Thursday, June 21, 2012

Study Offers Glimpse Into Suicide Motives


By Karen Parrish
American Forces Press Service

WASHINGTON, June 21, 2012 – Why? What makes people attempt suicide? It’s a vital question, as the answer could help mental health professionals and even friends and family better recognize when they need to step in to help to save a life.

Theories about suicide motives abound, but as one presenter noted yesterday at the annual suicide prevention conference sponsored jointly by the Defense and Veterans Affairs departments, not much data exists on the question.

Craig J. Bryan, a doctor of psychology, is associate director of the National Center for Veterans Studies at the University of Utah and an assistant professor for the university’s psychology department. At the conference, he presented the results of a study aimed at identifying the motives of 72 active-duty service members who attempted suicide.

“They had collectively attempted suicide 136 times over their lives,” he said, adding that 21 percent never attempted suicide and two participants had made five attempts each.

Study participants – 66 men and six women -- ranged in age from 19 to 44 and had served between one and 19 years in the military. Each person referred to the study had been discharged from an inpatient hospital stay for suicide risk.

Bryan noted the study also served as a course of treatment. Phase 1 focused on crisis management and distress tolerance. Phase 2 aimed at problem solving and restructuring of the participants’ suicide belief systems, and Phase 3 was dedicated to relapse prevention.

Each participant built a crisis response plan and underwent sleep therapy as part of the study, he said, and patients completed an average of 12 sessions, as many as 17 for some -- before “graduating” from the study.

Phase 1 must target emotion regulation, Bryan emphasized. Patients have to learn to deal effectively with painful emotions or they can’t progress further in therapy, he explained.

Most theories about suicide motivation assume suicidal attempts primarily stem from emotional distress, Bryan said. He described two models of approach and treatment for suicidal behaviors: the “syndromal model,” which assumes an underlying psychiatric disorder in suicidal patients, and the “functional model,” which seeks to explain why people attempt suicide so patients can learn how to cope with challenges.

Bryan told the conference audience that the “functional model of self-harm” widely referenced in suicide prevention work notes four major groups of possible suicide motives:

-- Emotion relief, or the desire to stop bad feelings;

-- Feeling generation, or the desire to feel something even if it’s bad;

-- Avoidance and escape, or the desire to avoid punishment from others or avoid doing something undesirable; and

-- Interpersonal influence, or the desire to get attention or “let others know how I feel.”

Identifying the “why” is one of the essential ingredients in work to reduce suicide attempt rates, he said, because once patients understand their motivations, they can develop strategies and coping skills to deal with those challenges.

Bryan said one aim of the study, which used the functional model, was to teach patients “how to suffer in a way that doesn’t require you to die.”

The study asked participants to identify their own motives for a suicide attempt from a list of 33 potential reasons, which were divided among the functional model’s four groups. Each patient chose one to 29 reasons, Bryan said, with 10.43 factors as the mean result, Bryan said.

All participants selected emotional relief, specifically “to stop bad feelings,” as a factor, he noted, though 95 percent also noted other reasons.

Bryan described the frequency of other factors noted in the study. Participants identified avoidance or escape -- with the top single reason being “to get away or escape from other people” -- as a factor 82.4 percent of the time. Interpersonal influence was noted by 80.1 percent of participants, with the most-cited response being “to communicate or let others know how desperate you were.” And 72.8 percent endorsed feeling generation as a factor, with “to feel something, even if it was pain” as the most common response.

After patients confronted the reasons they had attempted or considered suicide, Bryan said, “it was like a light bulb went on.” While all of the participants originally said they attempted suicide because they wanted to die, 95 percent acknowledged after selecting factors they realized they had not wanted to die, but wanted to end emotional pain.

“What this means from a clinical standpoint is we have to start integrating these behavioral [and] functional understandings of suicide attempts into our treatment,” he said. “This is a primary mechanism or ingredient of … behavioral therapy, which is the treatment that we’re currently testing for active-duty soldiers.”

As part of the study, participants received a “smart book” during their first 30 minutes of therapy, Bryan said. Patients wrote in the books throughout their course of therapy, adding lessons learned during each session about what was working for them.

At the end of Phase 3, the smart book comes out again and participants review the lessons and skills, Bryan said. If patients get “stuck” in thinking about how a previous suicide attempt could have been handled differently or how to face a current challenge, he added, the smart books remind them of approaches they learned in therapy. “It is a core intervention,” he said.

The suicide prevention conference continues through tomorrow.

Navy Partners with Coast Guard for Initial Fuel Test


From Naval Sea Systems Command Office of Corporate Communications

PUGET SOUND, Wash. (NNS) -- The Navy provided U.S. Coast Guard Cutter Henry Blake (WLM 563) with a 50/50 blend of F-76 and hydro-processed renewable diesel (HRD-76), June 20, to examine the feasibility of using renewable diesel fuel in Coast Guard cutters.

The ship was identified as a good candidate for an initial Coast Guard test because of the make and model of the cutter engines and the availability of HRD-76 at the cutter's existing fuel supply depot.

"The fuel provided was purchased by Defense Logistics Agency in 2010 for research, development and qualification testing, and had been staged in the area for our operational demonstrations last year in Self Defense Test Ship and USS Ford (FFG 54)," said Richard Leung, NAVSEA's Navy Fuels Engineering manager. "Besides supporting our sister maritime service, this partnership allows us to collect additional data on how the fuel operates in various engines as we continue qualification of 50/50 F-76/HRD-76.

The 175-foot Cutter Henry Blake has a crew of 28 and supports the waterways of the Puget Sound and San Juan Island area by maintaining navigational aids; performing search and rescue; enforcing maritime law; and protecting marine environment. The cutter is expected to operate for several months on the blend, and will perform routine operations while monitoring efficacy and reliability of the 50/50 HRD-76 fuel.

"Defense Logistics Agency (DLA) pipeline will increasingly contain biofuels as these fuels become commercially available and cost competitive with petroleum," said Fuel Section Chief Sam Alvord, Coast Guard Office of Energy Management.

To learn more about Naval Sea Systems Command's alternative fuel efforts, visit http://www.navsea.navy.mil/OnWatch/home.html.

For more news from Naval Sea Systems Command, visit www.navy.mil/local/navsea/.

Review Panel Urges Changes in Combat, Incentive Pays


By Jim Garamone
American Forces Press Service

WASHINGTON, June 21, 2012 – The 11th Quadrennial Review of Military Compensation recommends changes to combat pay and changes to special and incentive pays while saying current military pay rates are about right.

Tom Bush, the study’s director, said the review also recommended further study of compensation of wounded warriors and their caregivers, for survivors, and making compensation for reserve-component service members consistent.

Bush and Jeri Busch, the Pentagon’s director of military compensation policy, spoke with reporters yesterday and stressed that the review’s findings are recommendations. While some of the recommendations may become reality, they said, the review – convened by President Barack Obama – is meant to inform White House, congressional and Defense Department leaders.

The review found that military compensation compares favorably against private-sector pay, Bush said. Enlisted pay is at the 90th percentile of overall pay meaning it is ahead of 90 percent of comparable civilian workers’ pay. The review graphed enlisted regular military compensation against civilians with high school diplomas, civilians with some college and civilians with associate’s degrees. Service members do better than these comparable civilians at any point in a 20-year career, the study found.

Commissioned officers’ regular military compensation is higher than that of 83 percent of civilians with bachelor’s and master’s degrees.

The review recommends an overhaul of combat compensation, Bush said. The review recommends setting hostile-fire pay higher than imminent danger pay and having more than one level of imminent-danger pay to reflect varying levels of danger in different locations authorized for the pay.

A QRMC survey of service members indicate that they believe combat compensation is unfair, Bush said, noting that the longer service members are in the military, the better the benefit is for them. Because they receive higher pay than junior personnel, senior service members receive more benefit from the combat zone tax exclusion for military pay. The vast majority of those under fire are junior personnel – both officer and enlisted – who do not benefit as much from the tax exemption, Bush said.

The review also recommends replacing the combat zone tax exclusion with a refundable tax credit, Bush said. “Even if their tax bill is zero, they are going to get that credit back if it is refundable,” he added. The combat tax credit would be linked to coming under hostile fire, Bush explained.

Another suggestion from the review is a direct-support tax credit linked to imminent danger pay. “We would also suggest that the tax credit … be prorated,” Bush said. “If you are not in the zone, if you are not exposed to danger, you don’t get it.”

The review also recommends an annual recertification of combat zones, which are designated by presidential executive order, in the same manner as declaration of a state of emergency.

The review also delved into pay incentives such as bonuses and monthly incentive pays and the services use to manage particularly vital career fields. For example, nuclear officers aviators and some military medical personnel receive special pay. The review recommends establishing a general career incentive pay authority that isn’t linked to specific career fields such as aviation or medicine, but could be tailored to grow or shrink as circumstances warrant.

President Barack Obama’s letter of instruction on the review panel’s mission specifically cited four examples: special operations forces, remotely piloted vehicle operators, linguists and translators, and mental health experts, Bush said.

The QRMC is looking whether an authority exists to offer a career incentive pay that can be applied to any career field deemed critical. The review recommends that rather than just asking for another special pay category, the Defense Department would have the authority to pay anyone – cryptanalysts, for example – when needed, Bush said. This would require legislation, he added.

The review also made recommendations on wounded warriors and their caregivers, and for survivors. The review found that wounded warriors are well provided for financially, and recommends continued study of wounded warriors’ earnings and disability payments to monitor long-term financial well-being. Another recommendation looks to create a seamless transition between the Defense and Veterans Affairs departments for service members leaving the military.

The review revealed that DOD and VA need more empirical data on the financial situation of wounded warriors’ caregivers, and the report recommends more study of this.

Finally, the review recommends modifying the survivor benefit plan to allow surviving spouses to receive the portion of the SBP annuity funded by retiree premiums.

Secretary of the Navy to Celebrate Naming of USS Sioux City


From Defense Media Activity - Navy

WASHINGTON (NNS) -- Secretary of the Navy Ray Mabus will host a ship naming ceremony in honor of the littoral combat ship (LCS) USS Sioux City, June 23, at 10 a.m. CDT at Sioux City City Hall in Sioux City, Iowa.

The future USS Sioux City (LCS 11), a Freedom variant of the LCS class, was named to honor the patriotic, hard-working citizens of Sioux City and the state of Iowa for their support of and contributions to the military. Sioux City was termed an All American City by the National Civic League because of the balance it struck between community and industry.

Littoral combat ships are fast, agile, focused-mission platforms designed for successful operations in near-shore and open-ocean environments. They are designed to defeat threats such as mines, quiet diesel submarines and fast surface craft.

Sioux City will be outfitted with reconfigurable payloads, called mission packages, which can be changed out quickly as combat needs demand. These mission packages are supported by special detachments that will deploy manned and unmanned vehicles and sensors in support of mine, undersea and surface warfare missions.

Marinette Marine in Marinette, Wis. will build Sioux City, which will be 378 feet in length, have a waterline beam of 57 feet, displace approximately 3,000 tons, and operate at speeds in excess of 40 knots.

Media may direct queries to the Navy Office of Information at 703-697-5342.

For more information about littoral combat ships, visit http://www.navy.mil/navydata/fact_display.asp?cid=4200&tid=1650&ct=4.

For more news from the Secretary of the Navy, visit http://www.navy.mil/SECNAV.

Secretary of Defense to Host Warrior Games Recognition Ceremony at Pentagon


Secretary of Defense Leon E. Panetta will host a Warrior Games Recognition Ceremony on Monday, June 25 at 1 p.m. EDT in the Pentagon Center Courtyard.  The event is open to the Pentagon community and will be broadcast live on the Pentagon Channel.  The inclement weather location for this ceremony is the Pentagon Library Conference Center, Room B6.

During the ceremony, Panetta will recognize 50 Warrior Games athletes representing more than 200 athletes from the five military services and U.S. Special Operations Command that competed during the 2012 Warrior Games held in Colorado Springs, April 30 - May 5, 2012.  Additional guest speakers include Gen. Raymond T. Odierno, Army chief of staff, and Charlie Huebner, chief of Paralympics for the United States Olympic Committee.

The U.S. Olympic Committee (USOC) with the support of the Defense Department hosts the annual Warrior Games, an Olympic-style competition between wounded, ill and injured military members and veterans.  Athletes compete for medals in seven categories:  swimming, archery, track and field, wheelchair basketball, sitting volleyball, shooting, and cycling.

Media interested in covering the event must call 703-697-5131 to attend.  Journalists without a Pentagon building pass will be picked up at the North Parking Entrance only.  Plan to arrive no later than 45 minutes prior to the event; have proof of affiliation and two forms of photo identification.