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Participation Bias among Suicidal Adults in a Randomized Controlled Trial

Authors

  • Shannon Wiltsey Stirman PhD,

    1. Shannon Wiltsey Stirman, Women’s Health Sciences Division, National Center for PTSD, Boston University, Boston, MA, USA. Gregory K. Brown, Allison J. Fox, Mariam Zahid Chohan, and Aaron T. Beck, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Marjan Ghahramanlou-Holloway, Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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  • Gregory K. Brown PhD,

    1. Shannon Wiltsey Stirman, Women’s Health Sciences Division, National Center for PTSD, Boston University, Boston, MA, USA. Gregory K. Brown, Allison J. Fox, Mariam Zahid Chohan, and Aaron T. Beck, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Marjan Ghahramanlou-Holloway, Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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  • Marjan Ghahramanlou-Holloway PhD,

    1. Shannon Wiltsey Stirman, Women’s Health Sciences Division, National Center for PTSD, Boston University, Boston, MA, USA. Gregory K. Brown, Allison J. Fox, Mariam Zahid Chohan, and Aaron T. Beck, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Marjan Ghahramanlou-Holloway, Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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  • Allison J. Fox MFT,

    1. Shannon Wiltsey Stirman, Women’s Health Sciences Division, National Center for PTSD, Boston University, Boston, MA, USA. Gregory K. Brown, Allison J. Fox, Mariam Zahid Chohan, and Aaron T. Beck, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Marjan Ghahramanlou-Holloway, Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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  • Mariam Zahid Chohan BS,

    1. Shannon Wiltsey Stirman, Women’s Health Sciences Division, National Center for PTSD, Boston University, Boston, MA, USA. Gregory K. Brown, Allison J. Fox, Mariam Zahid Chohan, and Aaron T. Beck, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Marjan Ghahramanlou-Holloway, Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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  • Aaron T. Beck MD

    1. Shannon Wiltsey Stirman, Women’s Health Sciences Division, National Center for PTSD, Boston University, Boston, MA, USA. Gregory K. Brown, Allison J. Fox, Mariam Zahid Chohan, and Aaron T. Beck, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Marjan Ghahramanlou-Holloway, Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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  • This research was conducted at the Psychopathology Research Unit in the Department of Psychiatry, University of Pennsylvania. This research was supported by grants from the National Institute of Mental Health (R01 MH60915, K99 MH080100, and P20 MH71905) and the Centers for Disease Control and Prevention (R37 CCR316866).

Address correspondence to Shannon Wiltsey Stirman, PhD, Women’s Health Sciences Division, National Center for PTSD, Boston University, 150 S. Huntington Ave. (116B-3), Boston, MA 02130; E-mail: shannon.wiltsey-stirman@va.gov

Abstract

Although individuals who attempt suicide have poor compliance rates with treatment recommendations, the nature and degree of participation bias in clinical treatment research among these individuals is virtually unknown. The purpose of this study was to examine participation bias by comparing the demographic and diagnostic characteristics of adult suicide attempters who participated in a randomized controlled trial to a sample of nonparticipants. Results indicated that males and individuals with a diagnosis of substance abuse or dependence were more likely to be participants in the randomized controlled trial. The implications of these findings for suicide intervention research are discussed.

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