Mental health providers are inexperienced but interested in telehealth-based virtual reality therapy: survey study.

Virtual reality (VR) is an emerging technology that can enhance experiences and outcomes in mental healthcare. However, mental health therapists have been slow to adopt VR into practice. Implementation of telehealth-based VR therapy (tele-VR) could catalyze adoption and innovation in mental healthcare. To explore therapists' perspectives on tele-VR, we conducted a cross-sectional survey of practicing mental health providers in the United States in June-July 2023. We analyzed 176 completed surveys from therapists, of whom 51.14% had no prior experience with VR, only 6.25% had used VR clinically, and 56.82% had neutral impressions of VR for therapy. Despite therapists' general inexperience with VR, therapists indicated a wide variety of tele-VR simulations (e.g., social situations, flying, heights) and features (e.g., personalized spaces, homework, interactivity) would be moderately to extremely useful for their practices. Therapists also requested additional VR simulations and features for their telehealth clients such as behavioral skills training, exposure therapy, gender identity therapy, and psychological assessments in VR. Therapists rated Health Insurance Portability and Accountability Act compliance, the ability to try VR before buying, affordability for therapists, accessibility for clients, and insurance coverage as the five most influential implementation factors for tele-VR. Overall, therapists were generally inexperienced and neutral about VR for telehealth therapy, but were interested in tele-VR for specific applications. These findings provide actionable directions for future research and collaborative development of therapeutic VR content and features.

Mixed methods evaluation of a jail diversion program: Impact on arrests and functioning.

This mixed methods study had two aims: (1) to examine the effectiveness of a jail diversion program in reducing recidivism and promoting educational and employment outcomes; and (2) to qualitatively explore mechanisms through which the program was effective. Participants were 17 individuals arrested for drug offenses who participated in an intensive, law enforcement-based jail diversion program, and 17 individuals in a comparison group. Arrests were extracted from police records, and education and employment were extracted from program data. Four intervention participants completed qualitative interviews. Arrest rates in the intervention group decreased significantly postintervention, and arrest rates in the intervention group were numerically lower than those in the comparison group. Participants experienced significant increases in employment and driver's license status. Participants also identified mechanisms through which the program was effective. This jail diversion program shows promise in reducing recidivism and promoting adaptive functioning. Jail diversion programs that include mentorship, peer support, and removal of barriers to success may be particularly effective.

Examining the outcomes and acceptability of a peer-led spiritual intervention for moral injury in a veteran service organization.

The purpose of this proof-of-concept study was to examine the outcomes and acceptability of a spiritual intervention for moral injury led by veteran peers in a Veteran Service Organization (VSO), called "Heroes to Heroes." From baseline to 1-year follow-up, 101 veterans who participated in the intervention completed the evaluation surveys at four time points assessing psychological outcomes (moral injury, posttraumatic stress disorder [PTSD] symptoms, and life satisfaction), spiritual outcomes (spiritual struggles and spiritual transcendence), and their perceived helpfulness of the program. In addition, we conducted four focus groups with six to eight alumni to more fully understand veterans' views and experiences of the program. Focusing on the longitudinal surveys, latent growth modeling analyses revealed veterans generally improved across the psychological and spiritual outcomes in the study. Specifically, veterans reported steady decreases in moral injury outcomes, PTSD symptoms, and spiritual struggles along with increased life satisfaction and spiritual transcendence over the 1-year period. An inductive content analysis of veterans' responses to open-ended items in the surveys and focus group interviews revealed four possible mechanisms or facilitators of these outcomes: (a) social connectivity and belonging (e.g., shared vulnerability and camaraderie); (b) behavioral engagement in core aspects of their spirituality (e.g., sacred practices and visiting sacred places); (c) spiritual transformation and growth (e.g., closeness with God and divine forgiveness); and (d) appreciation for diversity (e.g., religious and military). Overall, these findings affirm the potential effectiveness and acceptability of the VSO's peer-led spiritual intervention for promoting the holistic healing among veterans who are contending with emotional and spiritual wounds of war. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

College extracurricular involvement as a suicide prevention and wellness promotion strategy: Exploring the roles of social support and meaning.

OBJECTIVE: Increased demands during the transition into college can negatively impact students' physical and mental wellness, and increase risk of suicide. A supportive campus culture that promotes social connectedness and meaningful engagement may amplify wellness and prevent suicide. This study explored whether involvement in extracurricular activities was associated with wellness and suicide ideation and non-fatal suicidal behavior through perceived social support and meaningfulness. METHOD: Undergraduate students (N = 583) recruited from a southeastern university completed a survey of self-report measures. Two parallel mediation models were tested utilizing Hayes PROCESS macro for SPSS. RESULTS: Perceived social support fully mediated the relationship between extracurricular activity involvement and wellness, ß = 0.06, 95%CI [0.03, 0.10], but not suicide ideation and non-fatal suicidal behavior. Meaningfulness was not associated with wellness or suicide ideation and non-fatal suicidal behavior. CONCLUSION: Increased stress is a natural and expected component of university life. ECA involvement may impact college wellness by promoting social support.

A Psychometric Pilot Study Examining the Functions of Suicidal Communications Using IRT and Factor Analysis.

BACKGROUND: Suicide prevention, an important public health issue, relies on suicidal communications to identify and intervene with those at risk. Scant research tests explicit theories of suicidal communication impeding applications to prevention science. The current study pilots a new measure assessing the functions of suicidal communications using factor analysis and item response theory. METHODS: MTurk workers (n = 898) completed an anonymous survey. The original scale included 35 items refined using exploratory and confirmatory factor analysis, bifactor modeling, and item response theory. RESULTS: The initial EFA identified a two-correlated-factor solution. The two-correlated-factor and unidimensional models yielded a poor fit. A bifactor model yielded a borderline to acceptable fit. The final four items were identified using a bifactor model and item response theory graded response models capturing ambivalence resolution defined as behaviors aimed to aid in suicide decision making. The final model yielded an excellent fit: 𝝌2(2) = 1.81, CFI (1.00), TLI (1.00), RMSEA (0.00), and SRMR (0.01). CONCLUSIONS: There may be one function of suicidal communications. Disclosure may elicit connection and reasons for living that serve as barriers to suicide and resolve ambivalence. Key limitations include convenience sampling and limited validity measures. Future research should partner with participants to improve scale and theory development efforts.

Exploring interpersonal theory of suicide typologies in patients with cancer: A latent profile analysis.

The current study examined patterns of endorsement of Interpersonal Theory of Suicide constructs in a group of patients with cancer (N = 133) via Latent Profile Analysis. Four profiles were identified: (1) Interpersonally Distressed (n = 7; 5.2%), (2) Burdened (n = 11; 8.3%), (3) Fearless About Death (n = 40; 30.1%), (4) Non-Distressed (n = 75; 56.4%). Profiles with higher levels of thwarted belongingness, perceived burdensomeness, and hopelessness were associated with greater suicide ideation. Results also suggest there may be characteristics of patients with cancer that require unique consideration about the potential meaning and relevance of such constructs.

Examining the temporal stability of suicide capability among undergraduates: A latent growth analysis.

BACKGROUND: Relatively few studies test the interpersonal psychological theory's monotonicity hypothesis. The monotonicity hypothesis proposes that suicide capability (i.e., fearlessness about death and pain tolerance) is stable or increases linearly with exposure to painful and provocative events. Research is conflicted, suggesting that suicide capability is static, decreases, or increases and returns to baseline. The current study thus tested this hypothesis in a sample of college students with histories of suicidal ideation. We hypothesized a stable and an increasing trajectory. METHODS: Participants were 206 undergraduates; primarily women (73%), on average 19.05 years old, heterosexual (85%), and first-years (69%). Participants completed a baseline battery of questionnaires on suicide risk factors and daily diaries on suicide capability and suicidal ideation for 90 days (n = 7,342 surveys, 40% compliance rate). Group-based trajectory analyses were conducted with the SAS macro PROC TRAJ. RESULTS: Modeling revealed a three group quadratic model.  Low (27.7%), Moderate (41.3%), and High (31.1%) suicide capability groups remained static over time. Baseline suicidal ideation, but not history of suicide attempts or family history of suicidal behavior, distinguished groups; participants with suicidal ideation at baseline were less likely to be in the low suicide capability group. LIMITATIONS: Brief, dichotomized assessments, and a high attrition rate. CONCLUSIONS: These data showed temporal stability of suicide capability and suggest that the "acquired" component of capability may be overemphasized. Clarifying the stability and modifiability of suicide capability will enable empirically-based applications of the theory to suicide prevention.

Socio-ecological context and the interpersonal theory of suicide: A response to hjelmeland & knizek.

The current paper is a response to Hjelmeland & Knizek's critique of the interpersonal theory of suicide. These authors raise a number of important points that have the potential to advance the understanding and prevention of suicide. However, the authors' message becomes lost in a series of errors in logic and misinterpretations of the theory. We attempt to clarify these errors and add some of our own ideas about how the theory and science examining it can be advanced.

The protective effects of grit on suicidal ideation in individuals with trauma and symptoms of posttraumatic stress.

OBJECTIVE: It is important to understand factors that moderate the likelihood of developing suicidal thoughts following traumatic exposure and posttraumatic stress symptoms. METHOD: In this cross-sectional study, a moderated atemporal mediation analysis was conducted in a sample of 709 college students (71% female, M age = 19.90 years, 67% Caucasian) to test the associations between trauma, posttraumatic stress disorder (PTSD) symptoms, and suicidal ideation, with grit entered as a moderator of all paths in the equation. RESULTS: PTSD symptoms mediated the association between trauma and suicidal ideation. Grit moderated the direct pathway from PTSD symptoms to suicidal ideation. CONCLUSIONS: Grit and other constructs of resiliency may inform strength-focused interventions to remediate the impact of trauma and posttraumatic stress symptoms and potentially reduce suicidal thoughts and risk for suicide.