follow through with a full course of face-to-face mental health treatment for a variety of reasons. We conducted a pilot effectiveness trial of an online intervention for veterans with current PTSD to determine the feasibility, safety, and preliminary effectiveness of an online writing intervention (i.e., Warriors Internet Recovery & EDucation [WIRED]) as an adjunct to face-to-face psychotherapy. Veterans ( 34) who had served in Iraq or Afghanistan with current PTSD subsequent to deployment-related trauma were randomized to Veterans Affairs (VA) mental health treatment as usual (TAU) or to treatment as usual plus the online intervention (TAU + WIRED). All research participants were recruited from the Trauma Services Program, VA Medical Center, Washington, DC. They completed baseline assessments as well as assessments 12 weeks and 24 weeks after the baseline assessment. The online intervention consisted of therapist-guided writing, using principles of prolonged exposure and cognitive therapy. The intervention was adapted from an evidence-based treatment used in The Netherlands and Germany for individuals who had been exposed to nonmilitary traumas. In addition to showing that the online intervention was both feasible to develop and implement, as well as being safe, the results showed preliminary evidence of the effectiveness of the TAU + WIRED intervention in this patient population, with particular evidence in reducing PTSD symptoms of hyperarousal. With minor modifications to enhance the therapeutic alliance, this intervention should be tested in a larger clinical trial to determine whether this method of online intervention might provide another alternative to face-to-face treatment for veterans with PTSD. (PsycINFO Database Record

Daily administration of CPT is associated with significant reductions in PTSD and suicide ideation.