Executive Dysfunction and Suicide in Psychiatric Outpatients and Inpatients

NCT ID: NCT01043432

Last Updated: 2015-05-12

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 133 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2010-06-30
• Study Completion Date: 2014-07-31

Brief Summary

Those with traumatic brain injury (TBI) are at increased risk for suicidal behavior, and suicidality is associated with executive dysfunction. In the aim of highlighting an important risk factor, this study will assess decision making in the context of an interaction between suicide and TBI. Findings will also allow for exploratory analyses aimed at identifying associations between performance on measures of executive functioning and psychological distress. The long-term objective of this study is to increase understanding regarding executive dysfunction, as a multidimensional construct, with the ultimate goal of conceptualizing assessment tools and interventions aimed at decreasing suicidality in the at-risk population of veterans with a history of TBI.

Detailed Description

Recent studies indicate that veterans who engage in suicidal behavior have a history of traumatic brain injury (TBI), and veterans with a history of TBI engage in suicidal behavior. Existing research also suggests an association between suicidality and executive dysfunction (e.g., impaired decision making). To date a clearly defined study has not been conducted to explore the relationship between executive dysfunction as a multidimensional construct (i.e., decision making, impulsivity, concept formation, and aggression) and suicidal behavior in the vulnerable population of those with a history of moderate to severe TBI. Increased understanding regarding this at-risk population is necessary to facilitate the creation of appropriate assessment strategies and interventions. This study will assess decision making in the context of an interaction between suicide and TBI. Findings will also allow for exploratory analyses aimed at identifying associations between performance on measures of executive functioning and psychological distress. Toward this end, the present study seeks to compare test performance among four well-defined groups of veterans: (1) those with moderate to severe TBI and a history of suicidal behavior; (2) those with moderate to severe TBI and no history of suicidal behavior; (3) those with no TBI and a history of suicidal behavior; (4) and those with no TBI and no history of suicidal behavior. This grant proposal is in direct support of the Rehabilitation Research and Development goal of maximizing functional recovery in those with TBI by potentially: 1) increasing clinicians' ability to identify neuropsychological correlates of suicidal behavior for those with moderate to severe TBI; 2) identifying psychometrically sound measures of executive functioning that correspond to real-life behaviors that impact treatment response and recovery; 3) facilitating the creation of innovative assessment techniques and psychosocial interventions (e.g., safety planning) to minimize complications in the management of suicidal behavior due to TBI-related impairments; and 4) creating a basis for further and much-needed research in this area. Ultimately, findings from this study would both contribute to clinicians' ability to identify veterans with TBI who are at risk for suicidal behavior, and create a foundation on which to base further research regarding the relationships between cognition, emotional distress, and suicidality in TBI survivors.

Conditions

Traumatic Brain Injury; Suicidality

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

Moderate/severe TBI and history of suicidal behavior Group 1

Moderate/severe TBI and history of suicidal behavior

No interventions assigned to this group

Moderate/Severe TBI and no history of suicidal behaviorGroup

Moderate/Severe TBI and no history of suicidal behavior

No interventions assigned to this group

No TBI and a history of suicidal behavior Group 3

No TBI and a history of suicidal behavior

No interventions assigned to this group

No TBI and no history of suicidal behavior Group 4

No TBI and no history of suicidal behavior

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

• Age between 18 and 65
• Ability to provide adequate effort (CARB score of Type 1 or 2)
• Determination of positive or negative history of moderate or severe TBI
• Determination of positive or negative history of suicidal behavior
• Ability to adequately respond to questions regarding the informed consent procedure

Exclusion Criteria

• Diagnosis of neurological conditions other than moderate or severe TBI
• Inability to adequately respond to questions regarding the informed consent procedure
• Inability to provide adequate effort (CARB score of Type 3 or 4)
• History of a psychotic or bipolar I mood disorder
• History of drug or alcohol abuse in the past 7 days
• Participating in another study in which the results of this study may be impacted
• History of non-alcohol substance abuse within the last 30 days as identified on the SCID substance use module
• History of same-day drug or alcohol abuse as identified on the UWRAP pre-administration questionnaire Veterans who report using substances the day of the study visit will be placed on hold and will be rescreened in 30 and 60 days
• History of mild TBI only

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

US Department of Veterans Affairs

FED

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Lisa Anne Brenner, PhD

Role: PRINCIPAL_INVESTIGATOR

VA Eastern Colorado Health Care System, Denver

Locations

VA Eastern Colorado Health Care System, Denver

Denver, Colorado, United States

Countries

United States

Other Identifiers

D7210-R

Identifier Type: -

Identifier Source: org_study_id