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Changes in suicidal ideation following cognitive processing therapy in a VA residential treatment program

APA Citation:

Stayton, L. E., Martin, C. E., Pease, J. L., & Chard, K. M. (2019). Changes in suicidal ideation following cognitive processing therapy in a VA residential treatment program. Military Psychology, 31(4), 326-334. https://doi.org/10.1080/08995605.2019.1630230

Abstract Created by REACH:

With a daily average of 20 deaths by suicide among Veterans (p. 326), it is important to understand the risk factors that contribute to suicide. Post-traumatic stress disorder (PTSD), which is prevalent among Veterans, has been linked to increased levels of suicidal ideation (i.e., thoughts about or plans for suicide). Evidence-based therapies, such as cognitive processing therapy, have been used in residential facilities to address PTSD symptomology; thus, suppositions were that this therapy might also address suicidal ideation. This study examined the impact of participation in cognitive processing therapy within the context of a residential treatment program on suicidal ideation, and assessed whether treatment outcomes were similar among Veterans based on various sociodemographic factors, including sex, age, race/ ethnicity, and marital status. 303 Veterans completed pre-, mid-, and post-assessments measuring suicidal ideation over the course of a seven-week residential treatment program. Findings suggest that suicidal ideation decreased across the course of treatment and was similarly effective for Veterans with varying sociodemographic characteristics.


Mental health

Branch of Service:

Air Force
Marine Corps
Multiple branches

Military Affiliation:


Subject Affiliation:



Adolescence (13 - 17 yrs)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)


Longitudinal Study
Quantitative Study


Stayton, Laura E., Martin, Colleen E., Pease, James L., Chard, Kathleen M.


In 2015, suicide accounted for over 44,000 deaths and was the 10th leading cause of mortality in the US. Although Veterans, in general, are at a high risk for suicide, Veterans with Posttraumatic Stress Disorder (PTSD) are at even greater risk. While evidence suggests that PTSD symptoms are reduced by Cognitive Processing Therapy (CPT), little is known about how this treatment impacts changes in suicidal ideation across residential treatment. Studies with active duty personnel have found reductions in suicidal ideation following CPT treatment; however, only one study to date has examined this question in a Veteran sample. The current study examined (a) changes in suicidal ideation across a residential CPT treatment program and (b) the influence of demographic variables on change in suicidal ideation across treatment. Participants (N = 303) were admitted to a residential PTSD treatment in a VA medical center and completed pre-, mid-, and post-treatment assessments. Multilevel modeling of archival data revealed that suicidal ideation significantly decreased over the course of CPT (B = −0.153, SE =0.028, 95%CI =[−0.21, −0.10], t= −5.40, p<.001); however, this change did not differ based on age, marital status, sex, or race/ethnicity. Clinical and research implications are discussed.

Publisher/Sponsoring Organization:

Taylor & Francis

Publication Type:

REACH Publication

Author Affiliation:

Trauma Recovery Center, Cincinnati VA Medical Center, LES
Trauma Recovery Center, Cincinnati VA Medical Center, CEM
Trauma Recovery Center, Cincinnati VA Medical Center, JLP
Trauma Recovery Center, Cincinnati VA Medical Center, KMC
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, KMC


attitude (psychology), change, cognitive therapy, confidence intervals, ethnic groups, evidence-based treatment, human services programs, marital status, post-traumatic stress disorder, psychology of veterans, PTSD, race, residential care, statistical models, suicidal ideation, suicide prevention, treatment of post-traumatic stress disorder, veterans, veterans' hospitals

View Research Summary:

REACH Publication Type:

Research Summary

REACH Newsletter:

  January 2020

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