Reducing Suicide-Specific Rumination in Veterans Using Real-time Functional Magnetic Resonance Imaging Neurofeedback
VA Office of Research and Development
Summary
Few treatments target core features of suicidal thoughts and behaviors in Veterans. Real-time functional magnetic resonance imaging neurofeedback can provide information regarding brain activation associated with suicide-specific rumination, defined as a "repetitive mental fixation on one's suicidal thoughts and intentions." The goal of this feasibility study is for Veterans to learn strategies for modulating activity within brain regions that have been demonstrated to contribute to the maintenance of rumination, as they receive neurofeedback feedback signals from the brain.
Description
Suicide is much higher in Veterans compared to non-Veterans and thus remains a major health crisis in the VA, but there are few treatments available that directly target core features of suicidal thoughts and behaviors. Rumination is the strong tendency to engage in self-critical repetitive thinking that is often difficult to interrupt and is associated with suicide attempts and the transition from suicidal ideation to intent above and beyond other suicide risk factors. Meta-analyses indicate that abnormalities in brain regions comprising the "default mode network," which play a role in daydre…
Eligibility
- Age range
- 18–65 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * U.S. military veteran between 18-65 years old * negative pregnancy test on MRI scan days * score greater than or equal to 10 on the Suicide Rumination Scale * clinically stabilized on psychotropic medications * engaged in mental health care treatment * able to provide written, informed consent Exclusion Criteria: * no major medical or neurological disorders that could interfere with treatment * moderate or severe traumatic brain injury * current imminent suicide risk, as determined through psychiatric interview, responses to C-SSRS, and clinical judgment of the assesso…
Interventions
- BehavioralReal Time fMRI Neurofeedback
The proposed pilot study is designed to collect feasibility and acceptability data regarding the utility of real-time functional magnetic resonance imaging (rt-fMRI) feedback in reducing suicide-specific rumination in veterans. Fifteen veterans will receive 2 rt-fMRI neurofeedback sessions while attempting to alter connectivity in brain regions that play a role in rumination. Pre- and post-treatment assessments of suicide, disability, functional impairment, and quality of life will be collected.
Location
- James J. Peters VA Medical Center, Bronx, NYThe Bronx, New York