Differentiating U.S. military veterans who think about suicide from those who attempt suicide: A population-based study

Nichter, Brandon; Monteith, Lindsey L.; Norman, Sonya B.; Maguen, Shira; Hill, Melanie L.; Herzog, Sarah; Pietrzak, Robert H.

doi:10.1016/j.genhosppsych.2021.08.007

Cited by 10 publications

(5 citation statements)

References 52 publications

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“…Almost half (46%) of our sample screened positive for current suicidal ideation; however, the severity of suicidal ideation did not differ depending on trauma type. These results are consistent with past work demonstrating high prevalence rates of suicidal ideation and attempts in Veterans (Kachadourian et al, 2022; Lemle, 2020; Nichter et al, 2021). Thus, although interpersonal trauma may increase severity of PTSD and depression symptoms which is related to suicidal ideation (Arenson et al, 2018; Forehand et al, 2019; Herzog et al, 2022), suicide screening should occur in all FVets who have experienced trauma in general.…”

Section: Discussionsupporting

confidence: 92%

Characterizing the Influence of Exposure to Military Sexual Trauma and Intimate Partner Violence on Mental Health Outcomes among Female Veterans

Esopenko

Souza

Wilde

et al. 2023

J Interpers Violence

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Military sexual trauma (MST) has deleterious long-term psychological consequences. Among female U.S. military members, MST is associated with increased risk for future interpersonal victimization, such as experiencing intimate partner violence (IPV). Few studies have investigated the implications of the cumulative effects of IPV and MST on psychological functioning. This study examined rates of co-exposure to MST, IPV, and their cumulative impact on psychological symptoms. Data were collected from 308 female Veterans (FVets; age: M = 42, SD = 10.4) enrolled in an inpatient trauma-focused treatment program in a Veterans Administration (VA) hospital. Data were collected at program admission on symptoms of posttraumatic stress disorder (PTSD), depression, and current suicidal ideation. Lifetime trauma exposure was assessed using semi-structured interviews that identified adverse childhood events (ACEs) and combat theater deployment as well as MST and IPV. Group differences on psychological symptoms were examined among those exposed to MST, IPV, MST + IPV, and compared to FVets with ACEs or combat exposure, but no other adulthood interpersonal trauma (NAIT). Half of the sample (51%) reported experiencing both MST and IPV, approximately 29% reported MST, 10% reported IPV, and 10% reported NAIT. FVets in the MST + IPV group had worse PTSD and depression symptoms than either the MST or IPV groups. The NAIT group had the lowest scores on these measures. There were no group differences in current suicidal ideation; however, 53.5% reported at least one previous suicide attempt. FVets in this sample reported significant lifetime exposure to MST and IPV, with the majority having experienced MST + IPV. Exposure to MST + IPV was associated with greater PTSD and depression symptom severity, yet an overwhelming proportion reported current and past suicidal ideation regardless of trauma exposure history. These results demonstrate the importance of assessing for lifetime interpersonal trauma history when developing and providing mental and medical health interventions for FVets.

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Section: Discussionsupporting

confidence: 92%

Characterizing the Influence of Exposure to Military Sexual Trauma and Intimate Partner Violence on Mental Health Outcomes among Female Veterans

Esopenko

Souza

Wilde

et al. 2023

J Interpers Violence

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“…from SI to suicidal behavior). Prior work has found that most individuals who report a lifetime history of SI do not report a history of suicidal intent or suicide attempts (Bryan et al, 2015;Nichter, Monteith, et al, 2021). Moreover, previous research has demonstrated that risk factors for different forms of suicidal behavior (e.g.…”

Section: Discussionmentioning

confidence: 99%

Subjective cognitive difficulties and posttraumatic stress disorder interact to increase suicide risk among middle-aged and older US military veterans

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Cook

Nichter

et al. 2023

Int. Psychogeriatr.

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Objectives To examine the role of subjective cognitive difficulties (SCD), posttraumatic stress disorder (PTSD), and their interaction in predicting suicidal ideation and current suicidal intent in middle-aged and older United States (US) military veterans. Design Population-based cross-sectional study. Setting and participants Data were analyzed from the 2019 to 2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 3602 US veterans aged 50 years and older (mean age = 69.0). Measurements Questionnaires including the Medical Outcomes Study Cognitive Functioning Scale (SCD), PTSD Checklist for DSM-5 (PTSD), Patient Health Questionnaire-9 (suicidal ideation in the previous two weeks), and the Suicide Behaviors Questionnaire-Revised (current suicidal intent). Results A total of 154 (4.4%) veterans screened positive for current PTSD, 239 (6.7%) reported past two-week suicidal ideation, and 37 (1.0%) reported current suicidal intent. The probability of suicidal ideation among veterans with both SCD and PTSD was more than six times higher than that observed in the full sample (44.5% vs. 6.7%) and more than 2.5 times higher than that observed in veterans with SCD and no PTSD (44.5% vs. 17.5%). Veterans with both subjective memory and concentration difficulties were more likely to report suicidal intent, though the interaction between SCD and PTSD was not significantly associated with suicidal intent. Conclusion Middle-aged and older U.S. veterans with subjective cognitive impairment and PTSD report higher rates of suicidal ideation than those with SCD alone. Interventions targeting SCD and PTSD may mitigate suicide risk among middle-aged and older veterans.

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“…Findings also add to a growing body of evidence highlighting the importance of examining the effects of multiple co‐occurring risk factors on suicide risk to improve predictive models of suicide (Franklin et al, 2017; Lee et al, 2018). As risk factors for suicidal behavior tend to co‐occur rather than manifest independently (Nichter, Monteith, et al, 2021; Ramsawh et al, 2014), additional research is needed to characterize the cumulative risk conferred by multiple coinciding vulnerability factors.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for suicide attempts among U.S. military veterans: A 7‐year population‐based, longitudinal cohort study

Nichter

Stein

Monteith

et al. 2021

Suicide & Life Threat Behav

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Background: Population-based data on risk factors for suicide attempts among veterans remains limited. Methods:A national probability sample of 2307 veterans was followed over the course of four timepoints spanning seven years to examine how a range of baseline risk factors predict incident suicide attempt. Suicide attempt data were aggregated into a single follow-up timepoint.Results: Sixty-two veterans (3.1%) reported attempting suicide during the 7-year period. The strongest risk factors for suicide attempts were higher baseline levels of loneliness, lower baseline levels of adaptive psychosocial traits (e.g., dispositional gratitude), baseline thoughts of self-harm, and greater post-baseline trauma exposures (12.3%-41.3% of explained variance). Veterans with multiple co-occurring risk factors were at greatest risk for attempts; of veterans with 0, 1, 2, 3, and all 4 of these factors, the predicted probability of suicide attempt was 2.0%, 5.3%, 13.5%, 30.4%, and 55.0%, respectively. Conclusions:Baseline loneliness, dispositional gratitude, thoughts of self-harm, and new-onset traumas emerged as the strongest risk factors for suicide attempts among veterans, underscoring the potential importance of targeting these factors in prevention efforts. Veterans with multiple co-occurring risk factors have

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Differentiating U.S. military veterans who think about suicide from those who attempt suicide: A population-based study

Cited by 10 publications

References 52 publications

Characterizing the Influence of Exposure to Military Sexual Trauma and Intimate Partner Violence on Mental Health Outcomes among Female Veterans

Characterizing the Influence of Exposure to Military Sexual Trauma and Intimate Partner Violence on Mental Health Outcomes among Female Veterans

Subjective cognitive difficulties and posttraumatic stress disorder interact to increase suicide risk among middle-aged and older US military veterans

Risk factors for suicide attempts among U.S. military veterans: A 7‐year population‐based, longitudinal cohort study

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