Is homelessness a traumatic event? Results from the 2019–2020 National Health and Resilience in Veterans Study

Tsai, Jack; Schick, Vanessa; Hernandez, Belinda; Pietrzak, Robert H.

doi:10.1002/da.23098

Cited by 35 publications

(23 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The sampling methodology of the NHRVS has been described previously. 14 The NHRVS sample was drawn from KnowledgePanel (Ipsos Inc), a research panel of more than 50 000 households. Knowl-edgePanel is a probability-based, online, nonvolunteer access survey panel of a population-based sample of US adults that covers approximately 98% of US households.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Trends in Suicidal Behavior Among US Military Veterans During the COVID-19 Pandemic

Nichter

Hill

et al. 2021

JAMA Psychiatry

Self Cite

View full text Add to dashboard Cite

IMPORTANCEThe COVID-19 pandemic has raised considerable concerns about increased risk for suicidal behavior among US military veterans, who already had elevated rates of suicide before the pandemic.OBJECTIVE To examine longitudinal changes in suicidal behavior from before the COVID-19 pandemic to nearly 10 months into the pandemic and identify risk factors and COVID-related variables associated with new-onset suicide ideation (SI). DESIGN, SETTING, AND PARTICIPANTS This population-based prospective cohort study used data from the first and second wave of the National Health and Resilience in Veterans Study, conducted from November 18, 2019, to December 19, 2020. Median dates of data collection for the prepandemic and peripandemic assessments were November 21, 2019, and November 14, 2020, nearly 10 months after the start of the COVID-19 public health emergency in the US. A total of 3078 US military veterans aged 22 to 99 years were included in the study. MAIN OUTCOMES AND MEASURES Past-year SI and suicide attempts. RESULTS In this cohort study of 3078 US veterans (mean [SD] age, 63.2 [14.7] years; 91.6% men; 79.3% non-Hispanic White veterans, 10.3% non-Hispanic Black veterans, and 6.0% Hispanic veterans), 233 (7.8%) reported past-year SI, and 8 (0.3%) reported suicide attempts at the peripandemic assessment. Past-year SI decreased from 10.6% prepandemic (95% CI, 9.6%-11.8%) to 7.8% peripandemic (95% CI, 6.9%-8.8%). A total of 82 veterans (2.6%) developed new-onset SI over the follow-up period. After adjusting for sociodemographic and military characteristics, the strongest risk factors and COVID-19-related variables for new-onset SI were low social support (odds ratio [OR], 2.77; 95% CI, 1.46-5.28), suicide attempt history (OR, 6.31; 95% CI, 2.71-14.67), lifetime posttraumatic stress disorder and/or depression (OR, 2.25; 95% CI, 1.16-4.35), past-year alcohol use disorder severity (OR, 1.06; 95% CI, 1.01-1.12), COVID-19 infection (OR, 2.41; 95% CI, 1.41-5.01), and worsening of social relationships during the pandemic (OR, 1.47; 95% CI, 1.16-1.88). CONCLUSIONS AND RELEVANCEThe results of this cohort study suggest that despite grim forecasts that the COVID-19 pandemic would exacerbate suicidality among US military veterans, the rate of SI decreased at the population level nearly 10 months into the pandemic. Veterans who were infected with COVID-19 were more than twice as likely to report SI, which suggests the need for future research to examine the potential link between COVID-19 infection and suicidal behavior.

show abstract

Section: Methodsmentioning

confidence: 99%

Prevalence and Trends in Suicidal Behavior Among US Military Veterans During the COVID-19 Pandemic

Nichter

Hill

et al. 2021

JAMA Psychiatry

Self Cite

View full text Add to dashboard Cite

show abstract

“…Details of the study have been described previously. 12 Briefly, the NHRVS sample was drawn from KnowledgePanel, a survey research panel of more than 50 000 US households maintained by Ipsos, a survey research firm. To promote generalisability of the results to the US veteran population, poststratification weights based on the demographic distribution of veterans in the contemporaneous US Census Current Population Survey Veterans Supplement were applied in inferential analyses.…”

Section: Methodsmentioning

confidence: 99%

“…Toward this end, we analysed data from the National Health and Resilience in Veterans Study (NHRVS 12 ) to examine (1) the prevalence of psychiatric conditions in US veterans who have and have not been infected with COVID-19, and (2) prepandemic and peripandemic risk and protective factors of peripandemic psychiatric conditions in veterans who survived COVID-19 infection.…”

Section: Introductionmentioning

confidence: 99%

Mental health and suicidal ideation in US military veterans with histories of COVID-19 infection

Tsai

Harpaz‐Rotem

et al. 2021

BMJ Mil Health

View full text Add to dashboard Cite

IntroductionThere have been reports of increased prevalence in psychiatric conditions in non-veteran survivors of COVID-19. To date, however, no known study has examined the prevalence, risk and protective factors of psychiatric conditions among US military veterans who survived COVID-19.MethodsData were analysed from the 2019 to 2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative, prospective cohort of 3078 US veterans. Prepandemic and 1-year peripandemic risk and protective factors associated with positive screens for peripandemic internalising (major depressive, generalised anxiety and/or posttraumatic stress disorders) and externalising psychiatric disorders (alcohol and/or drug use disorders) and suicidal ideation were examined using bivariate and multivariate logistic regression analyses.ResultsA total of 233 veterans (8.6%) reported having been infected with COVID-19. Relative to veterans who were not infected, veterans who were infected were more likely to screen positive for internalising disorders (20.5% vs 13.9%, p=0.005), externalising disorders (23.2% vs 14.8%, p=0.001) and current suicidal ideation (12.0% vs 7.6%, p=0.015) at peripandemic. Multivariable analyses revealed that greater prepandemic psychiatric symptom severity and COVID-related stressors were the strongest independent predictors of peripandemic internalising disorders, while prepandemic trauma burden was protective. Prepandemic suicidal ideation, greater loneliness and lower household income were the strongest independent predictors of peripandemic suicidal ideation, whereas prepandemic community integration was protective.ConclusionPsychiatric symptoms and suicidal ideation are prevalent in veterans who have survived COVID-19. Veterans with greater prepandemic psychiatric and substance use problems, COVID-related stressors and fewer psychosocial resources may be at increased risk of these outcomes.

show abstract

“…The sampling methodology of the NHRVS has been described previously (Tsai et al, 2020). Veterans completed a 50‐min anonymous, web‐based survey.…”

Section: Methodsmentioning

confidence: 99%

Moral injury and suicidal behavior among US combat veterans: Results from the 2019–2020 National Health and Resilience in Veterans Study

Nichter

Norman

Maguen

et al. 2021

Depression and Anxiety

Self Cite

View full text Add to dashboard Cite

Background: Recent research suggests that exposure to potentially morally injurious experiences (PMIEs) may be associated with increased risk for suicidal behavior among US combat veterans, but population-based data on these associations are scarce. This study examined the association between PMIEs with current suicidal ideation (SI), lifetime suicide plans (SP), and suicide attempts (SA) in a contemporary, nationally representative sample of combat veterans. Methods: Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of US combat veterans (n = 1321). PMIEs were assessed using the Moral Injury Events Scale (MIES). Multivariable logistic regression analyses were conducted to examine associations between MIES total scores and specific types of PMIEs with suicidal behavior.Results: Thirty-six point three percent of veterans reported at least one PMIE.Perceived transgressions by self, others, and betrayal were associated with SI, SP, and SA (odds ratios [ORs] = 1.21-1.27, all p s < .05), after adjusting for sociodemographic, trauma, and psychiatric characteristics. MIES total scores were significantly, albeit weakly, associated with SP (OR = 1.03, p < .01), but not SI/SA. Depression, posttraumatic stress disorder (PTSD), and age emerged as the strongest correlates of SI/SP/SA (14.9%-38.1% of explained variance), while PMIEs accounted for a comparatively modest amount of variance (3.3%-8.9%).Conclusions: Reports of potentially morally injurious experiences are prevalent among US combat veterans, and associated with increased risk for suicidal behavior, above and beyond severity of combat exposure, PTSD, and depression. Implications for clinical practice and future research are discussed, including the need for methodological advancements in the measurement of moral injury.

show abstract

Is homelessness a traumatic event? Results from the 2019–2020 National Health and Resilience in Veterans Study

Cited by 35 publications

References 37 publications

Prevalence and Trends in Suicidal Behavior Among US Military Veterans During the COVID-19 Pandemic

Prevalence and Trends in Suicidal Behavior Among US Military Veterans During the COVID-19 Pandemic

Mental health and suicidal ideation in US military veterans with histories of COVID-19 infection

Moral injury and suicidal behavior among US combat veterans: Results from the 2019–2020 National Health and Resilience in Veterans Study

Contact Info

Product

Resources

About