Publication Date


Advisor(s) - Committee Chair

Stephen O'Connor (Director), Rick Grieve, Amy Brausch

Degree Program

Department of Psychology

Degree Type

Master of Arts


A persistent difficulty in the field of psychology is identifying which individuals are at the greatest risk for suicide. Veterans of the US Military are at elevated risk for suicide as compared to the general population. One approach for designating tiers of risk is applying the “Suicide Index Score” to discriminate individuals based upon their reported wish to live (WTL) and wish to die (WTD; Kovacs & Beck, 1977). Brown, Steer, Henriques, and Beck (2005) demonstrated those who indicated a complete WTD and no WTL were at greatest risk to die. The current study expanded on previous research by using this approach with a highly elevated at-risk population of suicidal veterans. Participants for this study included 93 suicidal veterans hospitalized at the Robley Rex Veteran Affairs Medical Center in Louisville, Kentucky. The WTL and WTD items from the Scale for Suicidal Ideation-Current were used to create two quasi-independent groups: WTL/Ambivalent and WTD. The following outcome measures were included as dependent variables: Acquired Capability for Suicide Scale, Interpersonal Needs Questionnaire, Outcome Questionnaire-45.2, Suicide Attempt and Self-Injury Count, Alcohol Use Disorders Identification Test, Drug Abuse Screening Test, and the Stages of Change Questionnaire, as well as the Suicidal Ideation, Posttraumatic Stress Disorder and Insomnia items on the Common Data Elements. T-tests were used to examine patient characteristics for continuous outcomes and chi-square analyses were used for nominal outcomes; however, no group differences were found. T-tests were then used to measure between-group differences on the dependent variables. Individuals classified in the WTD group reported significantly higher levels of thwarted belongingness t(91) = 2.89, p = .00, acquired capability t(91) = 2.64, p = .01, suicidal ideation, t(91) = 3.51, p < .001, and posttraumatic stress t(91) = 2.53, p = .01. Furthermore, a negative binomial regression was used for count outcomes and results revealed that those in the WTD group also reported significantly greater accounts of suicide attempts (incidence rate ratio [IRR] = 2.08; standard error [SE] = 0.63; 95% confidence interval [CI] 1.14-3.77; p = .02) and non-suicidal self-injury (IRR = 3.49; SE = 0.69; 95% CI 2.36-5.16; p < .001).


Applied Behavior Analysis | Pain Management | Psychology