Factors protecting against the development of suicidal ideation in military veterans

Pietrzak, Robert H.; Pitts, Barbara L.; Harpaz‐Rotem, Ilan; Southwick, Steven M.; Whealin, Julia M.

doi:10.1002/wps.20467

Cited by 22 publications

(33 citation statements)

References 9 publications

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“…Nevertheless, empirical evidence for successful ER skill building does exist among military and veteran populations (Cox et al, ; Haase et al, ; Jha et al, ; Johnson et al, ); thus, it may present an innovative suicide prevention approach—since emotion dysregulation is a factor present in all suicides that could be targeted far in advance of deployment or other life adversities. As Pietrzak, Pitts, Harpaz‐Rotem, Southwick, and Whealin () note, “surprisingly scarce research has sought to identify modifiable protective factors” (p. 326) against military suicide risk, despite emerging theoretical frameworks. One exception is Elbogen et al ()’s study of post‐9/11‐era veterans, which found that secure relationships, life meaning, and perceptions of control were associated with decreased suicidal ideation risk.…”

Section: Resultsmentioning

confidence: 99%

Emotion Dysregulation and Military Suicidality Since 2001: A Review of the Literature

Stanley

Larsen

2018

Political Psychology

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Policy makers and researchers have worked to explain the perplexing rise in U.S. military suicides since 2001, with little progress in explaining this widespread phenomenon. This article synthesizes several literatures to highlight the role of emotion dysregulation in military suicidality. After considering advances in suicidal ideation‐to‐action frameworks and the factors that contribute to the prevalence of emotion dysregulation in the modern U.S. military, it explores how military service provides for two distinct circumstances in which such emotion dysregulation may facilitate the transition from suicidal ideation to behavior. The first circumstance is high distress tolerance, wherein the effects of disproportionately high rates of adverse childhood experiences (ACEs) among service‐members may increase vulnerability to suicidal behavior. The second circumstance is preexisting acquired capability with lethal means paired with executive functioning degradation. Empirically associated with military environments, such degradation may undermine the effectiveness of top‐down emotion regulation strategies—thereby allowing acquired familiarity with lethal means to assist the transition from suicidal ideation to action. Thus, emotion dysregulation’s unique relationship with the U.S. military may help to explain the powerful correlation between service and suicide since 2001—suggesting that enhancing emotion regulation skills may present a key leverage point for effectively addressing the issue.

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Section: Resultsmentioning

confidence: 99%

Emotion Dysregulation and Military Suicidality Since 2001: A Review of the Literature

Stanley

Larsen

2018

Political Psychology

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“…It may be that different forms of social support vary in their predictive ability. Indeed, while social support has been negatively related to SI in prior general population-based studies of veterans using the National Health and Resilience in Veterans Study (NHRVS), 14,17 other findings suggest that certain aspects of social support are not associated with SI. For instance, in an Air Force sample, different functions of social support (i.e., tangible, esteem, belonging, and appraisal) did not distinguish service members with and without SI, although SI was associated with lower tangible support in those with high emotional distress.…”

Section: Discussionmentioning

confidence: 99%

“…structural social support, perceived social support), and psychosocial protective characteristics (e.g., perceived resilience, purpose in life) were negatively related to the development of SI. 14,17 Specifically, among veterans surveyed who did not endorse SI at Wave 1, greater social support, curiosity, perceived resilience, and acceptancebased coping were associated with reduced risk of incident SI over a four-year follow up period. 17 Together, these factors accounted for over 40% of the variance in predicting risk of incident SI.…”

Section: Introductionmentioning

confidence: 99%

“…14,17 Specifically, among veterans surveyed who did not endorse SI at Wave 1, greater social support, curiosity, perceived resilience, and acceptancebased coping were associated with reduced risk of incident SI over a four-year follow up period. 17 Together, these factors accounted for over 40% of the variance in predicting risk of incident SI. Another NHRVS study revealed that among veterans with PTSD and/or MDD, greater purpose in life, curiosity, and optimism were inversely associated with SI.…”

Section: Introductionmentioning

confidence: 99%

“…13,15 Although relatively few studies have examined protective factors for SI, recent findings suggest that there are modifiable factors that may help buffer SI risk. 7,14,[17][18][19] Research from the National Health and Resilience in Veterans Study (NHRVS), a prospective cohort study of a nationally representative sample of U.S. veterans, has revealed that greater social connectedness (i.e. structural social support, perceived social support), and psychosocial protective characteristics (e.g., perceived resilience, purpose in life) were negatively related to the development of SI.…”

Section: Introductionmentioning

confidence: 99%

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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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Does coping reduce suicidal urges in everyday life? Evidence from a daily diary study of adolescent inpatients

Al‐Dajani

Horwitz

Czyz

2022

Depression and Anxiety

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Background: Youth suicide has been increasing at an alarming rate. Identifying how youth at risk for suicide cope with daily distress and suicidal thoughts could inform prevention and intervention efforts. We investigated the relationship between previous-day coping and next-day suicidal urge intensity in a high-risk adolescent sample for a 4-week period. We also investigated the influence of adolescents' average coping levels, over 4 weeks, on daily severity of suicidal urges.Methods: A total of 78 adolescents completed daily diaries after psychiatric hospitalization (n = 1621 observations). Each day, adolescents reported their use of specific coping strategies, overall coping helpfulness, and intensity of suicidal urges.Results: Greater professional support seeking from providers/crisis lines and perceptions of coping helpfulness on the previous day were associated with lower next-day suicidal urges. Adolescents who reported greater average use of cognitive strategies, personal support seeking from family/friends, and higher average perceptions of coping helpfulness, relative to others, had lower daily suicidal urges.Noncognitive strategy use was not related to daily suicidal urge intensity. Conclusion:Findings point to the benefit of intervention efforts focusing on strengthening personal and professional supportive relationships, assisting youth with developing a broader coping repertoire, and working with adolescents to identify strategies they perceive to be helpful.

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Factors protecting against the development of suicidal ideation in military veterans

Cited by 22 publications

References 9 publications

Emotion Dysregulation and Military Suicidality Since 2001: A Review of the Literature

Emotion Dysregulation and Military Suicidality Since 2001: A Review of the Literature

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

Does coping reduce suicidal urges in everyday life? Evidence from a daily diary study of adolescent inpatients

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