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Targeting problem-solving with a cognitive remediation intervention for suicide prevention in veterans: A pilot study
Kim E Goldstein1, Alice Medalia2, Emily R Nicholas2
1Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Summary
This study shows that a 10-week cognitive remediation program (NEAR-SB) is feasible and acceptable for veterans with major depressive disorder and suicidal behavior. The program improved clinical, cognitive, and adaptive functioning, suggesting potential for suicide risk reduction.
Area of Science:
- Clinical Psychology
- Neuroscience
- Psychiatry
Background:
- Major depressive disorder (MDD) and suicidal behavior (SB) are associated with specific cognitive deficits.
- Cognitive remediation (CR) has not been previously studied for suicide risk reduction in this population.
- There is a need for effective interventions to address cognitive impairments and reduce suicide risk in veterans with MDD and SB.
Purpose of the Study:
- To evaluate the feasibility and acceptability of a brief, group-based CR program (NEAR-Suicidal Behavior or NEAR-SB) adapted for veterans with MDD and SB.
- To assess the outcomes of the NEAR-SB program on suicidal ideation/behavior, depression, adaptive functioning, and problem-solving.
- To explore the relationship between improvements in problem-solving and reductions in depression.
Main Methods:
- A 10-week, group-based, remotely-delivered CR program (NEAR-SB) was implemented.
- Nine US Veteran outpatients with MDD and SB participated in 20 sessions.
- Feasibility and acceptability were assessed via engagement, satisfaction, fidelity, and retention. Outcomes were measured pre-treatment, post-treatment, and at 10-week follow-up.
Main Results:
- The NEAR-SB program demonstrated feasibility and acceptability, with good engagement, satisfaction, fidelity, and retention.
- Participants showed significant improvements in clinical, cognitive, and adaptive functioning at post-treatment and 10-week follow-up.
- Enhanced problem-solving skills post-treatment were correlated with greater reductions in depressive symptoms.
Conclusions:
- The NEAR-SB program is a feasible and acceptable intervention for veterans with MDD and SB.
- The program shows promise for improving cognitive and adaptive functioning and potentially reducing suicide risk.
- Pilot data support further investigation via a randomized clinical trial to confirm efficacy and explore a control condition.
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