Mindfulness-Based Cognitive Therapy for Preventing Suicide in Military Veterans: A Randomized Clinical Trial.
Alejandro Interian, Megan S Chesin, Barbara Stanley, Miriam Latorre, Lauren M St Hill, Rachael B Miller, Arlene King, Dianna R. Boschulte, Kailyn M. Rodriguez, Anna Kline
The Journal of Clinical Psychiatry August 31, 2021 DOI: 10.4088/jcp.20m13791 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 140 |
| Population | Veterans at high risk for suicide, mostly recruited during a suicide-related inpatient admission |
| Intervention | Mindfulness-Based Cognitive Therapy for Preventing Suicide Behavior (MBCT-S) |
| Duration | MBCT-S began during inpatient treatment with 2 individual sessions and continued post-discharge with 8 group sessions; four follow-up evaluations over 12 months |
| Topics | Meditation |
| Keywords | Humans Treatment outcome Suicide, attempted Middle aged Veterans United states Female Suicidal ideation Cognitive behavioral therapy Suicide prevention |
| Registration | NCT01872338 |
| Key findings | Adding MBCT-S to enhanced treatment-as-usual did not significantly delay time to suicide event (hazard ratio 0.86) but reduced the total number of suicide events (56 vs 92; incident rate ratio 0.59) and, in a post hoc analysis, the proportion of participants attempting suicide, and reduced psychiatric hospitalizations. No significant differences emerged for time to or number of suicide attempts or for suicide-related factors. The authors describe the primary-outcome findings as mixed and call for further research. |
Abstract
Objective: This study evaluated whether Mindfulness-Based Cognitive Therapy for Preventing Suicide Behavior (MBCT-S) effectively augmented treatment-as-usual enhanced for suicide prevention (eTAU).Methods: From December 2013 through March 2018, veterans (N = 140) at high risk for suicide were recruited mostly (88.6%) during a suicide-related inpatient admission and randomly assigned to either (1) eTAU augmented with MBCT-S or (2) eTAU only. MBCT-S began during inpatient treatment (2 individual sessions emphasizing safety planning) and continued post-discharge (8 group sessions emphasizing mindfulness skills and elaborated safety planning). Four follow-up evaluations occurred over 12 months, and primary outcomes were (1) time to suicide event and (2) number of suicide events. Secondary outcomes were time to and number of suicide attempts, proportion with acute psychiatric hospitalization, and change in suicide-related factors (eg, depression, hopelessness, suicidal ideation).Results: Relative to eTAU, MBCT-S did not significantly delay time to suicide event (hazard ratio = 0.86; 95% CI, 0.52-1.41; P = .54), but did reduce total number of suicide events (MBCT-S: 56 events; eTAU: 92 events; incident rate ratio = 0.59; 95% CI, 0.36-0.99; P < .05). There were no significant differences in time to or number of suicide attempts. In a post hoc analysis, however, MBCT-S significantly reduced the proportion of participants attempting suicide (P < .05). MBCT-S also reduced the proportion with a psychiatric hospitalization. No significant between-group differences emerged on any suicide-related factors.Conclusions: Adding MBCT-S to system-wide suicide prevention efforts produced mixed findings on the primary outcome (suicide events) and promising findings on other important outcomes (suicide attempts, psychiatric hospitalizations). MBCT-S should continue to be examined in future research.Trial
Registration: ClinicalTrials.gov identifier: NCT01872338.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 6
- Mindfulness-Based Cognitive Therapy for Individuals Who Are Suicidal: A Randomized Controlled Trial. Archives of Suicide Research 2024
- Addressing chronic pain and suicide risk using Mindfulness-Based Cognitive Therapy: Rationale, design and baseline characteristics. Contemporary Clinical Trials November 1, 2025
- Initial evaluation of a personalized advantage index to determine which individuals may benefit from mindfulness-based cognitive therapy for suicide prevention. Behaviour Research and Therapy December 1, 2024
- Mindfulness and mindful parenting: Strategies for preschoolers with behavioral issues. World Journal of Clinical Cases November 1, 2024
- A Pilot Study of Telehealth Mindfulness-Based Cognitive Therapy for Depression in Parkinson's Disease. Journal of geriatric psychiatry and neurology March 2023
and 1 more in the library
Cites 7
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: A randomized dismantling trial. Journal of Consulting and Clinical Psychology December 3, 2013
- Mindfulness‐Based cognitive therapy for prevention of recurrence of suicidal behavior Journal of Clinical Psychology December 9, 2005
- Rationale and study design of a trial of mindfulness-based cognitive therapy for preventing suicidal behavior (MBCT-S) in military veterans. Contemporary Clinical Trials September 2016
- Improvements in Executive Attention, Rumination, Cognitive Reactivity, and Mindfulness Among High-Suicide Risk Patients Participating in Adjunct Mindfulness-Based Cognitive Therapy: Preliminary Findings. The Journal of Alternative and Complementary Medicine August 2016
and 2 more in the library