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The ITS posits that SI stems from feeling like a burden (i.e., perceived burdensomeness) and a lack of belonging (i.e., thwarted belongingness). Previous research suggests that change in PTSD severity has a significant indirect effect on change in SI through changes in perceived burdensomeness, but not thwarted belongingness, among patients receiving residential PTSD treatment in a Veterans Affairs (VA) medical center; however, no research has investigated these associations in an outpatient VA setting with fewer confounding factors that might affect ITS constructs. Therefore, the current sample included veterans (<jats:italic>N<\/jats:italic> = 126) who completed PTSD treatment and pre\u2010 and posttreatment assessments in a VA outpatient clinic. Results from parallel models of multiple indirect effects suggest that change in PTSD severity was indirectly associated with change in SI through changes in perceived burdensomeness, <jats:italic>B =<\/jats:italic> 0.35, <jats:italic>p<\/jats:italic> &lt; .001; \u03b2 = .36, <jats:italic>p<\/jats:italic> &lt; .001, <jats:italic>SE<\/jats:italic> = .10, 95% CI [.15, .54], but not thwarted belongingness, <jats:italic>B<\/jats:italic> = 0.14, <jats:italic>p<\/jats:italic> = .146; \u03b2 = .14, <jats:italic>p<\/jats:italic> = .161, <jats:italic>SE<\/jats:italic> = .10, 95% CI [\u2212.05, .33]. Additional models were examined using PTSD cluster scores for exploratory purposes. The results indicate that PTSD treatment reduces the perceived and objective burden of PTSD to decrease SI. Study findings support the importance of access to evidence\u2010based care to treat PTSD and alleviate burdensomeness for suicide prevention.<\/jats:p>","DOI":"10.1002\/jts.23004","type":"journal-article","created":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T22:53:14Z","timestamp":1701989594000},"page":"1138-1150","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evidence\u2010based treatment for posttraumatic stress disorder decreases suicidal ideation by reducing perceived burdensomeness among veterans in an outpatient program"],"prefix":"10.1002","volume":"36","author":[{"given":"Rachel C.","family":"Blain","sequence":"first","affiliation":[{"name":"Cincinnati VA Medical Center Trauma Recovery Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2400-6039","authenticated-orcid":false,"given":"Colleen E.","family":"Martin","sequence":"additional","affiliation":[{"name":"Cincinnati VA Medical Center Trauma Recovery Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina C.","family":"Ehlinger","sequence":"additional","affiliation":[{"name":"Cincinnati VA Medical Center Trauma Recovery Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen M.","family":"Chard","sequence":"additional","affiliation":[{"name":"Cincinnati VA Medical Center Trauma Recovery Center  Cincinnati Ohio USA"},{"name":"Department of Psychiatry and Behavioral Neuroscience University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0128599"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.02.084"},{"key":"e_1_2_9_4_1","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12425"},{"key":"e_1_2_9_6_1","volume-title":"Manual for the Beck Scale for Suicide Ideation","author":"Beck A. 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