Cognitive Therapy and Research

, Volume 42, Issue 5, pp 711–719 | Cite as

Posttraumatic Cognitions and Suicidal Ideation Among Veterans Receiving PTSD Treatment

  • Adam G. Horwitz
  • Philip Held
  • Brian J. Klassen
  • Niranjan S. Karnik
  • Mark H. Pollack
  • Alyson K. Zalta
Original Article


With approximately 20 veteran suicide deaths per day, suicidal ideation (SI) among veterans is an important concern. Posttraumatic stress disorder (PTSD) is associated with SI among veterans, yet mechanisms of this relationship remain unclear. Negative posttraumatic cognitions contribute to the development and maintenance of PTSD, yet no studies have prospectively examined the relationship between posttraumatic cognitions and SI. Veterans (N = 177; 66% Male) participating in a 3-week intensive outpatient program for PTSD completed assessments of PTSD severity, depressive symptoms, SI, and posttraumatic cognitions. Negative posttraumatic cognitions about the self significantly predicted SI at posttreatment, controlling for pretreatment levels of SI, depression, and PTSD symptom severity. Self-blame and negative posttraumatic cognitions about others/world did not predict SI prospectively. Negative posttraumatic cognitions about the self appear to be an important factor in the manifestation of SI among veterans with PTSD and should be monitored as a potential indicator of suicide risk.


PTSD Suicidal ideation Posttraumatic cognitions Veterans 



We thank the Wounded Warrior Project for their support of the Warrior Care Network and the resulting research. We would also like to thank the participating veterans and their families. We also wish to acknowledge the administrators, research assistants, and clinicians in the Road Home Program.

Compliance with Ethical Standards

Conflict of Interest

Philip Held receives grant support from the Boeing Company and the American Psychological Association. Niranjan Karnik receives grant support from the Wounded Warrior Project; Welcome Back Veterans, an initiative of the McCormick Foundation and Major League Baseball; and the National Center for Advancing Translational Science of the National Institutes of Health (UL1TR002389). Mark Pollack receives funding from the Wounded Warrior Project, National Institute of Health, and Janssen Pharmaceuticals. Dr. Pollack serves on advisory boards for Aptinyx, Bracket Global, Palo Alto Health Sciences and has equity from Doyen Medical, Argus, Medavante, Mensante Corporation, Mindsite, and Targia Pharmaceuticals and receives royalties from SIGH-A, SAFER interviews. Alyson Zalta is supported by a career development award from the National Institute of Mental Health (K23 MH103394).

Informed Consent

All study procedures were approved by the Institutional Review Board with a waiver of consent because all assessments were collected as part of routine clinical care procedures.

Animal rights

No animal studies were carried out by the authors for this article.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychiatryRush University Medical CenterChicagoUSA
  2. 2.Department of Behavioral SciencesRush University Medical CenterChicagoUSA

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