The Mediating Role of Coping Self-Efficacy in Hope Box Use and Suicidal Ideation Severity

Abstract

In this study, we examined the indirect effect of the Virtual Hope Box (VHB) smartphone application on suicidal ideation, mediated through coping self-efficacy. A total of 117 veterans with suicidal ideation completed measures on coping self-efficacy and suicidal ideation at baseline and weeks 3, 6, and 12. Participants were randomly assigned to either the VHB or enhanced treatment as usual (eTAU) condition. Parallel process growth curve modeling (−0.20 [95% CI = −0.44, 0.00]) and auto-regressive modeling (−0.12 [95% CI = −0.35, −0.01]) revealed that a higher rate of change in coping self-efficacy in the VHB group was associated with a decrease in suicidal ideation severity, as compared to the eTAU group. Findings suggest that coping self-efficacy may be one mechanism by which the VHB operates to help reduce suicidal ideation. More broadly, the role of coping self-efficacy in reducing suicidal ideation is worthy of future study.

Keywords:

• coping
• suicidal ideation
• veterans

Acknowledgments

We gratefully acknowledge Aysha Crain, LCSW, Holly Williams, BA, Maura Pisciotta, MS, and April Lee, MPH for their assistance with participant recruitment and data collection.

Additional information

Funding

This material is based upon work supported by the Department of Veterans Affairs, Veterans Health Administration and grant #W81XWH-10-2-0178 from the Military Suicide Research Consortium, with oversight by the Military Operational Medicine Research Program. Dr. Denneson is a core investigator at the VA HSR&D Center to Improve Veteran Involvement in Care. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or United States government.

Notes on contributors

Lauren M. Denneson

Lauren M. Denneson, PhD, Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, and Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA.

Derek J. Smolenski

Derek J. Smolenski, PhD, MPH, Psychological Health Center of Excellence, Defense Health Agency, Tacoma, Washington, USA.

Brian W. Bauer

Brian W. Bauer, MS, Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, Oregon, USA.

Steven K. Dobscha

Steven K. Dobscha, MD, Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, and Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA.

Nigel E. Bush

Nigel E. Bush, PhD, Psychological Health Center of Excellence, Defense Health Agency, Tacoma, Washington, USA.