A longitudinal study of risk factors for suicide attempts among Operation Enduring Freedom and Operation Iraqi Freedom veterans

Lee, Dong Hoon; Kearns, James; Wisco, Blair E.; Green, Jonathan D.; Gradus, Jaimie L.; Sloan, Denise M.; Nock, Matthew K.; Rosen, Raymond C.; Keane, Terence M.; Marx, Brian P.

doi:10.1002/da.22736

Cited by 46 publications

(51 citation statements)

References 64 publications

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“…This latter finding is consistent with a body of research showing that unit cohesion is a driver of positive psychological outcomes among general military personnel, including general well-being (Oliver et al, 1999), decreased risk for posttraumatic stress symptoms (Brailey, Vasterling, Proctor, Constans, & Friedman, 2007), and decreases in suicidal ideation (Kessler, Berglund, Borges, Nock, & Wang, 2005;Mitchell et al, 2012). Suicidal intent is a necessary component ASD-RELATED TRAITS, COHESION, AND SUICIDALITY IN MILITARY 13 of suicidal behavior (Silverman, Berman, Sanddal, O'Carroll, & Joiner, 2007), and evidence suggests that higher suicidal intent is predictive of future suicide attempts (Lee et al, 2018).…”

Section: Discussionsupporting

confidence: 84%

Examining the interaction of autism spectrum disorder-related traits and unit cohesion on suicide risk among military personnel

Gallyer

Stanley

Day

et al. 2020

Journal of Affective Disorders

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Background: Suicide rates are elevated among United States (U.S.) military service members. Research has found that service members with autism spectrum disorder-related (ASD-related) traits are at increased risk for suicide. Complementary lines of inquiry have suggested that unit cohesion is a protective factor against developing suicidal ideation in military service members. However, given the social difficulties inherent in ASD, it is unclear whether unit cohesion might protect against suicide risk in this population. Method: Our sample consisted of 285 active duty U.S. military service members recruited online. We examined the interaction between ASD-related traits (as measured by the Autism Spectrum Quotient [AQ]), unit cohesion, and suicide risk (as measured by the Suicidal Behaviors Questionnaire-Revised [SBQ-R]). We also conducted exploratory analyses to examine whether unit cohesion attenuates the association between ASD-related traits and suicidal intent. Results: Elevated ASD-related traits were independently associated with higher levels of global suicide risk; however, unit cohesion was not independently associated with suicide risk. Unit cohesion did not significantly interact with ASD-related traits to predict suicide risk. Finally, we found that elevated ASD-related traits and unit cohesion have an independent effect on current suicidal intent. Discussion: Our findings suggest that unit cohesion might not buffer the effect of ASD-related traits on suicide risk. However, our results do show that greater unit cohesion may be independently associated with decreased suicidal intent. This study is limited by a cross-sectional design and use of self-report measures.

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Section: Discussionsupporting

confidence: 84%

Examining the interaction of autism spectrum disorder-related traits and unit cohesion on suicide risk among military personnel

Gallyer

Stanley

Day

et al. 2020

Journal of Affective Disorders

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“…We examined the interactive effects of PTSD symptoms and heavy alcohol use, opioid use, and marijuana use over the past 30 days, prospectively, on PTSD symptoms, suicidal thoughts, and suicidal behaviors over 12 months in a sample of at risk service members or veterans not engaged in behavioral health treatment. We expected to find that PTSD, heavy alcohol use, and opioid use prospectively predict PTSD symptoms as well as suicidal thoughts and behaviors (e.g., Ashrafioun et al, ; Conner et al, ; Lee et al, ). We further hypothesized that PTSD would exacerbate these effects.…”

Section: The Current Studymentioning

confidence: 99%

“…Posttraumatic stress disorder (PTSD) is the most common mental health problem in military personnel and has been identified as a risk factor for suicidal ideation and behavior (Lee et al, ; Sareen et al, ; Seal, Bertenthal, Miner, Sen, & Marmar, ). Recent meta‐analyses found that PTSD was associated with elevated suicidal ideation and attempted suicide across civilian and military samples (Krysinska & Lester, ; Panagioti, Gooding, & Tarrier, ).…”

Section: Introductionmentioning

confidence: 99%

Interactive effects of PTSD and substance use on suicidal ideation and behavior in military personnel: Increased risk from marijuana use

et al. 2019

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Background: The current study examines the unique and interactive effects of posttraumatic stress disorder (PTSD) symptoms and days using alcohol, opioids, and marijuana on PTSD symptoms, suicidal ideation, and suicidal behavior up to 1 year, later in a high-risk sample of military personnel not active in mental health treatment. Methods: Current and former military personnel at risk for suicide (N = 545; M age = 31.91 years, standard deviation = 7.27; 88.2% male) completed self-report measures of PTSD symptoms, past 30 days heavy alcohol use, opioid use, marijuana use, and current suicidal ideation via telephone at baseline and 1, 3, 6, and 12 months later. PTSD symptoms and the substance use variables (and relevant covariates) were entered as predictors of changes in PTSD symptoms, the likelihood of suicidal ideation, suicidal ideation severity, and the likelihood of suicidal behavior during the 11-month follow-up period. Results: PTSD symptoms predicted PTSD symptoms 1 month later. PTSD symptoms and marijuana use predicted the likelihood of suicidal ideation 1 month later and suicidal behavior during the 11-month follow-up period. The interaction between PTSD symptoms and marijuana use significantly predicted increased PTSD symptoms over time and suicidal behavior. At high, but not low levels of PTSD symptoms, more days using marijuana predicted increased PTSD symptoms over time and the likelihood of suicidal behavior. Conclusions: Results suggest marijuana, especially for military personnel experiencing elevated PTSD symptoms may negatively impact suicidal thoughts and behavior. These results are relevant to suggestions that medical marijuana could be used in treating or augmenting treatment for PTSD. K E Y W O R D S alcohol, cannabis, opioids, posttraumatic stress disorder, suicide

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“…2 Among veterans, the risk of suicide is even greater in those who have been diagnosed with posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD). [3][4][5][6][7] Although the relationship between PTSD and/or MDD and suicide risk is well established, [8][9][10][11] less is known about other factors that may influence the development of suicidal ideation (SI) in veterans with these disorders. Identifying modifiable factors that contribute to the development of SI, a significant risk factor for suicide attempts, 3 in veterans with PTSD and/or MDD is thus critical to informing preventative approaches and reducing suicide risk in this vulnerable subset of the veteran population.…”

Section: Introductionmentioning

confidence: 99%

Purpose in Life and Conscientiousness Protect Against the Development of Suicidal Ideation in U.S. Military Veterans With PTSD and MDD: Results From the National Health and Resilience in Veterans Study

et al. 2019

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Background:Although several studies have examined risk factors for suicidal ideation among veterans, little is known about risk and protective factors for suicidal ideation in high-risk veteran samples. Thus, this study examined a broad range of risk and protective factors associated with the development of suicidal ideation in a high-risk sample of U.S. veterans who screened positive for current posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD). Methods: Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative, prospective cohort study of U.S. veterans. Veterans completed self-report measures to screen for PTSD and MDD and to assess for risk and protective factors. The sample included 222 veterans with PTSD and/or MDD who did not endorse suicidal ideation at baseline and completed at least one assessment over a seven-year follow-up period. A multivariable binary logistic regression analysis was conducted to examine baseline factors associated with incident suicidal ideation. Results: Nearly one in three (27.1%) of veterans with PTSD and/or MDD developed suicidal ideation over the seven-year follow-up period. Non-Caucasian race and lower scores on measures of purpose in life, conscientiousness, and frequency of religious service attendance were independently associated with incident suicidal ideation. Lower purpose in life (52.3%) and conscientiousness (33.2%) explained the vast majority of variance in incident suicidal ideation. Conclusion: Nearly 30% of veterans with PTSD and/or MDD who did not endorse suicidal ideation at baseline developed suicidal ideation over a seven-year period. Prevention and treatment efforts designed to bolster purpose in life and conscientiousness may help mitigate risk for suicidal ideation in this high-risk population.

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A longitudinal study of risk factors for suicide attempts among Operation Enduring Freedom and Operation Iraqi Freedom veterans

Cited by 46 publications

References 64 publications

Examining the interaction of autism spectrum disorder-related traits and unit cohesion on suicide risk among military personnel

Examining the interaction of autism spectrum disorder-related traits and unit cohesion on suicide risk among military personnel

Interactive effects of PTSD and substance use on suicidal ideation and behavior in military personnel: Increased risk from marijuana use

Purpose in Life and Conscientiousness Protect Against the Development of Suicidal Ideation in U.S. Military Veterans With PTSD and MDD: Results From the National Health and Resilience in Veterans Study

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