More frequent negative social exchanges are associated with higher suicide ideation and risk in men service members/veterans

Abstract

Introduction Suicide is a leading cause of death in military service members/veterans (SM/Vs). Positive social exchanges (e.g., emotional support) buffer against suicide risk but the influence of negative social exchanges (e.g., unwanted advice) is understudied. Method The current study explored (1) the contributions of positive and negative social exchanges as simultaneous correlates of suicide ideation and risk, (2) whether positive social exchanges mitigated the association of negative social exchanges and suicide ideation and risk, and (3) if facets of social exchanges were uniquely related to suicide ideation and risk. SM/Vs men (N = 508) completed self‐report questionnaires. Results Roughly 27% endorsed suicide ideation. Between 23.62 and 41.14% reported elevated suicide risk. Adjusted analyses revealed higher negative social exchanges, particularly insensitive behaviors, and lower positive social exchanges were associated with higher suicide ideation and risk. The magnitude of positive and negative social exchanges with suicide ideation or risk was statistically similar. Higher positive social exchanges did not attenuate the association of negative social exchanges and suicide ideation or risk (p > 0.05). Conclusion Higher negative social exchanges are equally strong correlates of suicide ideation and risk as positive social exchanges. Decreasing insensitive behaviors may reduce suicide ideation and risk in men SM/Vs.

Moral Injury and Suicide Ideation Among Combat Veterans

“…In this study, we used a continuous measure of current SI levels, derived from Item 2, which taps the frequency of current suicidal ideation (“How often have you thought about killing yourself in the past year?”) on a variable 5-point Likert-type scale, ranging from 1 ( never ) to 5 ( very often ; 5 times or more). Other studies have employed a single item to assess suicidality, such as Item 2 of the SBQ-R, to assess SI (Blais et al, 2021; Levi-Belz & Zerach, 2018; Schwartz et al., 2021). Moreover, substantial evidence supports the predictive ability of a single item and its relevance for assessing suicidality (Green et al, 2015).…”

“…on a variable 5point Likert-type scale, ranging from 1 (never) to 5 (very often; 5 times or more). Other studies have employed a single item to assess suicidality, such as Item 2 of the SBQ-R, to assess SI (Blais et al, 2021;Schwartz et al, 2021). Moreover, substantial evidence supports the predictive ability of a single item and its relevance for assessing suicidality (Green et al, 2015).…”

Examining the relationship between negative social exchange and suicidal ideation: the role of thwarted interpersonal needs

“…Interactions characterized by NSE are associated with a range of negative physical health symptoms and mental health outcomes, including depression and loneliness (Tsai et al , 2019), PTSD symptom severity (Blais and Zalta, 2023), drug cravings among recovering opioid users (Knapp et al , 2021) and NSE may even impact the rate of symptoms change in cognitive behavioral therapy for depression (Eidelman et al , 2018). Unfortunately, there is a paucity of research examining the role of NSE as a contributor to suicidal thoughts and behaviors (Blais et al , 2021).…”

“…In the limited literature investigating this relationship, NSE have been positively correlated with suicidal thoughts and behaviors in college students, veterans and adults (Blais et al , 2021; Hirsch and Barton, 2011; Lincoln et al , 2012). One study demonstrated that NSE were positively associated with suicidal thoughts and behaviors in college students such that those who reported a greater experience with NSE reported higher levels of SI and suicidal behaviors.…”

“…Finally, one study demonstrated that US service members and veterans who reported frequent NSE and less frequent positive social exchanges reported higher levels of SI and suicide risk (Blais et al , 2021). However, more frequent positive social exchanges did not impact the deleterious effects of NSE (Blais et al , 2021).…”