Research Education Summit Bios and Abstracts
December 13, 2013
DoD/VA Suicide Prevention Education
Summit: Innovative Practices in Research
Bios and Abstracts
Table of Contents
SYNOPSIS .................................................................................................................................................... 3
Title: Innovative Practices in Research ..................................................................................................... 3
OPENING REMARKS ................................................................................................................................. 3
KEYNOTES ................................................................................................................................................. 4
Title: State of Innovation on Suicide Intervention Research with Veteran Populations ........................... 4
Title: An Overview of the Defense Advanced Research Project Agency’s (DARPA) Detection and
Computational Analysis of Psychological Signals (DCAPS) Program .................................................... 5
ARMY STUDY TO ASSESS RISK AND RESILIENCE (STARRS) ........................................................ 6
Title: Assessing Risk and Protective Factors for Suicide in US Army Soldiers: The Army STARRS
Study Michael Schoenbaum, PhD National Institute of Mental Health ................................................... 6
BEHAVIORAL AND SOCIAL HEALTH OUTCOMES PROGRAM ....................................................... 6
Title: Suicidal Behavior in the US Army: What’s Changed? ................................................................... 7
Title: Army's Continual Improvement of Suicidal Behavior Surveillance Data Collection for the
Department of Defense Suicide Event Report (DoDSER) ....................................................................... 7
Title: Focus Groups: A Qualitative Approach to Understanding Suicide and Accidental Death in HighRisk Service Member Populations ............................................................................................................ 8
PROMISING INTERVENTIONS WITH VETERAN POPULATIONS ..................................................... 9
Title: Discussion of models for evaluating public education campaigns and an evaluation of outcomes
associated with VA-sponsored suicide prevention messaging.................................................................. 9
Title: Altitude as an Environmental Risk Factor for Suicide: Implications for Improving Mental Health
Outcomes in Veterans with Hypoxic Conditions .................................................................................... 10
Title: Window to Hope: A Psychological Intervention for Hopelessness Among Veterans with
Traumatic Brain Injury ........................................................................................................................... 11
WORKING LUNCH EXHIBITS ............................................................................................................... 12
Title: VISN 2 CoE SP; VISN 19 MIRECC ............................................................................................ 12
Title: The Durkheim Project ................................................................................................................... 12
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Research Education Summit Bios and Abstracts
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Title: Medical Informatics and Analysis Toolkit .................................................................................... 13
Title: Cogito Dialog and VetGuard ......................................................................................................... 14
BRIEF INTERVENTIONS ........................................................................................................................ 15
Title: An Overview of the Military Suicide Research Consortium......................................................... 15
Title: Brief Interventions for Short-term Reductions in Suicide Risk among Suicidal Military Personnel
................................................................................................................................................................ 16
SAFETY PLANNING ................................................................................................................................ 16
Title: Safety Planning for the Military (SafeMil) to Reduce Suicide Risk for Military Service members
................................................................................................................................................................ 16
INTEGRATING RESEARCH INTO PRACTICE ..................................................................................... 17
Title: Marine Corps Behavioral Health Integrated Research Agenda..................................................... 17
ENABLERS OF INNOVATIVE SUICIDE RESEARCH ......................................................................... 18
Title: An Introduction to the Joint DoD/VA Suicide Data Repository ................................................... 18
Title: The Person-Event Data Environment (PDE): Leveraging Existent Data for Suicide Prevention
Studies ..................................................................................................................................................... 19
CLOSING REMARKS ............................................................................................................................... 20
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Research Education Summit Bios and Abstracts
December 13, 2013
SYNOPSIS
Title: Innovative Practices in Research
Context: As the topic of suicide among military and veteran populations becomes more visible,
the need for evidence-based approaches and solutions becomes stronger. In the past 5 years, the
Departments of Defense (DoD) and Veterans Affairs (VA) have devoted a significant amount of
resources towards understanding and addressing the challenge of military and veteran suicide.
Some of these resources have been devoted to research, which has improved our overall
understanding of risk factors and interventions. Despite this progress, recent DoD and VA
statistics on suicide show that the challenge remains. As a result, senior leaders, policy makers,
and program planners may need to consider new and different suicide prevention approaches. In
order to ensure these approaches are sound, these officials will need input from the research
community in order to produce innovative solutions with potentially lasting effects.
Purpose: This research education summit is intended to highlight studies of promising and
evidence-based approaches, interventions, tools, and practices. The summit is not intended to be
comprehensive of all military and veteran suicide research. Instead, it will focus on those studies
that introduce a new or different theory, methodology, technology, or practice, relevant to the
suicide research domain but not previously explored in significant ways.
Learning Objectives:
1. Demonstrate breakthrough innovations in suicide prevention technology and
measurement to enable new and more robust prevention activities and research studies
2. Explain the multi-modal nature of suicide prevention and the need for new measures that
reflect multiple modalities.
3. Present newly identified risk factors for suicide and the need to modify tracking of such
risk factors.
4. Demonstrate the efficacy of brief, practical preventive and crisis interventions.
OPENING REMARKS
Presenter: Ms. Jacqueline Garrick, LCSW-C, BCETS; Department of Defense Suicide
Prevention Office (DSPO)
Bio: Jacqueline Garrick is an expert in suicide prevention, policy, counseling, therapy, posttraumatic stress disorder, and numerous other disciplines. Ms. Garrick is the Director for DSPO.
She was appointed to the Department of Defense first as the Principal Director of the Wounded
Warrior Care and Transition Policy (WWCTP) Office in 2009 and then assigned to be the
Special Assistant in Reserve Affairs to oversee Resiliency, Readiness and Suicide Prevention.
She has had responsibility for Recovery Care, Transition Assistance, Disability Evaluation and
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National Guard/Reserve Suicide Prevention activities in the community. Prior to that, she served
on the House Committee on Veterans’ Affairs as a Professional Staff Member to assist the
Disability Assistance and Memorial Affairs Subcommittee hold hearings and draft legislation on
such issues as stressor evaluations, benefits outreach, and information technology. Ms. Garrick
is involved with many professional and civic organizations, and was the editor of Trauma Lines
for six years. After September 11, she was a disaster mental health counselor at the Pentagon
Family Assistance Center. She also ran her own consulting practice for four years, the
FARgroup, and provided policy analysis, strategic planning, fundraising, program development
and evaluation support to nonprofit, private and government entities. She has presented on PostTraumatic Stress Disorder (PTSD) throughout the United States, Germany, Great Britain,
Turkey, Russia, the Ukraine, Israel, and the Netherlands.
KEYNOTES
Title: State of Innovation on Suicide Intervention Research with Veteran
Populations
Presenter: Dr. Kenneth Conner, PsyD, Veterans Integrated Service Network (VISN) 2 Center of
Excellence on Suicide Prevention (CoE SP)
Bio: Dr. Kenneth Conner, PsyD, MPH, is Director of the VA VISN 2 Center of Excellence for
Suicide Prevention, and Associate Professor of Psychiatry and Co-Director of the Center for the
Study and Prevention of Suicide at the University of Rochester Medical Center. He conducts
clinical- and epidemiological research on suicidal behavior with a focus on the role of drinking
and alcohol use disorders. He has methodological expertise in postmortem research, record
abstraction, the study of stressful life events and meta-analysis. He was Chair of the SAMHSA
Center for Substance Abuse Treatment panel that developed Treatment Improvement Protocol
number 50 (TIP 50) entitled “Addressing Suicidal Thoughts and Behaviors in Substance Abuse
Treatment.” He received the Edwin Shneidman Award from the American Association of
Suicidology for his research.
Abstract: Dr. Conner will discuss innovations in new, ongoing, and recently completed suicide
intervention research with Veterans. He will examine novel adaptations of evidence based
treatments (e.g., motivational interviewing) and use of nontraditional strategies for participant
recruitment (e.g., social media), treatment delivery (e.g. phone/text), and choice of setting (e.g.,
home visits). Informed by a public health framework, he will further discuss the need for suicide
intervention research to be conceptualized more broadly including the development and
evaluation of treatments that are designed to affect multiple outcomes and/or to alter trajectories
prior to the onset of suicidal behavior. Along these lines, he will also discuss the importance of
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exploring the impact of interventions that are not designed to affect suicide per se (e.g.,
workforce preparation for new Veterans) but may be theorized to influence intermediate- and
long-term suicide outcomes.
Title: An Overview of the Defense Advanced Research Project Agency’s (DARPA)
Detection and Computational Analysis of Psychological Signals (DCAPS) Program
Presenter: CAPT Russell D. Shilling, Ph.D.; DARPA, Information Innovation Office
Bio: CAPT Shilling joined DARPA as a Program Manager in April 2010. His focus is on
information technology-based tools in support of military psychological health and in gamebased approaches to Science, Technology, Engineering, and Mathematics (STEM) education.
CAPT Shilling is an Aerospace Experimental Psychologist in the Navy's Medical Service Corps.
He joins DARPA after formerly helping establish the Defense Centers of Excellence for
Psychological Health and Traumatic Brain Injury as Executive Director - Science & Technology.
Since 2007, CAPT Shilling has developed programs with Sesame Street® to help children and
families learn to adjust to multiple deployments, injured family members, and the loss of a loved
one. In 2005, he applied his modeling and simulation background to the psychological health
arena by creating a program at the Office of Naval Research (ONR) to use Virtual Reality for
treatment of post-traumatic stress disorder. As part of his Navy R&D work, CAPT Shilling has
worked closely with THX®, Lucasfilm Skywalker Sound®, Dolby Interactive®, Creative
Labs®, Sesame Workshop® and various videogame developers. Dr. Shilling received his
Doctor of Philosophy in Experimental Psychology (Auditory Psychophysics/Neuroscience) from
the University of North Carolina at Greensboro in 1992 and his Bachelor of Arts in Psychology
at Wake Forest University in 1985. His military decorations include the Defense Superior
Service Medal, Meritorious Service Medal (three awards), the Navy Commendation Medal, and
the Navy Achievement Medal. He is also the recipient of the American Hospital Association's
2009 Executive Award for Excellence.
Abstract: The DCAPS program aims to develop novel analytical tools to assess psychological
status of Service members with the goal of improving psychological health awareness and
enabling them to seek timely help. DCAPS tools are being developed to analyze patterns in
everyday behaviors to detect subtle changes associated with PTSD, depression and suicidal
ideation. In particular, DCAPS strives to advance the state-of-the-art in extraction and analysis
of "honest signals" from a wide variety of sensory data inherent in daily social interactions.
DCAPS is not aimed at providing an exact diagnosis, but at providing a general metric of
psychological health. DCAPS tools to be presented during this Summit are developed by Cogito
Health, Inc. and Raytheon-BBN.
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ARMY STUDY TO ASSESS RISK AND RESILIENCE (STARRS)
Title: Assessing Risk and Protective Factors for Suicide in US Army Soldiers: The
Army STARRS Study Michael Schoenbaum, PhD National Institute of Mental
Health
Presenter: Dr. Michael Schoenbaum, PhD; National Institute of Mental Health (NIMH), Office
of the Director at the National Institute of Mental Health (ODNIMH), Office of Science Policy,
Planning and Communications (OSPC)
Bio: Michael Schoenbaum (PhD in Economics, University of Michigan, 1995) is Senior Advisor
for Mental Health Services, Epidemiology, and Economics in the NIMH OPSC. In that capacity,
he directs a unit charged with conducting analyses of mental health burden, service use and
costs, intervention opportunities, and other policy-related issues, in support of Institute decisionmaking. His responsibilities also include helping to strengthen NIMH's relationships with outside
stakeholders, both public and private, to increase the public health impact of NIMH-supported
research. Prior to joining NIMH, Dr. Schoenbaum spent nine years at the RAND Corporation,
where his work included studies of the feasibility and consequences of improving care for
common mental disorders, particularly depression; studies of the social epidemiology and
economic consequences of chronic illness and disability; design and evaluation of decisionsupport tools to help consumers make health benefits choices; and international health sector
development projects. Dr. Schoenbaum was a Robert Wood Johnson Scholar in health policy at
the University of California, Berkeley, from 1995-1997.
Abstract: Army STARRS (http://www.armystarrs.org) is the largest study of mental health risk
and resilience ever conducted among military personnel. Army STARRS investigators are
looking for factors that help protect a Soldier’s mental health and factors that put a Soldier’s
mental health at risk. Army STARRS investigators are using five separate study components two retrospective and three prospective - to identify factors that are associated with higher (and
lower) risk of fatal and non-fatal suicide events and other relevant outcomes. Army STARRS is
a five-year study that will run through 2014; however, research findings are reported as they
become available so that they may be applied to ongoing health promotion, risk reduction, and
suicide prevention efforts. Findings are being reported as they become available, so that the
Army may apply them to its ongoing health promotion, risk reduction, and suicide prevention
efforts.
BEHAVIORAL AND SOCIAL HEALTH OUTCOMES PROGRAM
Presenters & Co-authors’ Affiliation: US Army Public Health Command, Army Institute of
Public Health (AIPH, Behavioral and Social Health Outcomes Program (BSHOP)
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Title: Suicidal Behavior in the US Army: What’s Changed?
Presenter: Ms. Anita Spiess, MSPH
Presenter Bio: Anita Spiess, MSPH, is a behavioral health epidemiologist at BSHOP where she
leads analyses pertaining to suicidal behavior. She is a lead author of BSHOP’s Surveillance of
Suicidal Behavior publications and has contributed to a variety of presentations and abstracts
characterizing various aspects of suicidal behavior among Soldiers the US Army. In addition, Ms
Spiess provides subject matter expertise on the Army Behavioral Health Integrated Environment
(ABHIDE), helping to determine the feasibility of data analyses using the 25-plus disparate
administrative data sources that make up the ABHIDE. Ms Spiess received her MSPH from the
University of Miami where she studied the prevalence of heavy and binge drinking among
workers in different occupational groups.
Co-Authors: Dr. Eren Youmans Watkins, PhD, MPH; Dr. Amy Millikan Bell, MD MPH
Abstract: A key question in epidemiological surveillance is whether the population affected or
the behavior of that population has changed over time. Suicidal behavior appears to change little
from year to year. BSHOP grouped years into three periods (2004–2007, 2008–2009, 2010–
2012) based on increases in the crude suicide rate and secular trends across the force (e.g.,
combat operations, changes in accession policy, initiation of suicide prevention initiatives).
Statistical comparisons using chi-squared analysis examined changes in the distribution of
demographic, military, behavioral health, and other characteristics of Soldiers with suicidal
behavior across these periods. Results show increases in the proportions aged 25–34, married,
noncommissioned officers, with 2 or more deployments, previous behavioral health diagnoses,
pain or sleep problems, poly-pharmacy, as well as screened and enrolled in the Army Substance
Abuse Program.
Title: Army's Continual Improvement of Suicidal Behavior Surveillance Data
Collection for the Department of Defense Suicide Event Report (DoDSER)
Presenters: Mr. John Wills, BSIFSM; MAJ Clifton Dabbs, DO, MPH
Presenter Bios: John Wills is the Army DoDSER Program Manager in the BSHOP. Mr. Wills
received his degree from the University of Maryland where he studied the creation and
management of Information Systems. In addition to managing the Army DoDSER program, Mr.
Wills also works extensively with the ABHIDE, serving as the ABHIDE data manager, helping
to assure the ABHIDE is maintained to support BSHOP epidemiologists in their mission to
conduct surveillance and assessment of leader-prioritized behavioral health outcomes. Mr. Wills
also supports the collection of data for the Army STARRS project, helping to assure the
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STARRS analysts receive the data required to support their study of risk factors and Soldiers’
mental health.
MAJ Clifton Dabbs received his bachelor’s degree in Biology/Chemistry from the University of
Mississippi in 1995 and then went on to receive his Osteopathic medical degree from the
University of Health Sciences in 2001. Dr. Dabbs then completed a transitional internship at the
University of Mississippi before entering the Army on Active Duty in February 2003. Dr. Dabbs
was stationed at Walter Reed Army Medical Center (WRAMC) for the next 7 years. During that
time he also worked at the Walter Reed Army Institute of Research. During his time at
WRAMC he was deployed with the 10th Mountain Division to Iraq as part of Operation Iraqi
Freedom in 2004. In 2009 Dr. Dabbs received his Masters in Public Health from the Uniformed
Services University. In 2010 he joined the Behavioral and Social Health Outcomes Program
(BSHOP) which is part of the Army Institute of Public Health under the United States Army
Public Health Command. He currently serves as a clinical consultant and epidemiologist in
BSHOP for numerous issues to include suicide, poly-pharmacy, alcohol abuse, and sexual
assault.
Co-author: Dr. Amy Millikan Bell, MD MPH
Abstract: The Department of Defense Suicide Event Report (DoDSER) program is a
collaborative effort among the DoD, Air Force, Army, Marine and Navy stakeholders with a
history that spans over a decade. Each service manages its respective DoDSER program. The
Army DoDSER program is managed by BSHOP in collaboration with the National Center for
Telehealth and Technology (NCT2). The BSHOP tracks suicidal behavior events to ensure
timely reporting, performs quality assurance reviews, interfaces with NCT2 for technical issues,
and analyzes Army DoDSER data. The Army DoDSER program has evolved significantly over
the past years and is now focused on continually improving the quality of information contained
in the DoDSER across all COMPOS. Current initiatives include alignment of Army Regulations
600-63 and 600-24, and US Army Medical Command policy with the Vice Chief of Staff of the
Army’s Ready and Resilient campaign (R2C).
Title: Focus Groups: A Qualitative Approach to Understanding Suicide and
Accidental Death in High-Risk Service Member Populations
Presenters: Ms. Shelley Schmissrauter, MPH; Dr. Alexis Bender, PhD;
Presenter Bios: Alexis A. Bender is a Senior Social Scientist for the BSHOP. Dr. Bender is the
social science (qualitative) cell lead of the Field Studies section and has participated in the
design, implementation, and analysis of several behavioral health epidemiological consultations.
She joined BSHOP in 2011 after completing her Ph.D. in sociology from Georgia State
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University where she studied patient-physician interactions and life course transitions and
trajectories following traumatic injury.
Shelley Schmissrauter is a Behavioral Scientist for BSHOP. Since 2010, she has been working
with the Field Studies team to conduct behavioral health epidemiological consultations (BHEPICONs) and examine risk factors for negative behavioral and social health outcomes in Active
Duty military populations. She specializes in the design, implementation, and analysis of data
gathered through qualitative methods. Prior to joining BSHOP, Shelley graduated from Emory
University with a Masters in Public Health. Her professional interests are focused on bettering
the behavioral and social health of various populations and applying qualitative methodology to
better understand strategies for risk mitigation and/or prevention.
Co-authors: Dr. Christine Lagana-Riordan, PHD, LCWS-C; Dr. Amy Millikan Bell, MD MPH
Abstract: In an effort to identify perceived risk factors for suicide among US Service members,
BSHOP uses qualitative focus group methods to elicit the views and experiences of Service
members and other stakeholders during behavioral health epidemiological consultations (BHEPICON). Focus groups are successful in capturing the voice, perceptions, and experiences of
Service members to identify risk factors and inform strategies used to prevent suicide and
mitigate other behavioral health issues in the military. Data from focus groups with Service
members provide insight into perspectives about behavioral health issues not easily accessed
through other sources such as surveys or existing data. In addition to highlighting the use of
focus groups with Service Member populations, this presentation will give examples of study
findings related to suicide and accidental death among high-risk Service members.
PROMISING INTERVENTIONS WITH VETERAN POPULATIONS
Title: Discussion of models for evaluating public education campaigns and an
evaluation of outcomes associated with VA-sponsored suicide prevention messaging
Presenter: Dr. Elizabeth Karras, PhD; VISN 2 CoE SP
Bio: Dr. Karras is a health communication researcher at the VISN 2 CoE SP. Her work largely
focuses on the evaluation of VA public communication programs that promote mental health and
suicide prevention to Veteran populations (e.g., campaigns developed in support of the Veterans
Crisis Line (VCL); Make the Connection public awareness campaign). She currently conducts
assessments of the multilevel effects of these interventions, including examinations of
community-wide changes in attitudes and norms, and the individual-level impact on knowledge,
perceptions and behaviors.
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Abstract: This presentation proposes a paradigm shift in suicide prevention efforts by presenting
a public health communication framework for promoting mental health to Veteran populations,
and focuses on the development of social environments that motivate and support help seeking.
The varying effects of persuasive appeals (e.g., gain vs. loss), message frames (e.g., prevention
vs. promotion), and dissemination strategies (e.g., message primes) on the creation of such
environments will be discussed, and the ways in which information is shared among Veteran
social networks are considered. Finally, implications for the evaluation of public communication
efforts (e.g., public communication campaigns), and examples from the VA’s suicide prevention
public communication program will be reviewed.
Title: Altitude as an Environmental Risk Factor for Suicide: Implications for
Improving Mental Health Outcomes in Veterans with Hypoxic Conditions
Presenter: Dr. Perry Renshaw, MD, PhD, MBA; VISN 19 Mental Illness Research and
Education and Clinical Center (MIRECC), The University of Utah
Bio: Dr. Renshaw is a graduate of the University of Pennsylvania, Perelman School of Medicine.
He also holds a Ph.D. in Biophysics from the University of Pennsylvania and an M.B.A. from
the McCallum Graduate School of Business at Bentley College. Dr. Renshaw was formerly
Director of the McLean Hospital Brain Imaging Center and a Professor of Psychiatry at Harvard
Medical School. In 2008, he relocated to Salt Lake City, where he is currently a Professor of
Psychiatry at the University of Utah and the Medical Director of the VISN 19 MIRECC at the
Salt Lake City Veterans Affairs Medical Center. His training as a biophysicist and psychiatrist
has led to a primary research interest in the use of multinuclear magnetic resonance spectroscopy
(MRS) neuroimaging to identify changes in brain chemistry associated with mood and substance
abuse disorders. More recently, his research team has been exploring the effects of altitude on
mood, neurotransmission, and suicide. This work has led to the identification of and explanation
for the Utah Paradox: Utah is consistently rated as having one of the highest qualities of life and,
at the same time, very high rates of depression and suicide. Dr. Renshaw’s research has been
continuously supported by the National Institutes of Health (NIH) since 1994 and, more recently,
by the VA. He is an author of more than 300 peer reviewed publications and has won numerous
awards for his research, including the American Psychiatric Association’s Smith Kline Beecham
Young Faculty award, the World Psychiatric Association’s Pharmacopsychiatry section prize,
the National Alliance for Research in Shcizophrenia and Affective Disorders’ Gerald L. Klerman
Award for Clinical Research, and the National Institute on Drug Abuse Award for International
Collaborative Research.
Abstract: Active Duty Service members train in and may be deployed to areas of increased
altitude (e.g. Afghanistan). Studies of Marines who train at the Mountain Warfare Center
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(altitude 6,400 feet) for 90 days demonstrate significantly worsened mood states that persist for
at least 90 days after return to sea level. In the United States, regional variations in suicide rates
have been present for several decades, with the Rocky Mountain region showing the highest
suicide rates. However, the association of suicide with altitude persists when the Rocky
Mountain states are removed from the analysis, indicating that the phenomenon is not specific to
this region. We have recently reported that there is a strong correlation between suicide rates
and local elevations in the United States and similar relationships have been observed in Austria
and South Korea. Increased altitude is associated with hypobaric hypoxia and we have
constructed a hypobaric chamber to support animal studies. Female rats exposed to mild degrees
of simulated altitude demonstrate progressive increases in depression like behavior and, in
parallel, reductions in brain serotonin, a neurotransmitter that critically mediates mood. Using
this same model system, we have found that the animals’ behavior does not respond as expected
to the serotonin specific reuptake inhibitors (SSRIs) fluoxetine and paroxetine. We hypothesize
that this is due to the altitude-mediated reduction in brain serotonin levels and have begun
investigating the efficacy of the immediate serotonin precursor, 5-hydroxytryptophan (5-HTP),
which is an approved nutritional supplement in the United States. Should 5-HTP be successful
in reversing the effects of mild hypoxia, the findings would support clinical trials of 5-HTP in
Service members and Veterans who are stationed or who reside at altitude and who have had
incomplete responses to SSRI therapy. In addition, the findings would be relevant to the larger
number of hypoxic disorders that have also been linked to depression and suicide (COPD,
asthma, sleep apnea, etc.).
Title: Window to Hope: A Psychological Intervention for Hopelessness Among
Veterans with Traumatic Brain Injury
Presenter: Dr. Gina Signoracci, PhD; VISN 19 Mental Illness Research, Education, and Clinical
Center (MIRECC)
Bio: Dr. Signoracci is a Clinical Research Psychologist with VISN 19 MIRECC. She is the
Primary Investigator (PI) on several original studies and have obtained grant funding related to
investigating risk factors for self-directed violence in Veterans with Human Immunodeficiency
Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). She also serves as investigator
on several studies focused on Traumatic Brain Injury (TBI). She has an extensive employment
and training background including intervention and assessment with a wide range of neurologic
and physical impairment.
Abstract: RESEARCH AIMS: This project aims to adapt WtoH for US Military
personnel/Veterans, pilot and implement a Randomized Clinical Trial (RCT) at the Denver
Veterans Affairs Medical Center, and replicate results from the original Australian civilian trial
in this novel context with a larger sample. METHOD: A Consensus conference was organized to
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review WtoH and make initial cultural adaption of the program to the US military context. The
manualized program was then provided to 8 Veterans in four pilot groups by graduate
psychologists trained in the delivery of WtoH. To address acceptability and feasibility, the 8
participants completed the Client Satisfaction Questionnaire-8 (CSQ-8), the Narrative Evaluation
of Intervention Interview (NEII), and attendance was documented. The collected data were
analyzed and results reviewed at a second Consensus conference. RESULTS: Program
attendance was high. Nine participants were initially enrolled in the pilot, one withdrew prior to
program commencement. Seven participants recorded 90% or higher attendance across the 10
sessions, the final participant withdrew after session 3. Results on the CSQ-8 were strong with
average scores for seven of the eight items ranging between 3 and 4, indicating strong levels of
satisfaction for the eight participants. Themes from the qualitative data (NEII) indicate that most
participants felt they benefitted from the program and were able to identify changes they had
made, did not feel that any program elements were undesirable, and would recommend the
program to other Veterans. CONCLUSIONS: The adaptation of WtoH to the cultural context of
US Veterans required only minor modifications. Results demonstrated both the acceptability and
feasibility of delivering the program. A Phase II RCT has commenced to evaluate the program’s
efficacy in promoting hope among US Veterans with moderate to severe TBI.
WORKING LUNCH EXHIBITS
Title: VISN 2 CoE SP; VISN 19 MIRECC
Exhibitor: Dr. Caitlin Thompson, PhD; VISN 2 CoE SP
Bio: Dr. Thompson is the Department of Veterans Affairs’ Deputy Director in Suicide
Prevention. Prior to this role, she spent five years as the Clinical Care Coordinator for the VCL
and Veterans Chat service. A licensed clinical psychologist, she is Assistant Professor at the
University of Rochester Department of Psychiatry where she completed a post-doctoral
fellowship in suicide research. Dr. Thompson completed her pre-doctoral internship and some
post-doctoral work at the Denver VA Medical Center where she became interested in suicidal
behavior among Veterans. Last year, she spent five months detailed as the VA Liaison for the
DoD’s Defense Suicide Prevention Office. Dr. Thompson completed her Bachelor’s degree in
music at Brown University and her Master’s degree and Doctorate in clinical psychology at the
University of Virginia.
Title: The Durkheim Project
Exhibitors: Dr. Chris Poulin, PhD, Patterns and Predictions; Dr. Paul Thompson, PhD;
Dartmouth University School of Medicine
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Bios: Dr. Poulin is the Director of the Durkheim Project and the study’s Principal Investigator.
He is also Principal Partner of Patterns and Predictions, where he is co-inventor of Centiment™,
a semantic-analysis based event-prediction system with recent research support from DARPA.
Poulin also was co-author of the Patterns and Predictions software tool, a statistical classification
and decision engine used worldwide in universities and industry. He was most recently CoDirector of the Dartmouth College Meta-learning Working Group at Dartmouth Thayer School
of Engineering. Poulin’s other research affiliations include the University of Massachusetts —
in the area of high performance computing (HPC)/Supercomputing. He is a patent holding
inventor in Federated Web, Information Retrieval, and Predictive Analytics related systems.
A leader in the linguistics of deception and the security study of cognitive hacking, Dr.
Thompson is currently an instructor at the Geisel School of Medicine at Dartmouth’s Department
of Genetics. He has published numerous papers, journal articles and book chapters, and has
served as a reviewer for various conferences, journals, and the National Science Foundation.
Thompson has worked with the Santa Fe Institute, General Motors Research & Development,
The Sedona Conference, and the TREC conferences.
Abstract: The Durkheim Project is an Opt-In text mining initiative to reduce suicide risk among
military personnel (Active Duty and veteran), with eventual application for non-military cohorts.
Our Phase 1 clinical effort (completed in March of 2012) was the building of effective predictive
keyword models of suicide risk, in collaboration with the VA. Our Phase 2 clinical effort
(launched July 2013) is the targeting recruitment of up to 100,000+ individuals for the purpose of
real-time risk assessment. Our Phase 3 clinical effort (underway) is for the automation of
intervention strategies on our opt-in population. Funding sources include DARPA DCAPS and
Intelligence Advanced Research Projects Agency (IARPA; seeding). Current team members
include: Patterns and Predictions, The Geisel School of Medicine at Dartmouth, The U.S.
Department of Veterans Affairs: White River Junction Hospital, and Facebook, Inc.
Title: Medical Informatics and Analysis Toolkit
Exhibitors: Mr. Michael Crystal, MS; Mr. Maciej Pacula, MS; BBN Technologies
Bios: Michael Crystal is the Program Manager for BBN’s effort under the DARPA Detection
and Computation Analysis of Psychological Signals (DCAPS) program. He is a Senior Scientist
with over 20 years’ in BBN’s Speech, Language and Multimedia business unit, and over 25
years at BBN. He holds a MS in Computer Science from MIT.
Maciej Pacula received his BS and MS degrees in Computer Science from MIT in 2010 and
2011. His research at MIT focused on developing machine learning algorithms to automatically
tune computer programs in diverse execution environments. Since joining BBN in 2012 as a staff
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scientist, Maciej has been working on applying Natural Language Processing and machine
learning to the psychological health domain under the DARPA DCAPS program.
Abstract: Under the DARPA DCAPS program, BBN developed MINAT to analyze human
communication for mental health distress indicators, to triage conversations, and to collect data
for epidemiologic or other research studies. MINAT was developed to work on a broad range of
communication genres including human-human, human-computer (avatar), social network chats,
and personal diaries, and a broad range of modalities including text, audio, and biomarkers such
as electroencephalogram, electrocardiogram, and galvanic skin response. MINAT applies
supervised and unsupervised machine learning algorithms applied to a wide range of language
features include lexical, syntactic, semantic, biometric, and expert-provided markers. Truth is
established by a panel of VA-affiliated PTSD experts. Ongoing quantitative evaluations have
demonstrated continually improving performance. Current weighted mean F1 score is 0.65 and
mean weighted AUC is 0.84. Live demonstration prototypes are available.
Title: Cogito Dialog and VetGuard
Exhibitors: Mr. Joshua Feast, MBA; Dr. Skyler Place, PhD; Cogito Corporation
Bios: Mr. Feast is Founder and CEO of Cogito Corp, Inc. His track-record includes over a
decade of delivery to human services, government and financial services organizations, such as
DARPA, Humana, Blue Cross Blue Shield Plans, and Aetna. He holds an MBA from the MIT
Sloan School of Management where he was the Platinum-Triangle Fulbright Scholar in
Entrepreneurship, and a Bachelor of Technology from Massey University in New Zealand.
Dr. Place is a computational social scientist by training, specializing in quantifying human social
behavior. He is primarily focused on the design, development and use of new technology to
advance our abilities to understand, assess, and predict human decision-making. At Cogito, he is
the Senior Director of Product Research and Design, where he is responsible for managing both
government sponsored research efforts, and the translation of those efforts into products. Dr.
Place holds a BA in Computer Science from Colby College, PhDs in Psychology and Cognitive
Science from Indiana University, and completed his post-doctoral work at the Institute for
Quantitative Social Science at Harvard University.
Abstract: Cogito’s analytic software senses unconscious cues in human behavior and uses them
to infer psychological state, continuously collecting and interpreting the signals underlying
telephone conversations, video chats, and smartphone behaviors. Cogito’s insights improve realtime decision-making, workflows, and consistency of service; creating more opportunities for
early intervention and better operational results. In our work with DARPA as part of the DCAPS
program, Cogito has delivered Cogito Dialog, a real-time vocal analytics system for call centers
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which provides enhanced situational awareness and immediate feedback on states of engagement
and distress. Cogito has also developed VetGuard, a mobile phone application that passively
gathers behavioral data and provides continuous assessment of Depression, PTSD, and
suicidality symptoms.
BRIEF INTERVENTIONS
Presenter: Dr. Craig J. Bryan, PsyD, ABPP; National Center for Veterans Studies, The
University of Utah
Bio: Dr. Craig J. Bryan, PsyD, ABPP, is a board-certified clinical psychologist in cognitive
behavioral psychology, and is currently the Associate Director of the National Center for
Veterans Studies at The University of Utah. Dr. Bryan received his PsyD in clinical psychology
in 2006 from Baylor University, and completed his clinical psychology residency at the Wilford
Hall Medical Center, Lackland Air Force Base, TX. He was retained as faculty in the
Department of Psychology at Wilford Hall Medical Center, where he was Chief of the Primary
Care Psychology Service, as well as the Suicide Prevention Program Manager for Lackland
AFB. Dr. Bryan deployed to Balad, Iraq, in 2009, where he served as the Director of the
Traumatic Brain Injury Clinic at the Air Force Theater Hospital. He currently oversees two
treatment studies totaling approximately $3 million testing cognitive behavioral treatments for
suicidal Service members, and is the lead risk management consultant for the $25 million
STRONG STAR Research Consortium investigating treatments for combat-related PTSD among
military personnel. Dr. Bryan has authored and presented over 100 scientific articles and
presentations, and is considered a leading national expert on military suicide.
Title: An Overview of the Military Suicide Research Consortium
Abstract: The Department of Defense, Assistant Secretary of Defense (Health Affairs) from the
Defense Health Program Enhancement (DHPe) awarded a $30 million federal grant to Florida
State University and the Denver Veterans Affairs Medical Center to establish the Department of
Defense Military Suicide Research Consortium (MSRC). The consortium is the first of its kind
to integrate DOD and civilian efforts in implementing a multidisciplinary research approach to
suicide prevention. Consortium oversight is provided by CAPT Doug Forcino, Director of the
MOMRP.
The MSRC's mission is to 1) produce new scientific knowledge about suicidal behavior in the
military, 2) use high quality research methods and analyses to address problems in policy and
practice that have a direct impact on suicide-related and other mental health outcomes for
military personnel, 3) disseminate knowledge, information, and findings through a variety of
methods appropriate for decision makers, practitioners, and others who are accountable for
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ensuring the mental health of military personnel, and 4) train future leaders in military suicide
research through experience within a multi-disciplinary setting. The Consortium's cutting-edge
Research Program currently oversees 20 studies and 4 postdoctoral pilot projects that will
improve mental health outcomes for our men and women in uniform."
Title: Brief Interventions for Short-term Reductions in Suicide Risk among Suicidal
Military Personnel
Abstract: Since 2004, suicides by U.S. military personnel have steadily risen. A common
intervention for the short-term management of suicide risk is the crisis response plan (CRP), also
known as safety planning. The CRP was originally developed for use within the context of
suicide-focused psychotherapies to facilitate problem solving across treatment, but it is now
commonly used in military emergency settings as a single-session intervention. Because the
CRP was originally designed as a multi-session intervention, its effectiveness in emergency
settings is potentially diminished because it does not directly target suicidal intent. Research has
shown that suicidal individuals who can identify reasons for living are less likely to make suicide
attempts, and that greater ambivalence about suicide is associated with decreased risk for future
death by suicide. Directly targeting a suicidal individual’s desire to live might facilitate
ambivalence about suicide, which may be an essential element of effective crisis interventions.
The current presentation will provide an overview of a randomized controlled trial currently
underway with acutely suicidal Active Duty Soldiers, which is designed to test the effectiveness
of three different versions of the CRP and to determine if ambivalence about suicide can be
modified in the short-term, thereby reducing risk for subsequent suicide attempts. Progress with
preliminary data to date will be presented.
SAFETY PLANNING
Title: Safety Planning for the Military (SafeMil) to Reduce Suicide Risk for Military
Service members
Presenters: Dr. Jaime Carreno, PhD; Uniformed Services University of the Health Sciences,
Laboratory for the Treatment of Suicide-Related Ideation and Behavior
Bios: Dr. Carreno is a licensed clinical psychologist and research scientist at the Laboratory for
the Treatment of Suicide-Related Ideation and Behavior located at the Uniformed Services
University of the Health Sciences (USUHS). She has participated in federally funded research
projects and has provided a variety of clinical services at both the Baltimore and Syracuse VA
medical centers in addition to her current work at USUHS and the National Military Medical
Center. She has contributed to NIH funded longitudinal research projects and has developed and
evaluated new relapse prevention and strength focused recovery programs within the VA system
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Research Education Summit Bios and Abstracts
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for OEF/OIF Veterans. Dr. Carreno's primary research interests include the interaction of
behavioral health utilization and military career progression, risk and protective factors for the
development of severe mental illness including suicide-related ideation and behavior, and
resiliency in military families. She is currently coordinating clinical research trials of cognitive
interventions for suicide prevention in Active Duty Service members and their families. In
addition to her work in intervention evaluation, Dr. Carreno is leading several projects
examining the effects of behavioral health help seeking on career-related outcomes in the Air
Force and Marine Corp. Finally, Dr. Carreno is part of a group of scientists working to develop
guidance for Army standard operating procedures related to suicide-related events that occurring
during a deployment.
Co-author: Dr. Barbara Stanley, PhD; New York State Psychiatric Institute’s Suicide
Intervention Center and Columbia University’s College of Physicians and Surgeons;
Abstract: The Safety Planning Intervention (SPI) has been developed by Stanley and Brown
(2008, 2012) to help enhance coping with suicidal urges. The SPI consists of a written,
prioritized list of coping strategies and sources of support that patients can use to best manage a
future suicidal crisis. The primary purpose of this presentation is to educate the audience about a
current study, titled Safety Planning for the Military (SafeMil) which has been designed to
evaluate the efficacy of the SPI for military Service members who are hospitalized for recent
suicide ideation and/or a recent suicide behavior. Participants are randomly assigned to the
SafeMil intervention condition or to an Enhanced Usual Care condition (E-Care). The SafeMil
intervention consists of three targeted suicide prevention components including: a) structured
risk assessment; b) strategies to increase coping with suicidal thoughts and urges in order to
reduce suicide risk; and c) problem solving and motivational enhancement to increase
acceptability of mental health treatment and maximize likelihood for post-discharge utilization of
health services. The Enhanced Usual Care condition (E-Care) consists of the usual care patients
receive at an inpatient facility during their hospitalization in addition to assessment services
provided by independent evaluators who work directly with our research team. Primary
outcomes include suicide ideation, suicide-related coping, and acceptability and initiation of
mental health care and substance use treatment in the 30 days post hospital discharge.
INTEGRATING RESEARCH INTO PRACTICE
Title: Marine Corps Behavioral Health Integrated Research Agenda
Presenters: Dr. Jennifer Piver-Renna, PhD; Dr. Adam Walsh, PhD; Marines Corps Behavioral
Heath Branch
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Bios: Dr. Jennifer Piver-Renna is the Research & Program Evaluation Section Head in the
Behavioral Health Branch of the Marine and Family Programs Division. The mission of this
section is to enhance the impact of behavioral health programs and initiatives through empirical
research, testing, and evaluation. Dr. Piver-Renna received a bachelor's degree in psychology
from Old Dominion University and a PhD in public health from Johns Hopkins School of Public
Health. Dr. Piver-Renna’s expertise is in community mental health systems and theories,
program evaluation methodology, and injury prevention and control. Previously, Dr. PiverRenna worked as a public health scientist for the U.S. Army Public Health Command evaluating
behavioral health and wellness programs across installations. In addition, she served as Program
Manager for the injury, violence, and suicide prevention programs at the Virginia Department of
Health.
Dr. Walsh is section head of Community Counseling and Prevention Services for the USMC.
He has extensive experience in conducting suicide research; developing suicide prevention
programs and treatments; and more than 10 years of direct practice with individuals suffering
from suicidal thoughts and behaviors. Dr. Walsh has published articles in the area of suicide and
is currently the lead investigator on a research study examining suicide attempts in the Marine
Corps. In addition, Dr Walsh volunteers as the chief consultant for a project to prevent youth
suicide in Tajikistan.
Abstract: The Marine Corps Behavioral Health Branch leverages a risk and protective
framework to identify and equip field staff and Marines alike to recognize problems early and
intervene at the lowest possible level. The mission of the newly established Research & Program
Evaluation Section is to support the Behavioral Health Branch by leading collaborative and
translational research helping Marines and their families. This brief will focus on the framework
and theoretical underpinnings of developing and pursuing a research agenda focused more
broadly on the influence of behavioral health risk and protective factors. Innovative studies on
mentoring, stigma reduction, increasing coping and life skills, and developing a sense of
belonging will be discussed.
ENABLERS OF INNOVATIVE SUICIDE RESEARCH
Title: An Introduction to the Joint DoD/VA Suicide Data Repository
Presenters: Dr. Robert Bossarte, PhD, VISN2 CoE SP; Mr. Christopher Dorr, DSPO
Bios: Robert M. Bossarte, Ph.D., is Acting Associate Director and Chief for Epidemiology and
Populations Research Core at the VISN 2 Center of Excellence for Suicide Prevention at VA
Medical Center at Canandaigua and Assistant Professor in the Department of Psychiatry at the
University of Rochester. Dr. Bossarte’s work focuses on the assessment of suicide risk,
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Research Education Summit Bios and Abstracts
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identification of emerging risk characteristics and populations, and relationships between suicide
and other high risk behaviors. Some of his current projects include an assessment of the VA’s
Suicide Prevention Mass Media Campaign, identifying and developing improved sources of data
for the surveillance of suicide among Veterans, and evaluating the impact of Suicide Prevention
programs.
Mr. Christopher “Chris” Dorr is currently working at the Defense Suicide Prevention Office
(DSPO). Chris is responsible for coordinating efforts to improve the use of data and data driven
methodologies for prevention of suicide. He has been a Defense Department civilian since 1986,
when he started working for the Defense Communications Agency. Chris began working on
personnel related data systems in the late 1980’s for the Department of Navy’s Office of Civilian
Personnel Management. After working for the Navy Department, he went to the Statistical
Information and Analysis Division at Washington Headquarters Services. Just prior to joining
the team at DSPO, Chris worked at the Defense Manpower Data Center, where he became
involved in the use of data for the study of suicide in the active duty military population.
Abstract: The session will introduce participants to the DoD/VA Joint Suicide Data Repository.
Topics covered during the presentation will include background and justification for
development of a shared data resource, data sources, and collaboration with the Centers for
Disease Control and Prevention, parameters for the initial search of the National Death Index
(NDI), standards for validation of cases, and process for accessing data for DoD- and VAaffiliated staff. Current status of the DoD/VA Suicide Data Repository will be presented and
examples of priority activities will be used to facilitate discussion of the Suicide Data Repository
as a foundation for innovative, prospective studies of suicide to inform current and developing
prevention priorities.
Title: The Person-Event Data Environment (PDE): Leveraging Existent Data for
Suicide Prevention Studies
Presenter: Dr. Benjamin Bushong, PhD, Army Analytics Group Research Facilitation Team
Bio: Dr. Benjamin Bushong is the Lead Data Scientist and contractor with the Army Analytics
Group Research Facilitation Team. He leads development of the Person-Event Data Environment
and manages a number of studies within the environment. He received his PhD from California
Institute of Technology in Social Science - Economics. Prior to his work with the Army, Dr.
Bushong's research focused on behavioral economics and neuroeconomics.
Abstract: Predictive suicide research is fundamentally a data problem – the event is infrequent
and precursor signals are weak and often buried under useless data. Such research requires
efficiently managing large volumes of administrative data and repurposing this information for
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use in studies. The need is especially present in the United States Army, which maintains
numerous electronic databases on more than one million Active Duty, Reserve, and National
Guard soldiers, their family members, and Army civilian employees. Given the challenges of
disseminating sensitive personal and health information, the Person-Event Data Environment
(PDE) was created to unify disparate Army and DoD databases in a single, secure cloud-based
enclave. This talk demonstrates the utility of the PDE for suicide studies and highlights a suicide
study in progress within the PDE. By utilizing the PDE, the DoD and its scientific partners can
capitalize on the vast amounts of manpower, personnel, pay and financial, medical, training and
education, deployment and security systems that influence Army-wide policies and procedures.
CLOSING REMARKS
Presenter: Dr. Janet Kemp, PhD, RN; VA National Mental Health Program
Bio: As the National Mental Health Program Director for Suicide Prevention and Community
Engagement, Dr Kemp directs the policy and direction of the VA Suicide Prevention Program
out of Mental Health Services. She is responsible for policy development, provider and patient
education in the areas of suicide awareness and prevention, implementing assessment and
treatment strategies and the dissemination of new findings in the area of suicide throughout the
VA system. Dr. Kemp directs and advises the Suicide Prevention Coordinators at each local VA
and is the national program advisor for the VCL and Veterans Chat. Dr. Kemp has done
qualitative research in the area of war experiences and effects. Her current projects include
suicide attempt and completion database development. In 2009, Dr. Kemp was a White House
Appointee to the Department of Defense Task Force on the Prevention of Suicide by Members of
the Armed Forces and in 2010 served on the Army Suicide Prevention Task Force. She currently
serves on the Action Alliance Task force for Suicide Prevention and is the Co-Lead on the
Military and Veteran Taskforce. Major honors include the VA Secretary’s Exceptional Service
Award in 2007, and she was the Service to America Federal Employee of the Year in 2009.
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