Fluid vulnerability theory as a framework for understanding the association between posttraumatic stress disorder and suicide: A narrative review

Rugo, Kelsi F.; Kerig, Patricia K.; Crowell, Sheila E.; Bryan, Craig J.

doi:10.1002/jts.22782

Cited by 15 publications

(6 citation statements)

References 132 publications

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“…Research using numerous time points (i.e., weekly) to assess suicidal thoughts and behaviors instead of pre-and posttreatment data points could provide a clearer picture of the overall trend, as well as specific time points of risk. This would provide more granular data on how CPT impacts risk week to week and would also be more in line with the recent understanding of the fluid nature of suicide risk over time, particularly in individuals with PTSD (Rugo-Cook et al, 2021). Analysis of weekly sessions may have important associations with risk.…”

Section: Future Researchmentioning

confidence: 66%

Impact of residential PTSD treatment on suicide risk in veterans

Pease

Martin

Rowe

et al. 2022

Suicide & Life Threat Behav

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Introduction In 2019, 17 veterans died by suicide every day. Various suicide prevention treatments have emerged, yet limited research has explored the impact of Post Traumatic Stress Disorder (PTSD) treatment on suicidal ideation and behaviors. Methods This study examines the impact of Cognitive Processing Therapy (CPT) on suicidal ideation among veterans in three residential PTSD programs (women's, men's, and PTSD/Traumatic Brain Injury). Interview and self‐report data were collected from veterans (n = 446) throughout treatment. Results Over 50% of veterans reported current suicidal ideation and a history of suicide attempts prior to treatment. Variables that predicted change in suicidal ideation included prior suicide attempt (β = 0.21, p = 0.022), change in CAPS‐5 total score (β = 0.28, p = 0.038), employment status (β = −0.20, p = 0.035) and history of suicide attempt (β = 0.25, p = 0.009). Those without a previous suicide attempt made greater gains in CPT treatment than those with a previous suicide attempt. Conclusion Following 7 weeks of CPT residential treatment, a decrease in PTSD symptoms was significantly associated with a reduction in suicidal ideation. Implications are that CPT can reduce suicide risk in a variety of Veteran cohorts with differing trauma types.

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Section: Future Researchmentioning

confidence: 66%

Impact of residential PTSD treatment on suicide risk in veterans

Pease

Martin

Rowe

et al. 2022

Suicide & Life Threat Behav

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“…The fluid-vulnerability theory-a diathesis-stress model provides a framework for examining suicidal behaviors as a dynamic construct and may serve as a framework for the development of interventions for suicide prevention and aid clinicians in predicting one at high risk for a suicide. (24,25) In the model, predisposition or baseline risk (e.g., prior suicide attempts, adverse childhood experiences, and genetic vulnerabilities) are exacerbated by environmental triggers (e.g., relationship problems, trauma, death of a loved one, financial stress, job loss) which leads to "the suicidal mode", which consists of cognitive, behavioral, emotional and physiological domains that are actionable targets for intervention.…”

Section: Discussionmentioning

confidence: 99%

Recent Stressful Experiences and Suicide Risk: Implications for Suicide Prevention and Intervention in U.S. Army Soldiers

Dempsey

Benedek

Zuromski

et al. 2023

PRCP

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Objectives To identify the extent to which the presence of recent stressful events are risk factors for suicide among active‐duty soldiers as reported by informants. Methods Next‐of‐kin (NOK) and supervisors (SUP) of active duty soldiers (n = 135) who died by suicide and two groups of living controls: propensity‐matched (n = 128) and soldiers who reported suicidal ideation in the past year, but did not die (SI) (n = 108) provided data via structured interviews from the Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Multivariate logistic regression analyses were used to create a risk score for suicide. Results The odds of suicide increased significantly for soldiers experiencing relationship problems, military punishment, and perceived failure or humiliation in the month prior to death. Suicide risk models with these risk factors predicted suicide death among those who reported SI in the past year (OR = 5.9, [95% CI = 1.5, 24.0] χ2 = 6.24, p = 0.0125, AUC, 0.73 (0.7, 0.8) NOK) and (OR = 8.6, [95% CI = 1.4, 51.5] χ2 = 5.49, p = 0.0191, AUC, 0.78 (0.7, 0.8); SUP) suggesting the combination of these recent stressors may contribute to the transition from ideation to action. Conclusions Our findings suggest for the first time recent stressors distinguished suicide ideating controls from suicide decedents in the month prior to death as reported by informants. Implications for preventive intervention efforts for clinicians, supervisors and family members in identifying the transition from ideation to action are discussed.

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“…Quite often, military members are required to serve in combat for multiple rotations, which can indicate repeated exposure to trauma. With rates of PTSD being twice as high in military populations than in civilians (13.8% versus 6.8%), it is especially important to study the relationship between PTSD and suicidality among service members and veterans (Bullman et al, 2019;Rugo-Cook et al, 2021).…”

Section: Ptsd and Suicidal Ideationmentioning

confidence: 99%

Affective Depression Mediates PTSD to Suicide in Sample of Post-9/11 Combat Veterans

Kuzmina,

Switzer,

Ponder

et al. 2023

Journal of Veterans Studies

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Combat veterans are at high risk for suicide; consequently, it is paramount to examine factors that may relate to lower levels of suicide among this population. This study examined if somatic depression or affective depression symptoms mediate the relationship between posttraumatic stress disorder (PTSD) and suicidal behaviors in a treatment-seeking sample of post-9/11 combat veterans. Fluid Vulnerability Theory was utilized as a theoretical framework. We conducted two PROCESS simple mediation models with PTSD as the predictor, affective depression and somatic depression as the mediators, and suicidality as the dependent variable, while controlling for generalized anxiety. We found that affective depression significantly mediated the relationship between PTSD and suicidal behaviors, while somatic depression symptoms did not. In both simple mediation models, the direct effect of PTSD to suicidal behaviors was significant. This study provides a unique perspective on suicidal behavior in combat veterans and offers insights into the nature of mediating relationships between affective depression and somatic depression and suicidal behavior.

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Fluid vulnerability theory as a framework for understanding the association between posttraumatic stress disorder and suicide: A narrative review

Cited by 15 publications

References 132 publications

Impact of residential PTSD treatment on suicide risk in veterans

Impact of residential PTSD treatment on suicide risk in veterans

Recent Stressful Experiences and Suicide Risk: Implications for Suicide Prevention and Intervention in U.S. Army Soldiers

Affective Depression Mediates PTSD to Suicide in Sample of Post-9/11 Combat Veterans

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